EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
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W hat is arguably the hottest topic in cataract surgery for 2014? If you placed 100 ophthalmologists in several rooms around the coun- try and asked them that very question, one topic that rises to the top is fem- tosecond cataract surgery. It's therefore perfect t iming to have this month's issue of EyeWorld focus on "femtosecond phaco techniques." Femtosecond cataract surgery has certainly evolved as all new technologies do. Since it was first commercialized in 2011, we have seen an expansion of the market with a greater number of ASCs and hospitals now owning this technology, and more surgeons being trained on and using the technology. It's estimated that more than 500 lasers have been placed in more than 40 countries. More than 2,000 s urgeons have been trained and more than 250,000 procedures have been performed worldwide. There are now companies commercially selling femtosecond lasers for cataract surgery in the United States. Clearly the technology is gaining acceptance. Yet as this technology improves through the normal development cycle, as surgeon experience becomes more comprehensive and complications become better understood and reduced, this technology continues to be a hot topic. Why? Surgeons who are early adopters speak about the benefits of femtosecond cataract surgery, that it's the future of cataract surgery, and talk about precision and accuracy that laser technology and high definition OCT imaging can provide. Surgeons who do not use the technology look for hard data to demonstrate the benefits for their patients and their practice. These sorts of debates have historically existed time and time again. So are the early adopters correct as they were with phacoemulsification, or are they wrong as they were with holmium lasers for hyperopia? Market forces, patient acceptance, business models, and scientific data may help provide clarity over time. As an early adopter of femtosecond technology for cataract surgery, I have been pleased to be a part of its development. I believe, as many of my peers do, that this technology is the future of cataract surgery. It has been well accepted by my patients, staff, and referral sources. I continue to be impressed with the precision and accuracy of the technology as well as the research and development that continues (the development of image-guided systems to integrate with femtosecond lasers to more precisely align arcuate incisions and toric IOLs is an example). Our surgery center has benefited from its investment in this technology as have our operating surgeons and their patients. Will femtosecond cataract surgery stand the test of time? I certainly hope so. We have taken a comprehensive approach to the topic of femtosecond lasers for cataract surgery and have involved a number of experts from around the world. Femtosecond techniques and outcomes are covered by Drs. Lawless, Slade, Talamo, Trattler, and Weinstock, representing worldwide experience. Drs. Alpins, Donnenfeld, Holladay, Koch, and Stamatelatos further address corneal measurements including astigmatism and effective lens position. Femtosecond-related complications are discussed by Drs. Cionni, Culbertson, and Nagy. Ethical dilemmas are addressed by Drs. Banja, Hoffman, and Miller. Finally, the topic of marketing for femtosecond lasers is covered by Drs. Doane, Gills, Gordon, Kontos, and Thompson. I hope you enjoy this issue. Kerry D. Solomon, MD, refractive editor Publisher Donald R. Long d on@eyeworld.org Editorial Editor Erin Boyle e rin@eyeworld.org Managing Editor Stacy Majewicz stacy@eyeworld.org Staff Writer Ellen Stodola ellen@eyeworld.org Production G raphic Designer Julio Guerrero j ulio@eyeworld.org Graphic Design Assistant Susan Steury S usan@eyeworld.org P roduction Manager Cathy Stern c athy@eyeworld.org 703-383-5702 P roduction Assistant Carly Peterson c arly@eyeworld.org Contributing Writers Vanessa Caceres Lakeland, Florida Michelle Dalton Reading, Pennsylvania Matt Young M alaysia Enette Ngoei D ublin Rich Daly Arlington, Virginia Senior Contributing Writer Maxine Lipner N yack, New York Advertising Sales ASCRS Media 4 000 Legato Road Suite 700 F airfax, VA 22033 703-591-2220 fax: 703-591-0614 eyeworld@eyeworld.org www.eyeworld.org Advertising Sales Jeff Brownstein jeff@eyeworld.org 703-788-5745 Paul Zelin p aul@eyeworld.org 703-383-5729 Classified Sales Cathy Stern cathy@eyeworld.org 703-383-5702 EyeWorld Special Projects and Events Jessica Donohoe jessica@eyeworld.org 703-591-2220 ASCRS Publisher: EYEWORLD (ISSN 1089-0084) is published monthly by ASCRS Ophthalmic Services Corp., 4000 Legato Road, Suite 700, Fairfax, VA 22033-4055; telephone: 703-591-2220; fax: 703-591-0614. 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POSTMASTER: Send change of address to EYEWORLD, 4000 Legato Road, Suite 700, Fairfax, VA 22033. Periodical postage paid at Fairfax, VA 22033 and at additional mailing offices. The ideas and opinions expressed in E YEWORLD do not necessarily reflect those of the editors, publisher, or its advertisers. P U B L I S H I N G S T A F F March 2014 Volume 19 • No. 3 A S C R S The official publication of the American Society of Cataract & Refractive Surgery World view Will femto cataract surgery stand the test of time? Kerry D. Solomon, MD, refractive editor