EyeWorld Asia-Pacific June 2011 Issue

47 EW NEWS & OPINION June 2011 7. The Light Adjustable Lens (LAL, Calhoun Vision, Pasadena, Calif., USA) provides accurate post-op refractive outcomes, partly by ensuring proper pupil centration. The “perils of the pupil,” said R. Doyle Stulting, MD, Woolfson Eye Institute, Atlanta, Ga., USA, include the fact that the axis of the best-fit ellipse changes with lighting. 8. Monovision can reduce contrast sensitivity and stereoacuity and cause asthenopia through binocular rivalry; however, said Graham Barrett, MD, associate professor, Lions Eye Institute and Sir Charles Gairdner Hospital, Australia, limiting myopic defocus to 1.5 D avoids these problems. He also recommends prioritizing distance vision, i.e., aiming for emmetropia in the distance eye. Other issues affecting patient satisfaction are easily dealt with; managing expectations and prioritizing distance vision generally helps. 9. NuLens (Herzliya Pituach, Israel) uses the mechanics of the collapsed capsular bag to provide accommodation, said Jorge Alio, MD, Miguel Hernandez University, Alicante, Spain. A 100-micron variation achieves about 7 D of accommodation. In his experience, the NuLens can restore functional vision to legally blind patients. 10. Okihiro Nishi, MD, and his colleagues at Nishi Eye Hospital, Osaka, Japan, have developed an accommodating membrane IOL consisting of two artificial membranes that are used to seal the anterior and posterior capsulorhexes. Silicone liquid is then injected into the bag. Implantation, said Dr. Nishi, takes 20-30 minutes. The current design, he added, has solved the problem of leakage, and the anterior and posterior rhexes circumvent capsular opacification. 11. The restoration of accommodation using a femtosecond laser to “soften” the hardened presbyopic lens is theoretically possible, said Ronald Krueger, MD, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA. However, he and his colleagues have yet to prove it, having performed the procedure in 16 patients so far. 12. Bringing the symposium round full circle, Glauco Reggiani Mello, MD, Cole Eye Institute, said that the “best candidate” for managing presbyopia is manipulation of spherical aberration to expand depth of focus; however, the ideal magnitude of aberration is unknown. The solution may be to customize treatment using an adaptive optics visual simulator. EW Editors’ note: This article is a modified and extended version of reportage included in the EyeWorld US ASCRS 2011 Meeting Reporter, published May 2011. Dr. Alio has a financial interest in NuLens. Dr. Barrett has financial interests in Bausch & Lomb (Rochester, NY, USA) and Hoya (Santa Clara, Calif., USA). Dr. Carrizzo has no financial interests related to his topic. Dr. Findl has financial interests in several ophthalmic companies, including Abbott Medical Optics (Santa Ana, Calif., USA) and Alcon (Fort Worth, Texas, USA/ Hünenberg, Switzerland). Dr. Izquierdo has financial interests in NeoVista (Newark, Calif., USA) and NuLens. Dr. Krueger has a financial interest in LensAR (Winter Park, Fla., USA). Dr. Mello has no financial interests related to his topic. Dr. Nishi helped develop the bag-filling accommodative membrane IOL he described. Dr. Reinstein has a financial interest in Carl Zeiss Meditec (Dublin, Calif., USA/Jena, Germany). Dr. Steinert has a financial interest in ReVision Optics. Dr. Stulting has a financial interest in Calhoun Vision. Dr. Yeoh has a financial interest in Alcon.