Eyeworld

I magine for a moment this vision of the future. The date is July 2044. A group of residents is attentively listening to grand rounds on the history of cataract surgery. A video of how anterior capsulotomies were done at the turn of the century seems primitive. "Did they really use bent needles to tear a hole in the capsule?" asks one incredulous first-year resident. "And the chopping of the nucleus, are you kidding me? That looks barbaric. The phaco energy alone must have destroyed 10% of the endothelium." The lecture concludes with a new appreciation of how much cataract surgery has improved in the last 30 years. Meanwhile back in the present, there are certain things we can count on. What standard cataract surgery looks like in the future will continue to evolve. There is no doubt that much of what we now consider state of the art will someday seem primitive. The introduction of femtosecond laser technology has been heralded as the next step in the evolution of cataract surgery. Not everyone agrees, however, that the benefits are obvious. The one thing everyone does agree on is that the costs are substantial. In this issue of EyeWorld, we explore the current state of femtosecond laser use in cataract surgery. The adoption of the femtosecond laser in cataract surgery has had significant variance around the world. Physicians from various countries discuss how healthcare systems and private pay regulations interact to either limit or allow new technology. The laser will make accurate incisions, but does this really enhance AK predictability? Eric D. Donnenfeld, MD, thinks so, and he explains how this has changed the way he manages low levels of astigmatism. Stephen G. Slade, MD, addresses the perception that the femtosecond laser hasn't proven itself to be better than manual cataract surgery. While there is general agreement regarding the increased precision the laser has, we are still looking to establish if this translates into improvement in outcomes. Perhaps the real value of the femtosecond laser is the ability for other innovations built on the unique incisions it is capable of. William Trattler, MD, believes the capsulotomy is going to be the key for all future IOL designs. In the meantime, the rest of us are looking at how to make sense, clinically and economically, of an expensive new technology. We hope you find this issue of EyeWorld both informative and provocative. There is little doubt that femtosecond laser cataract surgery is a reality. The question remains if it will become mainstream or remain a niche. It may take a while to figure this out. John A. Vukich, MD, international editor Publisher Donald R. Long don@eyeworld.org Editorial Editor Erin L. Boyle erin@eyeworld.org Managing Editor Stacy Majewicz stacy@eyeworld.org Staff Writer Ellen Stodola ellen@eyeworld.org Staff Writer Lauren Lipuma lauren@eyeworld.org Production Graphic Designer Julio Guerrero julio@eyeworld.org Graphic Design Assistant Susan Steury Susan@eyeworld.org Production Manager Cathy Stern cathy@eyeworld.org 703-383-5702 Production Assistant Carly Peterson carly@eyeworld.org Contributing Writers Vanessa Caceres Lakeland, Fla. Michelle Dalton Reading, Pa. Matt Young Malaysia Enette Ngoei Dublin Rich Daly Arlington, Va. Senior Contributing Writer Maxine Lipner Nyack, N.Y. Advertising Sales ASCRSMedia 4000 Legato Road Suite 700 Fairfax, 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 paul@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. Printed in the U.S. Editorial Offices: EYEWORLD News Service, 4000 Legato Road, Suite 700, Fairfax, VA 22033-4055; toll-free: 800-451-1339, 703-591-2220; fax: 703-591-0614; email: eyeworld@eyeworld.org. Advertising Offices: ASCRSMedia, 4000 Legato Road, Suite 700, Fairfax, VA 22033-4055; toll-free: 800-451-1339, 703-591-2220; fax: 703-591-0614; email: eyeworld@eyeworld.org. 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The ideas and opinions expressed in EYEWORLD 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 June 2014 Volume 19 • No. 6 A S C R S The official publication of the American Society of Cataract & Refractive Surgery World view Exploring the current state of femtosecond cataract surgery John A. Vukich, MD, international editor Keep up on the latest in ophthalmology! Follow EyeWorld on Twitter at twitter.com/EWNews EyeWorld @EWNews 2-10 O&C_EW June 2014-DL_Layout 1 6/3/14 12:09 PM Page 8

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