SEP 2012

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

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September 2012 EW CATARACT 41 those ranges to be in the "gray area," where some are just as likely to be satisfied as dissatisfied. Dr. Pepose said a simple way to understand the importance of HOAs is that each of the polynomial equa- tions mathematically describes a different component of the shape of the wavefront, which are then math- ematically combined to describe the entire three-dimensional shape. The second order Zernike describes astigmatism and defocus, while the 3rd order describes coma and trefoil, he said. "When you examine the Zernike pyramid, anything that's in the center will generally have a far more negative impact on visual im- aging than those on the periphery," Dr. Pepose said. "Coma is in the center, so for me, that's much more visually significant than if the patient has trefoil, for example." Dr. Michelson added a second study he co-authored with Rory A. Myer, M.D., found that "pre-opera- tive topography may be able to pre- dict a patient's ability to pseudoaccommodate with an as- pheric lens." For practices without a topogra- phy instrument capable of deriving a corneal wavefront, Dr. Pepose suggested the VOL-Pro (Sarver & Associates, Carbondale, Ill.), a software program that can be used to convert the topographic informa- tion from any topography system into corneal wavefront data. "The software lets you input data from any topographer and then constructs a corneal wavefront map for you," Dr. Pepose said, adding he has no financial interests in the program. The bottom line? "We can now have a higher level of confidence about which patients are going to be satisfied with a multifocal lens," Dr. Michelson said. "And that, in turn, reduces patient dissatisfaction levels as well as chair time." EW References 1. Michelson MA, Myers RA. Corneal Higher Order Aberrations and Visual Dysfunction With Multifocal IOLs. Paper presented at: American Society of Cataract & Refractive Surgery. 2012: Chicago . 2. Rocha KM, Nose W, Bottos K, Bottos J, Morimoto L, Soriano E. Higher-order aberrations of age-related cataract. J Cataract Refract Surg. 2007;33(8): 1442-6. 3. Tong N, He JC, Lu F, Wang Q, Qu J, Zhao YE. Changes in corneal wavefront aberrations in microincision and small-incision cataract surgery. J Cataract Refract Surg. 2008; 34:2085-90. 4. Varavka A, Kachanov A, Nikulin S, Chruakov T. Clinical aberrometry and lens pathology. Paper presented at: European Society of Cataract & Refractive Surgeons. 2012: Milan. Editors' note: Dr. Michelson has finan- cial interests with Alcon (Fort Worth, Texas) and Oculus (Lynnwood, Wash.). Dr. Pepose has financial interests with Abbott Medical Optics (Santa Ana, Calif.) and B+L. Contact information Michelson: 205-969-8100, mmichel325@aol.com Pepose: 636-728-0111, jpepose@peposevision.com OVER 34 MILLION AMERICANS And they are walking into your practice everyday HAVE HEARING LOSS Increase Your Bottom Line ADD A HEARING CENTER TO YOUR PRACTICE A program designed to generate incremental sales Easy: Minimal eơort required from Physicians and staơ. No hiring, staƥng, ordering or other tasks. Avada does that for you. Simple Integration: Avada provides a seamless integration designed to flow with your current practice. To learn about the potential sales impact to your practice, call us today. 1-888-982-8232 Avada Hearing Care Partnering Vision & Hearing © 2012 Hearing Healthcare Management, Inc.

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