Eyeworld

MAR 2012

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

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42 EW ASCRS PREVIEW March 2012 April 20-24, 2012 In the eye of the innovator by Maxine Lipner Senior EyeWorld Contributing Editor Institute, Baylor College of Medi- cine, Houston, whose address is titled "Corneal Optics for IOL Selection—Cracking the Code." "I'm absolutely blown away to Douglas D. Koch, M.D. Douglas D. Koch, M.D., takes the honorary reins I t's one of the ASCRS•ASOA Symposium & Congress high- lights—the Charles D. Kelman Innovator's Lecture, offered up to those elite few who are held in the highest esteem for help- ing to bring ophthalmology to an- other level. The 2012 honor goes to Douglas D. Koch, M.D., professor and the Allen, Mosbacher, and Law Chair in ophthalmology, Cullen Eye be included with the other people who have given this lecture," Dr. Koch said. During this year's talk, which will be presented on Monday, April 23, from 10-11:30 a.m. at the McCormick Place West Convention Center, Dr. Koch will not only touch on post-refractive IOL calculations, but he will also highlight other areas as well. "I think that the topic is mature in the sense that there are no breakthroughs right there in front of us; however, I do have some things that I want to mention that I think are going to be helpful in that area," Dr. Koch said. "I'm also going to focus on some new work that I've done looking at the posterior corneal surface and its role in deter- mining the appropriate astigmatic power of toric IOLs." Specifically, he hopes to delve into why the poste- rior plays a much larger role in toric IOL selection than previously be- lieved and why it should be appreci- ated. New nomogram Dr. Koch plans to offer new help in this regard. "I'm going to propose a new toric IOL nomogram that is dif- ferent than what is currently done," he said. "Currently toric IOL nomo- grams are based on anterior corneal curvature only, and my finding is that the posterior cornea is steep vertically, and because the posterior cornea is a minus lens, being steep vertically means that it creates net plus power along the horizontal meridian." This contributes to the against-the-rule astigmatism and is pivotal in ascertaining the correct power. "If you treat patients who have with-the-rule astigmatism with a full strength toric IOL, you will often overcorrect them because the posterior cornea will contribute to the against-the-rule change," Dr. Koch said. Dr. Koch hopes that practition- ers will come away from this year's Innovator's Lecture reflecting on some of the complexities and ambi- guities in these calculations. "I hope that it will help them understand a little bit more about the role of the cornea and how we can leverage the knowledge that we have to better se- lect IOL power in refractive surgical patients and certainly in toric IOLs," he said. "I would also like to give them more insight on how they might educate patients in various situations about the role of the cornea and some of the things that we still need to learn or do better in understanding the cornea." In addi- tion to better educating patients, he thinks that it will give them more realistic expectations. Dr. Koch is honored to have joined the esteemed ranks of ASCRS innovators. He hopes that when he eventually draws his career to a close, he will be thought of as some- one who encountered problems and worked hard to improve patient outcomes in the clinic, as well as through other endeavors such as his work on the Journal of Cataract & Refractive Surgery. Overall, he credits ASCRS as of- fering an environment conducive for success. "The whole spirit and mentality of ASCRS fosters all kinds of work that this and the other lec- tures do," he said. "It has always been such a unique society in that regard—one of the great fortunes in my career has been to be a member of ASCRS and benefit from all that it brings to the field." EW Editors' note: Dr. Koch has no financial interests related to this article. Contact information Koch: 713-798-6443, dkoch@bcm.edu Cloud Gate, the metal sculpture by Indian-born British artist Anish Kapoor that has acquired the nickname "The Bean," is the centerpiece of Milliennium Park. It is comprised of 110 short tons of steel and expected to survive for 1,000 years Source: Explore Chicago

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