DEC 2013

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

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Page 45 of 74

February 2014 December 2013 What's ahead in2011 involved in early stage development or helping with the initial trials or roll out of devices," he said. Femtosecond lasers for cataract surgery, the next generation of refractive surgery lasers, advanced IOLs, and MIGS technology are among the areas that many are getting involved with. Profiles In today's group of forward-thinking young ophthalmologists, John Berdahl, MD, Vance Thompson Vision, Sioux Falls, S.D., and Elizabeth Yeu, MD, Virginia Eye Consultants, Norfolk, Va., stand out. Dr. Waring noted that Dr. Berdahl and Dr. Yeu were founding members of the Vanguard Ophthalmology Society. "They distinguished themselves very early on in our subspecialty as future key opinion leaders, but as current key opinion leaders as well," he said. Elizabeth Yeu, MD Personal work and interests Dr. Yeu is involved with several new technologies and has been involved both on the academic and private practice sides. Many of the younger thought leaders in the field are similarly minded in their thinking, Dr. Yeu said. The society offers a place to talk about aspects of the business side, practice side, and research side of ophthalmology. "The collaborations have been phenomenal in that way," she said. "I never knew the traction of being part of a group where each member has that same focus of being able to say they love and are passionate about what they do," Dr. Yeu said. "To be able to be a part of and listen to others who are innovative, technically and technologically, has been incredible." Dr. Yeu said she has a number of personal interests in her research and practice. "The one that I've really been working on has been astigmatism management, which has come into the limelight more so than ever before," she said. Although it is known that relaxing incisions are helpful, there have been some inconsistencies with depth and length. "Toric technology highlighted the importance of identifying the proper meridian of alignment and the proper power of toricity correction." Dr. Yeu also said that femto phaco has helped to create a whole other level of accuracy in astigmatism management. "Another passion of mine is understanding the refractive effects of corneal disease and surgeries," Dr. Yeu said. This includes intraocular lens calculations and tightening those up for post-refractive surgery. EW FEATURE 43 Additionally, she noted that microinvasive glaucoma surgery has been a big advancement. She has adopted the iStent (Glaukos, Laguna Hills, Calif.) to help reduce the toxicities of topical agents on the cornea. There are a number of devices and procedures under investigation and she is keeping her mind open as these options come to light. Dr. Yeu has been studying how interventional therapies for dry eye can fit into the entire picture. "We know now that dry eye disease really should be considered more globally as ocular surface disease," she said. New diagnostic tests and therapeutic interventions are constantly being introduced in this space, and it is necessary to determine the inconsistencies with these tests and see where they all fit together to best help these patients. continued on page 44 Posterior continued from page 40 Their study has added to this finding by "demonstrating that this relationship is dynamic and also varies with the magnitude of astigmatism and is different among regular and ectatic corneas." Future possibilities Improvements in toric calculators could be an important future innovation in the topic. Dr. Hamilton said IOL power calculators would most likely measure total corneal power, taking the front and back surfaces into account. In the future, techniques for measuring corneal astigmatism will also likely improve, Dr. Koch said, with more accurate and reproducible devices that will measure cases on an individual basis. "I am confident that we will have the ability, on a patient-bypatient basis, to precisely measure corneal refracting power and its astigmatism, front and back, and that this will be a major step forward for us in all of our IOL calculations, not just our selection of astigmatic correction techniques," Dr. Koch said. EW References 1. Koch DD, Ali SF, Weikert MP, Shirayama M, Jenkins R, Wang L. Contribution of posterior corneal astigmatism to total corneal astigmatism. J Cataract Refract Surg. 2012;38(12): 2080-2087. 2. Sy ME, Ramirez-Miranda A, Zarei-Ghanavati S, Engle J, Danesh J, Hamilton DR. Comparison of posterior corneal imaging before and after LASIK using dual rotating Scheimpflug and scanning slit-beam corneal tomography systems. J Refract Surg. 2013;29(2):96-101. 3. Koch DD, Jenkins R, Weikert MP, Yeu E, Wang L. Correcting astigmatism with toric intraocular lenses: the effect of posterior corneal astigmatism. J Refract Surg; 2013. Editors' note: Dr. Koch has financial interests with Alcon (Fort Worth, Texas), AMO (Santa Ana, Calif.), i-Optics (the Netherlands), and Ziemer. Drs. Basti, Grewal, and Hamilton have no financial interests related to this article. Contact information Grewal: Dilraj@gmail.com Basti: sbasti@northwestern.edu Hamilton: Hamilton@jsei.ucla.edu Koch: dkoch@bcm.edu Poll size: 222 EyeWorld Monthly Pulse EyeWorld Monthly Pulse is a reader survey on trends and patterns for the practicing ophthalmologist. Each month we send a four-question online survey covering different topics so our readers can see how they compare to our survey. If you would like to join the hundreds of physicians who take a minute a month to share their views, please send us an email and we will add your name. Email daniela@eyeworld.org and put EW Pulse in the subject line—that's all it takes. Copyright EyeWorld 2013

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