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73 EW RETINA December 2016 study. Ophthalmology. 2015;122:2179–85. 4. Day AC, et al. United Kingdom National Ophthalmology Database Study of Cataract Surgery: Report 3: pseudophakic retinal de- tachment. Ophthalmology. 2016;123:1711–5. Editors' note: Dr. de la Cour has no financial interests related to his comments. Contact information de la Cour: m.la.cour@dadlnet.dk public hospitals and private hospitals/clinics in Denmark between 2004 and 2012. Acta Ophthalmol. 2015;93:16–23. 3. Daien V, et al. Incidence, risk factors, and impact of age on retinal detachment after cat- aract surgery in France: A national population Dr. la Cour cited the results of a large French register study, 3 in which the incidence, risk factors, and impact of age on retinal detachment after cataract surgery was investigat- ed in 1.7 million individuals. The study used the general population as a control within a 4-year time frame, finding that the risk for RD was 1% after about 4 years. The risk of RD was increased from the gen- eral population by a factor of about four, which mirrors Dr. de la Cour's findings. The study also corroborates the age effect, showing a significant increased risk of pseudophakic RD in young individuals. Risk factors iden- tified were highly myopic eyes and anterior vitrectomized eyes in cases of capsular rupture. After 4 years, the risk of pseudophakic RD was around 8% to 10%, a marked risk increase. A study that looked at RD risk after complicated surgery revealed a higher risk of RD and also early RD after posterior capsular rupture. 4 Dr. de la Cour said, "The risk of posteri- or capsular rupture is relatively low. We tend to blame the surgeon if it happens. Posterior capsule ruptures occur in roughly 2% of cases. How- ever, the application of intravitreal anti-VEGF injections vastly increases the risk of a posterior capsule rup- ture. After 10 injections you may al- ready have a risk of posterior capsule rupture of a factor of three. "I think it is misleading to describe the risk of pRD in a fixed percentage without taking the time dimension and the inherent risk of the operated eye into consideration. The rate is shifted upward, so the increased risk is dependent on how much time passes. This means, for instance, in a 40-year-old male with a prior RD in his fellow eye who has a native RD risk of 1.5% per year, cataract surgery increases this risk to 6% per year, which is significant. But in an older female patient who has a risk of RD of 0.001% per year, cataract operation increases this risk to 0.004% per year." EW References 1. Boberg-Ans G, et al. Longterm incidence of rhegmatogenous retinal detachment and survival in a defined population undergoing standardized phacoemulsification surgery. Acta Ophthalmol Scand. 2006;84:613–18. 2. Solborg Bjerrum S, et al. Epidemiology of 411,140 cataract operations performed in 888-myLENSTAR myLENSTAR.com © 2016 Haag-Streit USA. All Rights Reserved. LENSTAR LS 900 is the only biometer that seamlessly integrates all the necessary components for 21st century IOL power and toric calculations. - Michael E. Snyder, MD Exclusive Rights To The Hill-RBF Method LENSTAR LS 900 is the only biometer that has this innovative technology built in.* Barrett & Olsen Formulas on Board Measured lens thickness and two of the latest generation multivariable IOL formulas allow for IOL power prediction with the LENSTAR. T-Cone Toric Platform The optional T-Cone complements LENSTAR'S measurement pallet with true Placido topography of the central cornea along with a powerful surgical planner using the Barrett toric calculator. EyeSuite IOL Toric Planner The optional IOL Toric Planner allows optimization of the incision location and planning of the surgery on real eye images to reach advanced refractive results. *The Hill-RBF Method is available on the Lenstar LS 900 Pro and LS 900 Pro with APS models. "The Lenstar puts everything I need at my fingertips with one device. It's the only biometer that has the Hill-RBF seamlessly integrated into its software. The accuracy of the built-in Barrett and Olsen IOL calculation formulas vastly surpasses the pre-millennium formulas used in other biometers. And its T-Cone topography permits rapid assessment of the relative regularity of the cornea and tear film, crucial for screening and managing premium IOL candidates." - Michael E. Snyder, MD See it at Hawaiian Eye Booth #309

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