Eyeworld

Reporting live from the 2010 Asia Cornea Society meeting, Kyoto, Japan EW MEETING REPORTER 62 January 2011 D uring the final day of the 2010 Asia Cornea Society Meeting (ACS), attendees were given the opportunity to learn of a variety of techniques, technol- ogy, and hot topics including refrac- tive surgery techniques, anterior chamber IOLs, multifocal IOLs, and treatment of corneal haze. Aim for the topo Both wavefront-guided and wave- front-optimized laser ablation pro- duce excellent results that are more or less comparable; the only signifi- cant difference is in patients with relatively high preoperative higher order aberrations (HOAs), in which case wavefront-guided ablation comes up on top with lower postop- erative HOAs. However, wavefronts take a "snapshot of a dynamic process," said R. Doyle Stulting, M.D. Wavefronts change with a vari- ety of factors, including accommo- dation, age, and pupil size; moreover, assuming inaccuracies may occur in the application of wavefront information—assuming that the information itself is accu- rate to begin with. Dr. Stulting was making the case for topography- guided laser ablation. Unlike wave- front, he said, topography is static, accurate, and reproducible. It is in- dependent of pupil size, provides better peripheral data, and can be adjusted to asphericity. In the in- terim data from the U.S. T-CAT Phase III study, topo-guided primary LASIK met the study's safety and performance endpoints; Dr. Stulting, who is medical monitor for the study, took the conclusion further, saying that topo-guided LASIK im- proved subjective visual acuity, "truly" taking LASIK to "a new area" in corneal refractive surgery. Piggyback multifocals Situations may arise where patients with monofocal IOLs may turn around and ask for multifocal IOLs. Lens exchange is the obvious ap- proach, but Hiroko Bissen-Miya- jima, M.D., suggests another, somewhat less drastic alternative. Dr. Bissen-Miyajima suggested using an add-on lens. These lenses are cur- rently available in spheric, diffrac- tive, and toric models. These lenses are designed to insert over the monofocal implant, with the haptics tucked under the iris. The piggyback procedure, she said, has the advan- tage of being faster and somewhat less invasive than a lens exchange, and can be used to enhance either or both sphere and cylinder correction. ReLEx, FLEx, & SMILE In the last 10 years, cornea and re- fractive surgeons at the Singapore National Eye Centre (SNEC) have performed around 38,000 LASIK pro- cedures; today, said Donald Tan, M.D., they perform about 96% of cases with the femtosecond laser. Dr. Tan and his colleagues are currently looking into refractive lenticule exchange (ReLEx) tech- 7-140-*-2( Tap into the incredible network of the The American Society of Cataract and Refractive Surgery and American Society of Ophthalmic Administrators with the ASCRS ASOA Ophthalmic Buyers Guide. Powered by MultiView, the Guide gives professionals a faster and easier way to ènd industry resources and suppliers. Simpliènd your search today at www.ascrs.org or www.asoa.org

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