Eyeworld

crosslinking has given us for the first time a treatment for this rare com- plication. Prolate ablation patterns with wavefront or wavefront-opti- mized ablation profiles have dramat- ically reduced the incidence of glare and halo to the point that they, while continuing to exist, are less common following refractive sur- gery than preoperatively. Finally, dry eye continues to be a problem fol- lowing LASIK and PRK but improved diagnostic instruments such as tear osmolarity and MMP-9 testing allow for a better preoperative evaluation of our patients coupled with better treatment plans including topical cyclosporine and oral omega-3 supplementation; smaller, thinner corneal flaps have reduced the incidence of postoperative dry eye. The golden age of refractive surgery is today, and tomorrow is going to be even better. Of this I am completely convinced. The demo- graphics of the patients eligible for refractive surgery are strongly in our favor as Generation Y, which is even larger than the Baby Boomers, becomes eligible for and demands a refractive solution. I recall the gold standard of early refractive surgery being 20/40 uncorrected postopera- tive vision. These standards have changed. When we can routinely provide better uncorrected vision following refractive surgery than the patient had with glasses prior to surgery with a high level of safety, the demand for LASIK and PRK will grow measurably. That day is almost here. I am extremely excited about several new technologies on the near horizon that are very promising and that I think will greatly improve refractive outcomes. These include the FDA approval of riboflavin UV crosslinking, topographic ablations for irregular corneas, better tracking devices and aberrometers such as the iDesign (Abbott Medical Optics, Santa Ana, Calif.), and small inci- sion lenticule extraction (ReLEX SMILE, Carl Zeiss Meditec, Jena, Germany). New treatments for pres- byopia are also coming, including multifocal ablations and several corneal inlays to improve depth of focus. I can promise that we have exciting times ahead in refractive surgery, and I look forward to bringing them to you here in EyeWorld. EW Contact information Donnenfeld: ericdonnenfeld@gmail.com July 2014 New refractive continued from page 43 " The golden age of refractive surgery is today, and tomorrow is going to be even better. Of this I am completely convinced. The demographics of the patients eligible for refractive surgery are strongly in our favor as Generation Y, which is even larger than the Baby Boomers, becomes eligible for and demands a refractive solution. " EyeWorld factoid A new report predicts more than $384 billion in 2032 and $717 billion in 2050 in nominal costs related to eye disease and vision problems. As the Baby Boomer generation ages into the Medicare program, costs will further shift from patients and private insurance to government. Source: Prevent Blindness 43-47 Refractive_EW July 2014-DL2_Layout 1 6/26/14 3:59 PM Page 44

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