DEC 2013

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

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60 EW MEETING REPORTER Reporting live from the 2013 American Academy of Ophthalmology Annual Meeting in New Orleans December 2013 "A patient who is not a candidate for a successful corneal transplant is a patient who is good for a keratoprosthesis," he said. Preoperative evaluation is key in these cases, Dr. Perez said. He presented a video of a modified osteo-odonto-keratoprosthesis (MOOKP) case, where a canine tooth was implanted into the eye. Other physicians who presented at the symposium were Francis W. Price Jr., MD, Indianapolis, who discussed what the future holds for endothelial keratoplasty; Rajesh Fogla, MD, Hyderabad, India, who presented advances in deep anterior lamellar keratoplasty with a bubble; Marjan Farid, MD, Irvine, Calif., who talked about femtosecond-assisted keratoplasty; Clara C. Chan, MD, Cincinnati, who offered tips for success with therapeutic keratoplasty; Deepinder K. Dhaliwal, MD, Pittsburgh, who discussed management of a failed graft; and Gerald W. Zaidman, MD, Valhalla, N.Y., who gave an update on pediatric keratoplasty. Editors' note: The physicians have no financial interests related to their presentations. Femtosecond laser technology In the "Advanced Application of Femtosecond Lasers for Refractive Surgery" session, a number of surgeons discussed the development and advancement of the femtosecond technology and the ways in which it has changed corneal and refractive surgery. Perry Binder, MD, San Diego, presented a short overview of femtosecond laser technology and said the diagnosis of its capabilities began on accident. Now, he said, there are numerous platforms that have evolved. He cited several goals moving forward with femtosecond laser technology, including increasing procedure speed, reducing the laser energy to eliminate potential side effects, creating additional applications and trying to find one laser that will be able to do it all. Steven Schallhorn, MD, San Diego, discussed using the femtosecond laser for LASIK procedures. "I believe the femtosecond laser, particularly for a LASIK flap, is more con- Scan QR code to go to EWrePlay.org John Kanellopoulos, MD, Athens, Greece, and New York, (right) describes topographic changes to the corneal epithelium in pathology and in response to keratorefractive surgery. guna Hills, Calif.). The real breaking sistent," Dr. Schallhorn said. He also news on this topic, Dr. Samuelson said that it allows for more control, said, is how the device is evolving in a greater safety profile, improved how it is being used. The fact that visual outcomes and faster visual rephacoemulsification lowers intraoccovery. Technology will drive more ular pressure has changed glaucoma innovation and improved results, he management, Dr. Samuelson said. said. And new uses for this technolDeciding when in the spectrum of ogy are beginning to be seen. The glaucoma to use the iStent is imporfemtosecond laser is clearly repretant, he said. When you look at the senting a paradigm shift in corneal severity spectrum of glaucoma, there surgery and now in cataract surgery, are some people who do not notice Dr. Schallhorn said. There have been at all that they have the disease and numerous innovations in flap techsome who may have severe function nology, as well as other advances for impairment from their glaucoma. smoother cuts, customized flaps and Similarly, there is a wide range on improved graphics for the user interthe spectrum of available surgeries. face. Dr. Schallhorn said that not There are some that are extremely only is femtosecond laser technolsafe and modestly effective, while ogy attractive to surgeons, but many others are marginally safe and patients are showing a preference for highly effective. "We have the it as well. "The femtosecond laser for opportunity to individualize care LASIK has revolutionized the procelike we never have before," Dr. dure," Dr. Schallhorn said. "It has Samuelson said. The phaco platform allowed us to do LASIK in aviators. for glaucoma management has a It's allowed us to do LASIK in astromodest IOP benefit, is extremely nauts. It's allowed us to do LASIK in safe, and the ancillary effects are any population of patients safer, beneficial. In a study of two-year more effectively, with fewer compliresults of the iStent in conjunctive cations." cataract surgery compared to results of cataract surgery alone, results Editors' note: Dr. Schallhorn has were similar when looking at the financial interests with AMO. Dr. safety, with no measureable differBinder has financial interests with ence. "To say that you can do a glauAMO, Accelerated Vision, AcuFocus, coma operation in conjunction with Outcomes Analysis Software, and cataract surgery and compare it in Stroma Medical. safety in cataract surgery alone and not have a measurable difference is breaking news," Dr. Samuelson said. Tuesday, November 19 EW Evolving use of MIGS device Thomas Samuelson, MD, Minneapolis, spoke about the FDA approval of the iStent (Glaukos, La- Editors' note: Dr. Samuelson has financial interests with Glaukos and Ivantis.

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