Eyeworld

67 EW SECONDARY FEATURE September 2014 Additional possibilities include scleral pocket expansion devices, but he is unsure where they fi t into the treatment plan. "The treatment of presbyopia is the holy grail for current refractive surgery," Dr. Hamill said. "You've got all these ideas out there, but so far nothing has risen to the top." Dr. Smith spoke about newer forms of monovision where the depth of focus is increased with either laser or lens-based procedures. Corneal inlays are another option that are approved in some places and undergoing trials in others. In Canada, the KAMRA (AcuFocus, Irvine, Calif.) has been approved, and other inlays such as the Flexivue Microlens (Presbia, Irvine, Calif.) and the Raindrop (ReVision Optics, Lake Forest, Calif.) will be available in the future. Dr. Daya said that he is inter- ested in a WIOL that is coming out from the Czech Republic. It com- bines a depth of fi eld lens with some accommodation. Light-adjustable IOLs Dr. Smith thinks that the Light-Ad- justable Lens (LAL, Calhoun Vision, Pasadena, Calif.) is a "very powerful technology, not only for the correc- tion of nearsightedness, farsighted- ness, and astigmatism, but also the potential for correcting higher order aberrations and for presbyopia cor- rection involving increasing depth of focus." He plans to begin work with this technology soon. Dr. Smith did note that a light- adjustable IOL is a fairly big under- taking for the patient because not only is it a bit more expensive than a multifocal IOL, there are addition- al treatments and visits that the pa- tient must be willing to make. There are 2 to 3 light-adjusted treatments. It is necessary to wear ultraviolet protection during that time to prevent the lens from being affected by normal daylight. Dr. Daya does not expect to use the light-adjustable lens because his results using the trifocal lens are so good. He added that he does not fi nd it practical to use a technology where a patient has to wear dark glasses and come back for follow-up appointments several times before the lenses are fully functional. "I'm always interested in new technologies," Dr. Daya said, but added that it is important to ex- amine if the new technologies will be better than what is already in use and how they will benefi t the patient. EW Editors' note: Drs. Smith and Hamill have no fi nancial interests related to their comments. Dr. Daya has fi nancial interests with Bausch + Lomb, Carl Zeiss Meditec (Jena, Germany), and PhysIOL (Liege, Belgium). Contact information Daya: sdaya@centreforsight.com Hamill: mhamill@bcm.edu Smith: smithdean@rogers.com The power of one Two types of incisions – one module The Ziemer FEMTO LDV Z Models are FDA cleared and CE marked and available for immediate delivery. The FEMTO LDV Z6 is FDA cleared and CE marked for creation of corneal incisions in patients undergoing cataract surgery. For some countries, availability may be restricted due to local regulatory requirements; please contact Ziemer for details. Exclusively available for the FEMTO LDV Z6 www.femtoldv.com Visit us at AAO booth 2362 CLEAR CORNEAL & ARCUATE INCISIONS • Custom-designed incisions • Topographically matched • Added precision and reproducibility • Intrastromal incisions possible

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