Eyeworld

EW NEWS & OPINION 23 In memoriam: Endre A. Balazs, MD A SCRS Hall of Fame member Endre A. Balazs, MD, passed away on August 29. Dr. Balazs distinguished himself through pioneering research on the structure and biological activity of hyaluronan, a viscoelastic polysaccharide present in all tissues of the human body but in large amounts in the vitreous of the eye and the soft tissues of joints and skin. "The concept of viscosurgery was born from his seminal work on hyaluronan," said Stephen Obstbaum, MD, New York. "Sodium hyaluronate made the uncomplicated case of cataract surgery with intraocular lens implantation a safe and predictable event, while surgery on the challenging case also benefitted by utilizing the unique physicomechanical characteristics of this agent." Dr. Balazs received his medical degree from the University of Budapest in 1942 and began his research career in the university's Department of Histology and Embryology. In 1951, at the invitation of Harvard Medical School, Dr. Balazs moved to Boston to set up the research laboratories and organize the Retina Foundation. He co- founded the Boston Biomedical Research Institute. In 1962, on Dr. Balazs' initiative, Experimental Eye Research, the first international eye research journal, was started. Dr. Balazs was the editor in chief until 1991. He also initiated and co-founded the International Society for Eye Research. Dr. Balazs was recipient of the Friedenwald Award from the Association for Research in Vision and Ophthalmology (1963), the Cornelius D. Binkhorst Medal from ASCRS (1986), and the Distinguished Alumni Award from the Schepens Eye Research Institute (2008). EW September 2015 their astigmatism in much the same way as a pair of glasses and allevi- ates the need for distance glasses for most, if not all, distance activ- ities. I discuss that depending on how much astigmatism they have, a small glasses correction may be necessary for perfect distance vision. Occasionally the lens may need to be readjusted if it is not perfectly aligned with the patient's astigma- tism, although I use intraoperative measurements to assure I have placed the lens in the proper posi- tion to correct their astigmatism. I stress that the toric implant will not take away the need for reading glass- es, and they should expect to wear glasses for all intermediate and near activities. In addition, I explain that should they choose the standard lens they will still be able to see well at distance but will always require glasses to do so. I explain that in my opinion the quality of vision with correction of the astigmatism intraocularly results in a better image quality than with glasses. Ultimately, the choice comes down to whether or not they want to have great vision with or without a pair of glasses. I further clarify that this is an elective procedure and is considered to be cosmetic for most insurance companies; therefore, they will not be reimbursed for this lens. Lastly and perhaps most importantly, I am careful to reassure patients that the surgical technique and quality of the implant is the same no matter which procedure they choose and that they will enjoy improvement of their vision. EW Editors' note: The physicians have no financial interests related to this article. Contact information Arbisser: drlisa@arbisser.com Coles: nancyhcolesmd@aol.com Davison: jdavison@wolfeclinic.com Figure 1. Large model showing the cornea and lens as sources of astigmatism Figure 2. Dave Taylor, COT, demonstrates that opposing 90 degree karate chops neutralize refractive cylinder. Source: James Davison, MD

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