Eyeworld

EW MEETING REPORTER January 2011 131 had previous refractive surgery. A web-based calculator (http://doctor- hill.com/iol-main/keratorefractive- calculator.html) determines IOL power for eyes undergoing cataract surgery with previous LASIK, PRK, or radial keratotomy. Dr. Mamalis said he takes a printout of the results to his patient for pre-op counseling. "I tell the patient, 'These are the meas- urements we have with all of the formulas, and we're going to pick the lens that we think is best for you, but this is not a perfect science. We still may have to do an addi- tional procedure,'" he said. Andrew Collins, M.D., Charlottesville, Va., asked Drs. Foster and Mamalis whether they prefer LASIK or PRK after cataract surgery, and whether there are issues with in- cisions leaking. Dr. Foster said he prefers PRK because it causes less dry eye, al- though he acknowledged that opin- ion is controversial. "If you're doing it for free, it's nice to not have to pay for the IntraLase (AMO)," he said. "It depends on how much you're comfortable with, too," Dr. Mamalis said. "It doesn't faze some people to lift a flap afterward, but I think the majority of people would say PRK, just for the fact that you've eliminated any issues with the flap and previous wounds." Lyn E. Yakubov, M.D., Youngstown, Ohio, said she has a patient with ReSTOR multifocal IOLs (Alcon) who complains about prob- lems with fluorescent lighting, espe- cially the kind used in Wal-Mart or Lowes. "You need to make sure the lens is well centered with the visual axis," Dr. Foster advised. Also, his practice uses tear film management aggressively in patients with fluores- cent light sensitivity, especially with those patients who are in that envi- ronment often. Dr. Mamalis referenced a talk given earlier by Dr. Stulting, who is researching why patients are un- happy with multifocal IOLs. "It wasn't that the lens required explantation in most of the cases," Dr. Mamalis said. "It was that pa- tients either had surface disease or refractive error. If there's any kind of refractive error, that exaggerates the symptoms. Dry eye, blepharitis, meibomian gland disease—those can really disrupt the image in a multifo- cal IOL. Then the patient is suscepti- ble to problems with lights." Dr. Mamalis advised against per- forming a YAG capsulotomy as a first-line treatment for these pa- tients. Editors' note: Drs. Barish, Collins, Holland, Lane, Stulting, and Yakubov Meet the OCULUS Diagnostic Taskforce ...and save up to $ 3,000 ! OCULUS is offering a customer appreciation discount on selected products at ASCRS 2011. To get your discount, go to www.oculusvoucher.com to print your ASCRS discount voucher in 3 easy steps. Bring the voucher to our booth (#1607) at ASCRS, San Diego. www.oculusvoucher.com SAMPLE SAMPLE VOUCHER Meet the OCULUS Diagnostic Taskforce Product: Various OCULUS Products Name: John Doe Location: Doecity, Washington Discount: up to $ 3,000 Voucher-Code: AS10BO0315X Valid until April 14, 2011. No cash value. had no financial interests to report. Dr. Foster has a financial interest with Alcon. Dr. Mamalis has financial inter- ests with AMO and Alcon. Josh Young, M.D., of the podcast As Seen From Here, reported live from the ASCRS Winter Update. The inter- views are featured on www.asseenfromhere.com.

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