Eyeworld

EW MEETING REPORTER 120 Reporting from the 2016 World Ophthalmology Congress, February 5–9, Guadalajara, Mexico ABBOTT LOGO FOR MR Reporting from the 2016 World Ophthalmology Congress, February 5–9, Guadalajara, Mexico Reporting from the 2016 World Ophthalmology Congress Surgeons must weigh RLE pros and cons, consider patient selection Refractive lens exchange (RLE) can have good outcomes if surgeons carefully select patients, said physi- cians presenting at "Refractive Lens Exchange: Indications, Limitations and Outcomes." "The role of the surgeon is key to patient satisfaction, and surgeons must rely on clinical judgment," said Cecilio Velasco Barona, MD, Mexico City. Although RLE can be successful, it's better to consider it an alterna- tive to corneal refractive surgery rather than a primary procedure, said Jorge Alió, MD, Alicante, Spain. Refractive lens exchange can be risk- ier and have less precise outcomes, he explained. Dr. Alió discussed RLE in a variety of patient circumstances, including myopia, hyperopia, and astigmatism. Sheraz Daya, MD, London, focused on RLE for patients age 55 and over; the use of RLE in patients age 30 to 50 is more controversial, he said. One major reason is that you may be removing a patient's intact visual optics. "If you take a good set of visual optics and destroy them, the patient won't forgive you," he said. Options he considers more frequently in younger patients are laser in situ keratomileusis (LASIK), phakic IOLs, and Supracor LASIK. Another consideration is that endophthalmitis, cystoid macular edema, and retinal detachment (RD) all can be more common in the 30- to 50-year-old age group. Some factors to consider with the risk for RD include a longer axial length, myopia, and surgical complications, Dr. Daya said. George Beiko, MD, St. Cath- arines, Canada, reviewed how he chooses IOLs in RLE patients. In patients under the age of 50 who are ametropic, he prefers to use phakic IOLs such as the Artisan (Ophtec, Groningen, the Netherlands) or per- form RLE if the patient needs only a +1, +2, or +3 D lens. In patients older than 50 who are ametropic or presbyopic, he uses the Tecnis (Abbott Medical Optics, Abbott Park, Ill.), enVista (Bausch + Lomb, Bridgewater, N.J.), or the Tecnis multifocal. He also uses phakic March 2016 continued on page 122

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