Eyeworld

EW NEWS & OPINION 24 October 2016 Chief medical editor's corner of the world and myopic astigmatism. My innate sense of optimism predicts that many of these new technologies will change the way we practice, improve outcomes, and increase patient satisfaction. We are a specialty driven by technology, and technology is certainly alive and well in ophthalmology. Between meetings, we can com- municate, connect, and learn thanks to email, phones, the internet, and digital education. But nothing compares to visiting a new city, reconnecting with colleagues over dinner, and being surrounded by the buzz on the convention center floor. While I'm more than ready for Chi- cago and the AAO annual meeting, I've already started anticipating Los Angeles in the spring for the 2017 ASCRS•ASOA Symposium & Con- gress, and I hope you have, too. EW Editors' note: Dr. Donnenfeld has financial interests with Abbott Medi- cal Optics, Alcon (Fort Worth, Texas), Allergan, Bausch + Lomb (Bridgewater, New Jersey), and Shire. Contact information Donnenfeld: ericdonnenfeld@gmail.com by Eric Donnenfeld, MD, EyeWorld chief medical editor (Transcend Medical, Menlo Park, California) and the AqueSys XEN Gel Stent (Allergan, Dublin) to perform microinvasive ab-interno filtering blebs. There has not been a new therapeutic agent for dry eye in more than a decade since the launch of Restasis (cyclosporine, Allergan), and this past summer the FDA approved Xiidra (lifitegrast, Shire, Lexington, Massachusetts), and we are at the precipice of launching the first device for the treatment of dry eye, Oculeve (Allergan), which cre- ates new tears through nasal stimu- lation. Two corneal inlays, KAMRA (AcuFocus, Irvine, California) and Raindrop (ReVision Optics, Lake For- est, California), now offer a new op- tion for the treatment of presbyopia. To complete my list, we have three new refractive corneal procedures, topographic laser ablations that can transform irregular corneas such as keratoconic eyes into more regular refracting surfaces, iDesign (Abbott Medical Optics, Abbott Park, Illinois) wavefront ablations that improve our ability to treat refractive error, and the SMILE procedure, which eliminates the excimer laser to perform small incision femtosecond lenticule removal to correct myopia practice continues to make the final payments for an extinct procedure that will never again see the light of day. Sometimes I look around at my junkyard of discarded technology and I cannot help but ask myself, "What was I thinking?" This year, as I prepare my talks and look forward to seeing old friends, I have a sense of giddiness that a generation ago I used to feel around my birthday and the holidays. I cannot recall a time in ophthalmology when there was more excitement about so many new technologies, in so many sub- specialties. I cannot do justice to all of them, but off the top of my head, the bedrock of ophthalmology— cataract surgery and femtosecond laser cataract surgery—continues to improve. We are launching a new class of presbyopic IOLs that are extended depth of focus and appear to be more forgiving of residual refractive error and quality of vision than most multifocal IOLs. We have not had a new MIGS device for com- prehensive cataract surgeons since the iStent (Glaukos, Laguna Hills, California), and now we are expect- ing a new device virtually every year starting with the CyPass Micro-Stent Annual meetings are invigorating thanks to good colleagues, exciting new technologies, and interesting cities T his month I expect that many of us will be attend- ing the American Academy of Ophthalmology (AAO) annual meeting. I always enjoy attending major meetings like those of the AAO, the Association for Research in Vision and Oph- thalmology (ARVO), and especially the American Society of Cataract and Refractive Surgery (ASCRS). I feel like the proverbial kid in the candy store, surrounded by all the exciting advances in ophthalmol- ogy. These major meetings include the unveiling of new technology, pharmacology, and procedures. We are invited to see what is recently approved or about to become avail- able, and sometimes we even get to look down the pipeline into the future. We hear from experts who have been involved in the develop- ment and clinical trials of these new areas of interest. Often, we can visit companies' booths to get hands-on experience with the latest technol- ogies. The new pharmaceuticals, surgical devices, and procedures create extraordinary possibilities and opportunities to improve the care we provide to our patients. I return home revitalized, and brimming with optimism and enthusiasm about the future of our specialty. However, my enthusiasm is always tempered by previous experi- ences with what has been touted as new and improved. We still have to sort out the hype from the real McCoy or caveat emptor (let the buyer beware). It seems for every successful new technology, there is a dud. My office is littered with old technology that serves as giant paperweight testimonials to my gullibility and poor judgment. These relics gather dust like some prehistoric dinosaur skeleton as my Being there Eric Donnenfeld, MD, chief medical editor

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