EyeWorld Asia-Pacific September 2012 Issue

September 2012 60 EWAP MEEting REPoRt “I hope femtos will one day be easy to use under the same microscope as phaco and become maneuver-specific and reasonably cheap,” Dr. Arshinoff said. He also said he hopes femto technology will become adaptable to remote area surgery and make surgery time shorter, not longer. “I want them to make me feel like my surgical art has been enhanced, so that I will still love to do it,” Dr. Arshinoff said. Editors’ note: Prof. Dick has financial interests with Abbott Medical Optics (AMO, Santa Ana, Calif., USA), Novartis (Basel, Switzerland), OptiMedica (Sunnyvale, Calif., USA), and Bausch + Lomb (Rochester, NY, USA). Dr. Arshinoff has financial interests with Alcon (Fort Worth, Texas, USA/Hünenberg, Switzerland), AMO, and B+L. The other physicians had no financial interests to report. Day 3 The Congress opened Monday, 10 September 2012, with the well- attended Combined Symposium of Cataract and Refractive Societies (CSCRS). Surgeons from Europe, Asia-Pacific, Latin America, and North America discussed vision and optical quality after anterior segment surgery, refractive corneal surgery, monofocal and multifocal IOLs, and keratoplasty. New monofocal IOL Graham D. Barrett , FRACO , president of APACRS, Perth, Australia, gave attendees the latest information about a new monofocal IOL designed to extend depth of focus and enhance modest monovision. A new clinical study on the extended depth of focus (EDF) IOL began in February, with results showing that a patient gains 1-2 lines of focus with the lens, Prof. Barrett said. The lens, which was previously tested in an eye model and compared to spherical, aberration-free, and multifocal IOLs, preserves stereoacuity and enhances functional near vision when combined with modest monovision, Prof. Barrett said. The new IOL provides an additional 1 D depth of focus compared to a standard negative aspheric monofocal IOL, but still meets the ANSI and ISO standards for optical quality required for a monofocal IOL, he said. A 1-month test with the Salzburg Reading Desk showed functional near and intermediate reading vision, Prof. Barrett added. Editors’ note: Prof. Barrett has no related financial interests. AC-supported phakic IOL High myopes experience improved quality of vision and increased point-spread function (PSF) under mesopic conditions after being implanted with an angle-supported phakic IOL, according to an ESCRS speaker. Implantation of the lens also induced negative spherical aberration, said Simonetta Morselli, MD , Verona, Italy. Dr. Morselli and colleagues measured quality of vision and visual outcomes after implantation of the lens by using aberrometry data in a nonrandomized cohort study in which 35 eyes with high myopia were implanted with the AcrySof Cachet angle-supported PIOL (Alcon). The mean total spherical aberration Z(4,0) was −0.001±0.076 µm pre-op and −0.13±0.11 µm post-op (P ≤ 0.05). The mean PSF was 0.28±0.15 pre-op and 0.34±0.16 post-op (P<0.05), according to the study abstract. The data is in press for the Journal of Cataract & Refractive Surgery. “This phakic IOL induces negative spherical aberration, thereby reducing positive ocular spherical aberration,” Dr. Morselli said. Editors’ note: Dr. Morselli has no related financial interests. Femto incisions in PK Though a femtosecond laser has an “almost infinite number” of programmable cut patterns in corneal transplants, the zigzag appears to be best because its wound becomes hermetically sealed, and the angled edge offers a smooth transition between the donor and host tissue, according to one speaker. “This results in better visual acuity and faster recovery of vision,” said Roger F. Steinert, MD , Irvine, Calif., USA. The technique also induced 1.5 D less of astigmatism and fewer aberrations when compared to conventional transplants using a trephine, Dr. Steinert said. Femtosecond laser-assisted keratoplasty incisions also allow for better initial incision integrity because the surgeon can avoid excess suture tightness as well as more surface area in the incision, which improves wound healing and allows for earlier suture removal. Less induced astigmatism means better alignment of the tissue, as well as elimination of the “suture factor”, Dr. Steinert said. Dr. Steinert said he believes femtosecond-enabled PK could be the way of the future. “The days of keratoplasty patients being optical cripples with hard contact lenses are over,” he said. “The evolution in techniques and reporting of outcome studies over the next several years will continue to drive improvement in the optical performance of corneal rehabilitation.” Editors’ note: Dr. Steinert has financial interests with AMO, OptiMedica, and Revision Optics (Lake Forest, Calif., USA). Day 4 A Tuesday ESCRS symposium focused on innovations in IOL power calculations, with experts from all over the globe giving their insights. Milan - from page 59