Eyeworld

AUG 2014

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

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51 EW REFRACTIVE SURGERY August 2014 focus just in the periphery and moderate the growth of the eye without any impact on the central focus," Dr. Aller said. Ironically, the type of defocus that stimulates myopia progres- sion is what typically results from traditional glasses and contact lenses, he went on. "The holy grail is that typical eyeglass lenses or contact lenses only focus well on the fovea but tend to allow the focus to fall behind the back of the eye," Dr. Aller said. "That's a stimulus to growth." So with classic lenses there's an out-of-focus image in the periphery because the light is falling behind the retina, he explained. Ideally this could be aligned to the retina, improving peripheral vision and sending a stop signal to myopic growth. However, even an equal amount of blur that fell in front of the retina would not serve as a myopic trigger. Even without availability of such an optimized lens, traditional bifocal contacts can still help. "The lenses I've been using for 20 years are clinically available, standard bi- focal contact lenses for presbyopes," Dr. Aller said. "The earlier you can start with something that's at least moderately effective, the better the outcome will be 18 years down the road." Based on the same principles, lined bifocal spectacles may also slow eye growth, Dr. Aller continued. In a group of Canadian children of Chinese descent with rapidly progressing myopia, use of bifocals slowed this by 40%. In his practice, Dr. Aller uses either bifocal contacts or Ortho-K as early as a child is willing to wear these. He stays away from atropine, unless there are no other options, noting that permanent changes in receptors in the eye have been found with its use. Going forward, a new treatment called 7-methylxanthine, a caffeine metabolite, is being considered. "Researchers found that children taking this in oral form had a dra- matically lower rate of progression of myopia," Dr. Aller said, adding that this does not have neural effects of caffeine. The treatment is currently being tried in Denmark and reviewed in the United States as well. EW Reference Aller TA. Clinical management of progressive myopia. Eye. 2014 Feb:28(2)147–53. Editors' note: Dr. Aller has several patents in the area. Contact information Aller: cptreyes@earthlink.net Introducing the Latest Innovation in Single-Use products Beaver-Visitec International, Inc. | 411 Waverley Oaks Road Waltham, MA 02452 USA | BVI, BVI Logo and all other trademarks (unless noted otherwise) are property of a Beaver-Visitec International ("BVI") company © 2014 BVI For more information, call 1.866.906.8080 or visit us at www.beaver-visitec.com Visitec ® Capsulorhexis Forceps Beaver-Visitec International, Inc. | 411 Waverley Oaks Road Waltham, MA 02452 USA | BVI, BVI Logo and all other trademarks (unless noted otherwise) are property of a Beaver-Visitec International ("BVI") company © 2014 BVI For more information, call 1.866.906.8080 or visit us at www.beaver-visitec.com Capsulorhexis Forceps Single-Use Solution Reduces risk of cross-contamination Consistent performance with every surgery Sterile and ready to use • Consistent performance • Excellent visibility • Optimum control Designed to fi t a 1.8 mm Micro Incision Available on the shelf as you need it, or in your Readypak™ for every surgery!

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