EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/618732
EW FEATURE 42 Management of the irregular cornea • January 2016 AT A GLANCE by Vanessa Caceres EyeWorld Contributing Writer • An improved aberrometer that can benefit refractive treatment for irregular corneas was approved by the U.S. FDA in May 2015. • Advantages of this aberrometer include more precise image capture, greater resolution, and more personalized treatment. • Many patients could benefit from use of the aberrometer during refractive surgery, but the patient must first be a candidate for excimer laser treatment. Not all patients with irregular corneas fit into this category. • The new aberrometer is used outside the U.S. in keratoconus patients but cannot be used in the U.S. for this purpose. iDesign targets more accurate image capture for better outcomes P atients with irregular corneas may be a relative- ly small group, but their treatment during refractive surgery can be challenging. One key to better treatment is getting the best measurements pos- sible before excimer laser use. "Any technology that helps surgeons detect or measure each level of refractive aberration will make their "The iDesign has significantly greater resolution—about 5 times— compared to the WaveScan [Abbott Medical Optics]," said Edward E. Manche, MD, professor of ophthal- mology, Stanford University School of Medicine, and director of cornea and refractive surgery, Stanford Ill.), which was approved by the U.S. Food and Drug Administration (FDA) in May 2015. The iDesign has a number of advantages that make the technol- ogy particularly useful for irregular corneas. 1–3 Eyeing more precise treatment for irregular corneas Monthly Pulse Management of the irregular cornea T his month we asked physicians about "Management of the irregular cornea." When asked what the most important aspect of topographic ablations is, more than 93% said, "A stable tear film and ocular surface." We asked, "Which of the following is not helpful in treating an irregular cornea?" Almost half of the respondents chose, "Optimized ablations." Treatment of irregular corneas with the excimer laser will often be combined with riboflavin UV crosslinking, according to 68% of respondents. Finally, treatment of irregular corneas with the topographic and advanced wavefront laser will often be performed by PRK, according to more than 62% of respondents. treatment outcome that much more superior," said Arun C. Gulani, MD, Jacksonville, Fla. One new technical advance assisting surgeons in the treatment of irregular corneas is the iDesign Advanced WaveScan aberrometer (Abbott Medical Optics, Abbott Park, S/P herpes, deep and excavated corneal scar corrected with VISX laser in PRK mode Source: Arun Gulani, MD Preop Postop