EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/78716
March 2012 Refractive February 2011 EW FEATURE 83 are taken while a patient is sitting, but the patient is ultimately treated while lying on the operating table. "Therefore we have issues of cy- clorotation, different pupillary dila- tion status, and a potential shift of the visual axis," Dr. Kanellopolous said. "The [issue] in my mind going into anything customized is that you're increasing the risks of creat- ing a bigger problem than the prob- lem you are trying to treat." The next step Investigators now are trying to marry the advantages of both the wavefront- and topography-guided systems. "It's called ray tracing, where they include topographic data, wavefront data, and axial length data, and anticipated tissue response to the treatment into an extremely calculated formula," Dr. Kanellopolous said. "This is not yet commercially available, but I think it will be toward the end of 2012 as a one-box machine that will be able to give you all these measurements together and give you more elegant topography and wavefront." In Europe, surgeons are using the fourth generation of the Wavelight platform called Vario, which incorporates different pupil sizes on the topography and trans- fers that data for the laser to use. Iris recognition and limbal anatomy also are used as landmarks to perform the treatment, as well as correct for cyclorotation. "We're seeing very good results with this, but I have to mention that it's extremely rare that cyclorotation is a big issue," Dr. Kanellopolous cautioned. For improvements, Dr. Probst said the tracking on the excimer lasers could be better. "They are designed to work on the reflecting surface of the cornea, but not on the bed of a LASIK flap," he said, adding that he would also like to see a higher tracking speed and a better way to use the LASIK interface. Dr. Goldman said wavefront- guided and wavefront-optimized platforms are top-notch today. "We've already raised the bar so high with what we can do, which is a great thing, but we're always look- ing for more improvement. The Whether you're just beginning or experienced in cataract and refractive surgery, ASCRS is the professional society that's right for every stage of your career. Young Ophthalmologists & Residents When you're the newest member of the team, things can be a little overwhelming. ASCRS can help with the transition. Our monthly Journal of Cataract and Refractive Surgery, Annual Symposium, and online educational initiatives work to continuously augment your formal training. Through them you'll meet like-minded young ophthalmologists facing similar challenges and concerns, along with those who've successfully navigated the waters and can provide the guidance to answer your clinical, financial, and practice management questions. For young practitioners, ASCRS is where the anterior segment ophthalmology community comes together. ASCRS offers U.S. residents and fellows an unmatched opportunity to experience anterior segment ophthalmology beyond your training program—all at no cost! Resident and fellow membership, which includes the Annual Symposium, is free during your training. ASCRS makes it easy to gain real-world experience and education with no added cost. Join ASCRS today! The Society for Surgeons AMERICAN SOCIETY OF CATARACT AND REFRACTIVE SURGERY 4000 Legato Road, Suite 700, Fairfax, VA 22033 • 703-591-2220 • www.ASCRS.org ways of us improving are faster lasers, faster capture rates, and smoother ablations." EW Editors' note: Dr. Goldman has no financial interests related to this article. Dr. Kanellopoulos has financial interests with Alcon. Dr. Probst has financial interests with AMO. Contact information Goldman: 561-515-1543, dgoldman@med.miami.edu Probst: 708-562-2020 Kanellopoulos: +30-210-74-7277, ajk@laservision.gr An ASCRS Membership For every stage of your career