APACRS 2021 Daily News (Saturday, 31 July 2021)

SNEC Symposium: Preparing for the New Wave in Optometry On Friday, 30 July 2021 , the 33rd APACRS–SNEC 30th Anniversary International Meeting held several Master- Classes and SNEC Instruction Courses on the first day of its scientific program. In an 85-minute SNEC Symposium, eye care leaders pre- sented on toric intraocular lenses (IOLs), the role of op- tometrists in advanced eye care systems, pseudophakia, phakic intraocular lenses, and ocular surface disease. Daniel Chua, MD, Singapore, discussed the many factors that must be considered when using toric IOLs in astig- matic patients. With the aim of decreasing postoperative astigmatism when using toric IOLs, Dr. Chua believes that outcomes are very good with significant improvement in visual acuity for many patients who opt for toric IOLs. Koh Lian Buck, MD, Singapore, expressed the importance of counseling cataract and refractive patients on expected outcomes, post-surgery aftercare, managing presbyopic symptoms, and continual screening for ocular diseases. Especially during the pandemic, it is important to conduct community eye screening before escalating a patient to surgical care and to determine whether worsening eyesight is due to a cataract or a work-from-home situation. Ryan Tay, OD, Singapore, provided an overview on differ- ent intraocular lens (IOL) types, stating that “the future will see new iterations of IOLs.” Multifocal IOLs can provide a patient with both distance and near focus in the same lens. The optical design for multiple optical zones within this IOL usually results in side effects of halos from multifocality; however, with proper counseling, a significant number of patients are happy with multifocal IOLs. With accommo- dative IOLs, movable haptics dynamically shift a single optical focus. Extended depth of focus (EDOF) IOLs also provide multiple optical zones by using diffractive optics to create elongated focus which provides good distance and intermediate vision. When determining which IOL to use for a patient, it is crucial to take a comprehensive case history that includes past eye surgical history and current vision problems. Mohamad Rosman, MBBS, MMed (Ophth), FRCSEd (Ophth), FAMS, Singapore, introduced phakic IOLS (pIOLs), describing three types: anterior chamber, iris-fixated, and posterior-chamber pIOLs. Due to long-term complications of angle-fixated and iris-fixated IOLs (endothelial cell loss), the primary pIOL in use currently are posterior chamber pIOLs. Endothelial cell loss with posterior chamber pIOLs does occur but at a lower rate of about 5% in 12 months and stabilizes in the long term. Jean Chai, MD, Singapore, presented on ocular surface disease in cataract and refractive surgery, suggesting that these surgeries can worsen dry eye disease (DED) through corneal nerve disruption, tear instability, Meibomian gland dysfunction, and inflammation. In a patient with dry eyes, ocular surgery may be deferred until the corneal surface is stabilized. Operative considerations such as SMILE or advanced surface ablation may be better in dry eyes compared to femtosecond LASIK. Getting a proper pre- operative assessment is important and performing a slit lamp exam, fluorescein staining, corneal staining, and tear break-up time assessments will lead to better outcomes for patients. Asia-Pacific Association of Cataract & Refractive Surgeons Saturday, 31 July 2021 EWAP Daily News - 1