EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/307638
Sunday, October 23 10:30–11:15 am Cataract Surgeries, Diabetes and Systemic Diseases: Their Impact on Dry Eye Marguerite McDonald, MD (Moderator) .JUDIFMM+BDLTPO.%t8JMMJBN5SBUUMFS.% 1:00–1:45 pm Complex Case Management: Utilizing iLASIK ® Technology for Optimal Vision Rehabilitation Eric Donnenfeld, MD (Moderator) $ISJTUPQIFS#MBOUPO.%t4UFQIFO-BOF.% -PVJT1SPCTU.% Saturday, October 22 10:00–10:45 am Clinical Success and Outcomes with the TECNIS ® Multifocal Lens Kerry Assil, MD (Moderator) %XBZOF-PHBO.%t'BSSFMM5ZTPO.%t,FWJO8BMU[.% 1:00–1:45 pm Surgical Techniques for Management of Complicated Cases %BWJE$IBOH.% .PEFSBUPS "NBS"HBSXBM.%t3PTB#SBHB.FMF.% 5IPNBT4BNVFMTPO.% 2:00–2:45 pm Complex Cases Utilizing Advanced Lens Extraction Technology 3PHFS4UFJOFSU.% .PEFSBUPS 4UFWFO%FXFZ.%t5BM3BWJW.%t,FOOFUI3PTFOUIBM.% SCHEDULE OF EVENTS* "CCPUU.FEJDBM0QUJDT""00SMBOEP 41&",&34'036. :06326&45*0/4 :063$63*04*5: :0634)"%&4 bring Important Safety Information for TECNIS ® Multifocal Intraocular Lens (IOL) Indications:5&$/*4 ® .VMUJGPDBM*0-TBSFJOEJDBUFEGPSWJTVBMDPSSFDUJPOPGBQIBLJBJOBEVMUQBUJFOUTXJUIBOEXJUIPVUQSFTCZPQJB JOXIPNBDBUBSBDUPVTMFOTIBTCFFOSFNPWFECZQIBDPFNVMTJýDBUJPO5IF*0-TBSFJOUFOEFEUPCFQMBDFEJOUIFDBQTVMBSCBH Warnings: 1IZTJDJBOTDPOTJEFSJOHMFOTJNQMBOUBUJPOVOEFSBOZPGUIFDPOEJUJPOTEFTDSJCFEJOUIF%JSFDUJPOTGPS6TFMBCFMJOHTIPVME XFJHIUIFQPUFOUJBMSJTLCFOFýUSBUJPQSJPSUPJNQMBOUJOHBMFOTPrecautions:%POPUSFTUFSJMJ[FPSBVUPDMBWF6TFPOMZTUFSJMFJSSJHBUJOH TPMVUJPOTTVDIBTCBMBODFETBMUTPMVUJPOPSTUFSJMFOPSNBMTBMJOF%POPUTUPSFJOEJSFDUTVOMJHIUPSPWFS¡$Adverse Events:5IFNPTU GSFRVFOUMZSFQPSUFEBEWFSTFFWFOUUIBUPDDVSSFEEVSJOHUIFDMJOJDBMUSJBMPGUIF5&$/*4 ® .VMUJGPDBMMFOTXBTTVSHJDBMSFJOUFSWFOUJPOXIJDI PDDVSSFEBUBSBUFPG MFOTSFMBUFEOPOMFOTSFMBUFE XIJDIJODMVEFEMFOTFYDIBOHFSFUJOBMSFQBJSJSJTQSPMBQTFXPVOE SFQBJSUSBCFDVMFDUPNZMFOTSFQPTJUJPOJOHBOEMFOTSFNPWBMEVFUPQBUJFOUEJTTBUJTGBDUJPO0UIFSFWFOUTJODMVEFENBDVMBSFEFNB IZQPQZPO BOEFOEPQIUIBMNJUJT Caution:'FEFSBMMBXSFTUSJDUTUIJTEFWJDFUPTBMFCZPSPOUIFPSEFSPGBQIZTJDJBO 4QFBLFSTTVCKFDUUPDIBOHF#PPUIQSFTFOUBUJPOTBSFOPUBGýMJBUFEXJUIUIFPGýDJBMQSPHSBNPGUIF"OOVBM.FFUJOH J-"4*,BOE5&$/*4BSFUSBEFNBSLTPXOFECZPSMJDFOTFEUP"CCPUU-BCPSBUPSJFTJUTTVCTJEJBSJFTPSBGýMJBUFT ª"CCPUU.FEJDBM0QUJDT*OD4BOUB"OB$" XXX"CCPUU.FEJDBM0QUJDTDPN .& *GZPVSFMPPLJOHUPCSJOHIPNFJOTJHIULOPXMFEHFBOEOFXJEFBTGSPNUIJTZFBST""0TIPXJOTVOOZ0SMBOEPUIFSFTOPCFUUFSQMBDFUP ýOEUIFNUIBOBUUIF"CCPUU.FEJDBM0QUJDT4QFBLFST'PSVN.PEFSBUFECZTPNFPGUIFNPTUSFOPXOFEOBNFTJOPQIUIBMNPMPHZJUT UIFPOFBUUSBDUJPOJO0SMBOEPUIBUTIPVMECFPOFWFSZPOFTNVTUTFFMJTU AAO ORLANDO t BOOTH #2421 t OCTOBER 22–23 EW FEATURE 64 "The best, most predictable thing we can currently offer is monovision. One eye won't need surgery, and you're putting a lens implant in the other eye that will in- duce myopia," he said, noting there is not enough accommodative range with current technology, and he's "very concerned" with the quality of vision the multifocal lenses can offer "if the patient is an emmetrope without visual problems other than presbyopia." "This is a patient that as an oph- thalmologist I would love to be able to do something for, but I need to take a step back and be cautious," Dr. Lane advised. "I may not be able to meet the patient's expectations. I may be able to hit the refractive tar- get, but it may take several whacks to meet it. Patient frustration may never let you achieve it." These patients "have always seen well otherwise. They require a lot of time and education—they don't understand presbyopia or the compromise that would be required with current technology in order to give them near vision," Dr. Koch said. Surgical considerations Dr. Weiss advised surgeons to con- sider the patient's age and lens changes before deciding to offer a lens-based option—and to be pre- pared to spend a considerable amount of time in the pre-op phase educating patients. "If they're +0.5 or +0.75 D and have already undergone a monovi- sion contact lens trial, I'll opt for monofocal lens surgery," Dr. Harton said. The newer aspheric monofocal lenses, such as the Lenstec Softec HD (St. Petersburg, Fla.) or the STAAR Affinity and nanoFLEX aspheric lenses (Monrovia, Calif.), "tend to give patients a bigger depth of field, so we don't have to make them –2 D in one eye just to give them great reading vision," Dr. Harton said. The dilemma with any currently avail- able lens is "we can't predict who's going to get the best accommoda- tion out of it." The "biggest change" in normal human accommodation is the change in the radius of curva- ture, he said. "With lens exchange, you're removing the entire anterior capsule and taking away that en- gine. You might see a little bit of movement, but forward movement of the lens is not giving us the ac- commodation." Cornea-based options "Absent a good accommodating IOL, I do not recommend any lens- based surgery," Dr. Koch said. "On selected patients, I have done hyper- opic LASIK or PRK in order to induce myopia and generate monovision. It works very well in patients who have already experienced monovi- sion." Limitations, of course, include some regression and potential re- treatment "anywhere from 2 to 5 or even 8 years down the road as the eye changes and grows toward hy- peropia," he said. February 2011 Challenging refractive cases October 2011 Presbyopia continued from page 63 continued on page 66 perfect result, the near-emmetropic presbyope will remain one of oph- thalmology's most difficult chal- lenges," said Jack L. Weiss, M.D., private practice, Gordon & Weiss Vision Institute, San Diego. "I do offer refractive lens exchange to some near emmetropes, but not to everyone." If the patient is +0.5 D or +0.75 D, "those are fair game," said Paul "Butch" Harton, M.D., private practice, Harbin Clinic Eye Center, Rome, Ga., who prefers to offer monovision to those who have had some experience with monovision contact lenses. For now, Douglas D. Koch, M.D., professor and the Allen, Mosbacher, and Law Chair in oph- thalmology, Cullen Eye Institute, Baylor College of Medicine, Hous- ton, avoids accommodative lens- based surgery in this group. To Register visit www.ophthalmologysummit.com For more information contact: Carissa Stavrakos, Executive Producer, International Business Forum, Inc. (516) 765-9005 ext. 310 or Carissa@ibfconferences.com Presented By: 3 R D A N N U A L I N N O V A T I O N S U M M I T O P H T H A L M O LO G Y October 20, 2011, Rosen Plaza Hotel, Orlando, FL ϮϬϭϭŽŵƉĂŶLJ^ŚŽǁĐĂƐĞƚŽ/ŶĐůƵĚĞ͗ AcuFocus, Inc. ĞƌŝĞWŚĂƌŵĂĐĞƵƟĐĂůƐ ŬŬŽ>ĞŶƐ/ŶƚĞƌŶĂƟŽŶĂůs ůŝŵĞƌĂ^ĐŝĞŶĐĞƐ Avedro, Inc. K^EĞƵƌŽƐĐŝĞŶĐĞ ůĞǀĞŶŝŽƚŚĞƌĂƉĞƵƟĐƐ LJĞ'ĂƚĞWŚĂƌŵĂĐĞƵƟĐĂůƐ ŝŽdŚĞƌĂƉĞƵƟĐƐ /ŵƉůĂŶĚĂƚĂKƉŚƚŚĂůŵŝĐWƌŽĚƵĐƚƐ /ŶŽƚĞŬWŚĂƌŵĂĐĞƵƟĐĂůŽƌƉŽƌĂƟŽŶ MacuCLEAR, Inc. 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Carissa Stavrakos, Executive Producer (516) 765-9005 ext. 310 or Carissa@ibfconferences.com D Ɛ Ğ Đ ŝ ǀ ƌ Ğ ^ Ő Ŷ Ɵ ů Ƶ Ɛ Ŷ Ž Ő Ğ Z Ŷ ŝ ů ʹ ů Ă Đ ŝ Ő ƌ Ƶ ^ ď ŵ Ž > н Ś Đ Ɛ Ƶ Ă Ɛ Ğ Đ Ŷ Ğ ŝ Đ ^ Ğ Ĩ ŝ > s ^ ʹ .ophthalmologysummit.com , International Business Forum, Inc. (516) 765-9005 ext. 310 or Carissa@ibfconferences.com y: ed B t esen Pr ƌ Ğ Ŷ ď ŝ Ğ Ś Đ ^ Ɛ Ă Ŭ Ƶ > Ž ƚ Ă ƌ Ž ď Ă > Ŷ Ž Đ ů ʹ : ͕ D ͕ Ŷ Ğ ƌ Ƶ Ś ^ ī Ğ : A – FD D ͕ Ɖ Ƶ Đ ƚ ŝ Ś t Ʃ Ž Đ ^ Đ Ŷ / ͕ Ŷ Ă Ő ƌ Ğ ů ů ʹ .ophthalmologysummit.com ͘ Đ Ŷ / ͕ Ɛ Ğ ŝ ƌ Ž ͘ Đ 52-67 Feature_EW October 2011-DL33_Layout 1 9/29/11 4:52 PM Page 64