EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/387844
EW MEETING REPORTER 134 October 2014 Reporting from the 2014 European Society of Cataract & Refractive Surgeons (ESCRS) Congress, London Preoperative surgical complica- tions were similar, but postoperative complications were higher in the femto group, at 3.2%, compared to 1.8% in phaco. Complications identified as "other" were the most common in that group, at 1.7%, followed by early posterior capsular opacification reducing visual acuity at 0.6% (compared to 0.1% in the phaco group). For postoperative BCDVA, the femto group had slightly better results than the phaco group, Dr. Barry said. There was no real differ- ence between the groups in targeting postop biometry prediction error. The femto group had more postop complications, less postop astigmatism, and somewhat less surgically induced astigmatism than the phaco group, Dr. Barry said. The study does have limitations, including circularity and centration of the capsulorhexis, endothelial cell loss, and effective lens position, he said, because there is no comparison for these in the EUREQUO database benchmarks. "At the moment, I think we can conclude that in its current state of infancy, femto cataract surgery is as good as traditional phaco but currently does not, by these mea- surements, outperform it," he said. 'Femto cataract surgery still evolving,' clinicians say Femtosecond cataract surgery shows promising results but continues to evolve, expert speakers said at the "Why Bother With Femto-Assisted Cataract Surgery?" symposium. "It is yet uncertain whether the procedure will be as good or better than standard phaco," said Dr. Bellucci, who co-chaired the symposium. In addition to Dr. Barry and other experts speaking on the topic, Julian Stevens, MD, London, U.K., presented "Femto cataract—it's the panacea." During a discussion period, Dr. Stevens said that femtosecond technology is being used on younger patients, so while surgery becomes faster, better, and cheaper, it also needs to achieve high standards. "We have to ensure long-term safety, not just short-term results," Dr. Stevens said. JCRS Symposium highlights controversies in cataract and refractive surgery The Journal of Cataract & Refractive Surgery (JCRS) Symposium explored controversies in cataract and refractive surgery and was chaired by the journal's European editor, Thomas Kohnen, MD, PhD, Frankfurt, Germany, and its American editor, Nick Mamalis, MD, Salt Lake City, Utah, U.S. Steve A. Arshinoff, MD, Toronto, Canada, and José Güell, MD, PhD, Barcelona, Spain, delved into the pros and cons of simul- taneous bilateral cataract surgery. Dr. Arshinoff shared some of the advantages of ISBCS, which include avoiding fear from patients who had previous trouble in the first eye, i - mediate rehabilitation of the visual system, and fewer patient visits. Dr. Güell discussed some of the cons of ISBCS; however, he also not- ed a number of advantages as well. The literature shows no statistically significant difference in complic - tion rate and visual results between "same" day and "consecutive" day cataract surgery, he said. However, higher refractive pre- dictability and final patient satisfa - tion favors "consecutive" for some investigators, and because of the delayed onset of postoperative CME, it could potentially benefit a patient to have an interval between surger- ies. Both Dr. Arshinoff and Dr. Güell noted there are some patients who would definitely not be candidates for bilateral surgery. John Kanellopoulos, MD, Athens, Greece, and Doyle Stulting, MD, PhD, Atlanta, Ga., U.S., discussed the indications for crosslinking for forme fruste kerato- conus (FFKC). Both agreed that FFKC is confusing in the way it is defined. But D . Stulting pointed out that FFKC is a benign condition. The frequency of progression to keratoconus and visual loss is un- known, so there is time to monitor for progression without potential for visual loss. The complication rate from crosslinking is high enough to justify waiting for progression before recommending treatment, Dr. Stulting said. Oliver Findl, MD, Vienna, Austria, and Douglas D. Koch, MD, Houston, Texas, U.S., presented on the topic of correcting low astigma- tism in cataract surgery. Dr. Findl argued against using a laser in these cases and in favor of using an IOL. Meanwhile, Dr. Koch argued in favor of using a laser for low astigma- tism, noting that it is safe, effective, cheaper in the long term, and faster. It is also the future, he added. View it now: ESCRS 2014 ... EWrePlay.org Graham Barrett, MD, describes toriCAM, a free app for toric IOL alignment.