Eyeworld

EW CATARACT 24 Cataract editor's corner of the world W hen I started doing cataract surgery 20 years ago, I wish I had had a crystal ball to foresee the future of technological innovation and advancements within this field. I probably would have invested a little more wisely. But nonetheless, cataract surgery and IOL technology have advanced leaps and bounds over the last 10–20 years and are continuing to do so at tremendous speed. Before Bonnie An Henderson, MD, gave up the reins as EyeWorld cataract editor, she came up with the idea for this article, "The future of cataract surgery." I hope she reads it and invests wisely. It is definitely an interesting time in cataract removal and IOL technology, and it will be even more interesting in the next 10–20 years, as our experts share their thoughts on potential hot topics. Rosa Braga-Mele, MD, MEd, FRCSC, cataract editor by Ellen Stodola EyeWorld Staff Writer June 2015 The future of cataract surgery AcrySof Toric IOL Source: Alcon Tecnis Toric IOL Source: Abbott Medical Optics Trulign Toric IOL Source: Bausch + Lomb STAAR Toric IOL Source: STAAR Surgical Two surgeons comment on changes in cataract surgery and what they see for the future C ataract surgery has seen many advances over the past several decades, and it continues to move forward with new technologies and techniques. Richard Hoffman, MD, clinical associate professor, Casey Eye Institute, Oregon Health & Sci- ence University, Eugene, Ore., and Susan MacDonald, MD, assistant professor, Tufts School of Medicine, and director of comprehensive ophthalmology, Lahey Clinic, Burlington, Mass., commented on the current state of cataract surgery and what they see in the future of the field. The next big area of advancement IOL technology is a hot topic in the field, with a number of IOLs avail- able for use in the U.S., and even more coming to market internation- ally. Dr. Hoffman hopes for toric continued on page 26 multifocal IOLs to be widely avail- able soon in the U.S., and is also hoping for a truly accommodative IOL that has no optical aberrations, which is not yet available. Similarly, Dr. MacDonald said that IOLs are a major focus, specifi- cally the problem of dislocated IOLs. "These dislocations will contin- ue to present," she said. "Finding a stable solution with limited compli- cations would be extremely helpful. I am looking forward to the FDA approval of iris-fixated AC IOLs. " Dr. MacDonald thinks there will be amazing smart IOLs developed in the future. "We will have intraocular lenses that will have cameras, data storage, and the ability to monitor intraoc- ular pressure and possibly deliver drugs," she said. "I think we will be able to connect our smart IOL with our smartphones, watches, tablets, and computers." There will also likely be opportunities to take photos and video with IOLs and to monitor IOP and retinal pathology and deliver medicine from the IOL implant, she said. Dr. Hoffman thinks that the Calhoun Vision Light Adjustable Lens (Pasadena, Calif.) is an interest- ing new technology, but he is unsure if it will catch on due to the labor required following implantation for the patient's maximum benefit. "I think the autofocus technolo- gy is fascinating, but I believe it has been placed on the shelf for now and will probably never make it to market," he said. "I believe mul- tifocal IOL technology has major advantages over multifocal corneal procedures and will be the technol- ogy of choice for presbyopia correc- tion for the foreseeable future." Future of peri- and postoperative medications "Intraocular/intracameral injection of steroids, antibiotics, and perhaps nonsteroidals will be the future of postoperative medications," Dr. Hoffman said. "We will pretreat the patients in the holding area and inject medications into the vitreous following the cataract operation, and patients will no longer be

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