Eyeworld

R EFRACTIVE by Karolinne Rocha, MD, PhD Refractive Editor 46 | EYEWORLD | WINTER 2024 H ow fitting that as we come to the end of the year, we're both taking stock and reaching forward to improve visual outcomes for our pa- tients. In this issue, we look back on tried methodologies that are experienc- ing rapid growth and innovation, diving into the areas of corneal crosslinking, refractive lens exchange, and—you may have guessed it—arti- ficial intelligence (AI). First, Brandon Ayres, MD, Kenneth Beckman, MD, Michael Belin, MD, Roy Rubinfeld, MD, and William Trattler, MD, take on the topic of "Crosslinking: then, now and next up." The physicians do a great job of cov- ering where we've been with the epi-off tech- nique and where we are going, awaiting U.S. Food and Drug Administration approval for the epi-on technique. Personally, I'm anticipating a broader patient base who can benefit from epi- on crosslinking in the future, particularly those who have thinner corneas and thus don't qualify for epi-off currently. Marjan Farid, MD, D. Rex Hamilton, MD, and Luke Rebenitsch, MD, discuss the growth of lens surgery in "A shift toward RLE." In this article, Dr. Hamilton points to the decision mak- ing that goes into employing this solution for patients, including considering age, refractive error, and age-related changes of the crystalline lens. I appreciate his concept of approaching refractive surgery for the patient's lifetime. We as clinicians are able to diagnose dysfunctional lens syndrome (DLS) earlier, as indicated by loss of accommodation, changes in contrast, light scatter, and higher-order aber- rations. Especially with regard to DLS stage II and III, the clinical advancements in diagnostics make presbyopia-correcting IOL options a more suitable option for the patient. The final refractive article for this issue is with Renato Ambrósio Jr., MD, PhD, Ella Faktorovich, MD, Nambi Nallasamy, MD, and Travis Redd, MD, in which they discuss "AI expanding in refractive surgery." The ability of AI to help eyecare practitioners in the diagnosis and management of disease states can be sig- nificant. I imagine a future where the surgical decision-making process could benefit from precise data analysis and allow the doctor to help the patient make informed decisions about their care. Dr. Ambrósio said it quite succinctly, "AI's ability to analyze complex datasets and identify subtle patterns by considering multiple features instantaneously makes it a valuable tool for improving accuracy and inclusivity in refractive procedures." As this is the final issue for the 2024 cal- endar year, I want to wish you all happy, slow holidays spent with family recharging for the new year! Looking forward to improved visual outcomes In this issue, we look back on tried methodologies that are experiencing rapid growth and innovation, diving into the areas of corneal crosslinking, refractive lens exchange, and—you may have guessed it—artificial intelligence (AI).

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