Eyeworld

EW MEETING REPORTER 61 Ophthalmology Management Trends Beginning a series of scientific pro- grams surrounding APAO Sydney 2011, Alcon brought together an im- pressive panel of experts for an Ophthalmology Management Trends (OMT) symposium. Kicking off the symposium, Abhay Vasavada, F.R.C.S., director, Iladevi Cataract and IOL Research Centre, Raghudeep Eye Clinic, Ahmedabad, India, and a renowned specialist in cataract surgery in the region, delivered his lecture on "UV filtering IOLs; a Glaring Problem?" in which he raised the banner for blue light filtration in IOLs. Examining the evidence from both published research and his own clinical experience, he said that he found the balance between the ben- efits of photoprotection and the risk of effects on vision favors blue light- filtering IOLs. Con Moshegov, M.D., director, Perfect Vision Laser Correction Cen- tres, Sydney, Australia, made the case for micro-incision surgery. In theory, he said, smaller incisions mean a decrease in induced astigma- tism, a lowered risk for endoph- thalmitis, quicker stabilization, and easier anterior chamber mainte- nance. In Dr. Moshegov's experience, of the three techniques for small-inci- sion cataract surgery currently domi- nating the discussion—standard 2.75-mm incision phaco surgery; bi- manual cataract surgery through two 1.2-mm incisions (more cor- rectly referred to as "biaxial" cataract surgery); and micro-coaxial surgery through a 2.5-mm incision—micro- coaxial surgery, particularly with the Intrepid Micro-Coaxial System (Alcon), produced the best results. Among other things, micro-coaxial surgery resulted in the least amount of post-op stretch, with 2.75-mm in- cisions ending up 2.8-3.0 mm, 2.2- mm ending up 2.4-2.6, and 2.2-mm ending up not more than 2.4 mm, respectively. Phacoemulsification with the OZil Infiniti torsional phaco system (Alcon) is further enhanced by Intel- ligent Phaco (IP), which David Lubeck, M.D., corneal and refractive surgeon, Chicago, likened to the ref- eree in a boxing match, separating boxers in a match to allow the fight to continue; that is, separating a nu- clear fragment from the tip to allow the torsional phaco to function more efficiently and effectively, even in complex cataract cases including those with hard cataracts, zonular weakness and dislocated cataracts, and small pupils. Perhaps the most exciting trend described in the first part of the OMT symposium was femtosecond laser cataract surgery. Describing the emerging procedure, particularly using the LenSx femtosecond laser system (Alcon), Michael Lawless, M.D., chairman, ophthalmology de- partment, Royal North Shore Hospi- tal, Sydney, and clinical senior lecturer, University of Sydney, said that the trend provides cataract sur- geons with a way to potentially im- prove outcome predictability and effective lens position, creating a whole new level of refractive cataract surgery. Much of the afternoon was spent with Dr. Lawless, Paul Hughes, M.D., Rohit Shetty, F.R.C.S., Ronald Krueger, M.D., and Alan Faulkner, M.D., who described their experiences with the WaveLight sys- tem (Alcon), the company's foray into laser refractive surgery. Alcon, said Dr. Moshegov, who moderated this last part of the symposium, had been mostly silent in this field; with the WaveLight system, he said, it seems that "a giant has awakened." Michael Mrochen, M.D., a spe- cialist in corneal laser surgery, physiological optics, laser-tissue in- teraction, and laser physics, noted that WaveLight and other similar trends in laser refractive surgery demonstrate a shift toward increas- ing the degree of individualization and customization by improving performance and safety through the integration of diagnostics. In his lecture on ray tracing, Dr. Mrochen described a system that will allow surgeons to create an indi- vidual eye model for each patient's eye. Finally, Mark Troski, M.D., a surgeon devoted exclusively to cataract surgery, described a trend that many surgeons have been wait- ing for over the better part of the last decade: the ReSTOR toric multi- focal IOL (Alcon). Dr. Troski managed to systemati- cally "myth bust" what he called the "7 Myths of Multifocals": multifo- cals don't work, particularly in pa- tients with astigmatism (the latter addressed specifically by the new lens); patients still need glasses with multifocals; monovision works bet- ter than multifocals; small (0.50 D) errors don't need a multifocal; mul- tifocals don't work well in myopia; multifocals don't work monocularly; and multifocals don't work for em- metropic presbyopes. To bust each myth, Dr. Troski presented published evidence as well as ecstatic blurbs from some of his most enthusiastic patients. Editors' note: Ophthalmology Manage- ment Trends was sponsored by Alcon. APAO Sydney 2011: Information strategy This year, APAO turned "An Interna- tional Focus on Ophthalmology" with its Congress in Sydney, Aus- tralia. The Asia-Pacific region, said APAO president Frank Martin, M.D., bears a "disproportionate bur- den of blindness," with a third of the world's blind population, includ- ing half of the world's blind chil- dren. While "enjoying remarkable economic and technologic advance- ment over the past decade," said Reporting live from APAO 2011, Sydney, Australia Editors' note: This Meeting Reporter contains original reporting by the EyeWorld news team. April 2011 continued on page 62 APAO Sydney 2011, the 2011 Congress of the Asia-Pacific Academy of Ophthalmology, opened March 20. On that day, Alcon (Fort Worth, Texas) sponsored an Ophthalmology Management Trends (OMT) symposium, kicking off a series of programs surrounding the meeting.

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