EyeWorld Asia-Pacific September 2013 Issue

56 EWAP DEVICES September 2013 MD (Randall Olson, MD, is the subeditor) as three go-to authors for explaining complicated cases. Helpful hints “Review tapes, do your homework, and review the case with your staff the morning of surgery,” Dr. Talley-Rostov said. “Use what’s available—the ASCRS clinical videos, YouTube, call a colleague. Make sure the OR is prepped that morning, from the particular suture to the specific hook, blade, or needle.” Schedule these cases when time does not matter, Dr. Heiner said. “These are not the types of cases to be training new staff on,” he said. “Check and ensure your capsular dyes, iris hooks, Malyugin rings, vitrectomy instruments are all in the room.” And ensure there are backup IOLs available for times you discover the initial lens is not suitable. “Take your time and approach the case with your usual technique (chop or divide and conquer, etc.),” Dr. Heiner said. “At the end of the day the surgeon could reflect on what went well or otherwise and consider how to manage these difficult cases next time.” One last pearl—“Make sure that if things start to go sour, you have the instruments necessary to shut it down quickly,” Dr. Crandall said. “You should have a chamber maintainer ready to go in cases where a suprachoroidal hemorrhage starts. And since we don’t suture often, make sure there’s some 10-0 nylon in the room in case you do need to shut down quickly.” EWAP Editors’ note: The physicians have no financial interests related to this article. Contact information Crandall: alan.crandall@hsc.utah.edu Heiner: pheiner77@hotmail.com Talley-Rostov: ATalleyRostov@nweyes.com Corneal - from page 53 Planning - from page 54 Raindrop is a very forgiving inlay,” he said. “If it moves 0.5 mm this way or that way it doesn’t seem to affect vision.” The surgery itself it short—about 5 minutes—and Dr. Whitman said within the first 10-15 minutes after surgery patients are already sitting and reading. Currently, Dr. Whitman uses a 110 micron flap for his LASIK patients, but has changed the depth in all non-dominant eyes to 150 microns “just in case down the road this is something the patient wants done.” Patients he’s discussed the procedure with tend to view the inlays as more of a lifestyle choice. “It’s like Botox in terms of making them feel younger,” Dr. Whitman said. Patients like the idea of the Raindrop “because it’s made out of the same material as soft contact lenses, which is known as a safe material,” Dr. Hovanesian said. “There are few materials that we have greater experience with than hydrogel, so people have an inherent comfort level.” He added the Raindrop “probably alters the corneal curvature so there needs to be some allowance for that in the biometry, but it’s along the lines of someone who has undergone hyperopic LASIK.” Ongoing studies In the U.S., studies are evaluating the device in near emmetropes, but outside the U.S., inlays are undergoing trials with simultaneous LASIK, Dr. Whitman said. “Once the Raindrop is approved I think you’ll see a lot of surgeons combining it with LASIK,” he said. “It’s got the potential to change how we look at premium lens implants in the future.” For instance, the age of the ideal inlay patient is pre-cataract, so “there may be no reason to do a premium lens implant on them later on,” he said. With “literally billions of presbyopes, including a good number who had prior laser surgery,” corneal inlays represent a “really good option,” Dr. Hovanesian said. “Inlays allow us to provide a visual experience that is as rewarding to a 45-year-old as LASIK is for a 25-year- old.” Inlays represent “a truly lifelong benefit. There are not too many procedures we can give our mid-40s patients that will benefit them forever,” he said. But once the inlays are approved, “a whole new world is in front of us.” EWAP Editors’ note: Drs. Hovanesian, Verdoorn, and Dr. Whitman have financial interests with ReVision Optics. Dr. Waring has financial interests with AcuFocus. Contact information Hovanesian: 949-951-2020, jhovanesian@harvardeye.com Verdoon: c.verdoorn@lasikcentrum.nl Waring: 843-876-2020 Whitman: 888-215-1999 Fully Automated OCT 9-Point Internal Fixation Target for Peripheral Mosaic Fundus Image Live Fundus View Cataract Mode Anterior Segment Analysis* TM * Optional function NEW NEW NEW NEW The OCT World at Your Fingertips Optical Coherence Tomography 1 JALAN KILANG TIMOR #09-01 PACIFIC TECH CENTRE SINGAPORE 159303 Tel : +65 6872 0606 E-mail : medical_sales@topcon.com.sg Website : www.topcon.com.sg TOPCON SINGAPORE MEDICAL PTE LTD * Not available in all countries, please check with your distributor foravailability in your country