EyeWorld Asia-Pacific June 2014 Issue

50 EWAP rEfrActivE June 2014 Dr. Price noted that the information from this study is important to help put LASIK into the correct perspective. “It’s also important to realize that LASIK improves vision for night driving relative to both contacts and glasses, and very importantly, there’s a need for improved dry eye treatments for all forms of visual correction.” follow-up “To our knowledge, this is the first time a longitudinal prospective study has been done to assess vision and satisfaction with LASIK and contact lenses,” Dr. Price said. “Before we were just looking at the final refractive results patients have, and as time has gone by, there’s been a move The Next-Generation Visian ICL CentraFLOW by Kimiya Shimizu, MD, PhD Optimizing fluid flow within the eye eliminates the need to perform peripheral iridotomy. M any studies have shown that visual performance after Visian ICL (STAAR Surgical, Monrovia, Calif., U.S.) implantation is superior to visual performance after LASIK. 1,2 This was enough to persuade me to move toward implanting phakic IOLs and away from laser vision correction in the majority of my refractive surgery patients. The need to perform Nd:YAG peripheral iridotomy (PI) may be one drawback for surgeons to make this switch. Additionally, PIs can be painful for the patient, they may lead to significant changes in the aqueous dynamics after surgery, may occasionally cause cataract, bullous keratopathy, and damage to the corneal endothelium. My first operation with Visian ICL was in 1997. In 2004, the idea of adding a central port to the lens came to my mind and I began to study this concept in porcine subjects. I conducted two clinical studies beginning in 2008 to determine if the Visian ICL CentraFLOW with the KS- AquaPORT could restore a more normal aqueous flow and eliminate the need for PIs. These two studies demonstrated that the modified Visian ICL is safe and effective in providing excellent refractive outcomes while simultaneously eliminating the need for PIs. The 6-year follow up of 152 patients after Visian ICL CentraFLOW implantation illustrates that implantation is safe and effective and provides predictable and stable refractive results in the treatment of moderate to high myopia. No complications occurred during this observation period. With the introduction of the new generation Visian ICL CentraFLOW with KS-AquaPORT, PIs are a thing of the past. This latest model may look strange with a hole in the middle, but this hole—the KS-AquaPORT— eliminates the need for a PI and creates a more comfortable and convenient experience for both the patient and the surgeon. By eliminating the need for PI, phakic IOL implantation not only offers better visual performance than LASIK, but it also has equal efficiency. The Visian ICL CentraFLOW is an exciting development. More than 60,000 lenses have Kimiya Shimizu, MD, PhD been implanted worldwide since receiving CE mark in 2011. It helps reduce the burden of phakic lens implantation by eliminating the need for PIs. As we continue our observation of cataract formation after implantation of the Visian ICL CentraFLOW, we are encouraged by the results of our studies and look forward to implanting more lenses in our patients. EWAP Editors’ note: Dr. Shimizu is a Professor and Chair of the Department of Ophthalmology, School of Medicine, Kitasato University, Kanagawa, Japan. He is a paid consultant for STAAR Surgical. References 1. Kamiya K, Shimizu K, Igarashi A, Komatsu M. Comparison of collamer toric implantable contact lens implantation and wavefront-guided laser in situ keratomileusis for high myopic astigmatism. J Cataract Refract Surg . 2008;34:1687-1693. 2. Igarashi A, Kamiya K, Shimizu K, Komatsu M. Visual performance after implantable collamer lens implantation and wavefront- guided laser in situ keratomileusis for high myopia. Am J Ophthalmol . 2009;148:164-170. contact information Shimizu: +81-42-778-8464; fax: +81-42-778-2357; kimiyas@med.kitasato-u.ac.jp. by some people to compare LASIK to an emmetropic perfect eye that probably doesn’t exist.” “I think as clinicians, we have some general ideas on how things are going to be, but I was surprised with a number of the results,” Dr. Price said. Although doctors tend to see patients who are experiencing problems, it was nice to see how patients were doing overall. He added that an interesting aspect of the study is that it gauges only patient response and doesn’t factor in the opinions of the doctors doing the procedures. EWAP Editors’ note: Dr. Price has no financial interests related to this article. contact information Price: fprice@pricevisiongroup.net LASIK - from page 47