EyeWorld Asia-Pacific September 2015 Issue

21 September 2015 EWAP FEATURE ASCRS Eyeworld Pentacam Cataract 123.4x247.7 e 03.15.indd 1 05.0 Views from Asia-Paci c FAM Han Bor, MD Senior Consultant & Head, Cataract & Implant Service The Eye Institute @ Tan Tock Seng Hospital 11 Jalan Tan Tock Seng, Singapore 308411 Tel. no. +65-6357-7726 Fax no. +65-6357-7718 famhb@singnet.com.sg T he expectation for good outcomes in cataract surgery is ever increasing. Good outcomes are demanded not just by the patients but surgeons as well. Cataract surgery has come a long way. Today, it’s highly ef cacious, fast and safe. The journey onwards will be many small incremental steps. To have better outcomes, we have to look beyond the surgery; we need to look at the total work ow. In short, cataract outcomes are not just about the surgery but a total care-path: a comprehensive journey. The availability of cataract suites using advanced technology helps make that journey a reality. There are presently two comprehensive suites: the Alcon Verion System and the Zeiss Markerless System. We can expect more suites in the future. Both suites, in their most advanced forms, contain preoperative biometry and planning, an intraoperative guidance system, and postoperative optimization. Both suites perform ocular registration, be it iris, conjunctival or both. Patients’ biometry data are tagged with these identi cation features. These are transferred digitally to the planning desktop and subsequently to the microscope guidance system. Transferring the data digitally avoids transcription error, thus enhancing safety. The use of ocular registration ensures the correct plan is used on the correct eye. Both suites negate the need to mark the axes of the eye which can be another source of error. This makes surgery more ef cient and comfortable. Alignment of toric IOLs becomes easier and more precise. Clinic ef ciency is enhanced and con dence in implanting these advanced technology IOLs boosted. Both systems come with the options of operating microscopes and phacoemulsi cation machines. Zeiss’s latest IOLMaster uses the impressive swept-source OCT technology. This has the ability to penetrate much denser cataracts. Its measurements, including lens thickness and retinal thickness are highly consistent and should enhance accuracy in IOL power calculation. The Alcon VerifEye (previously Wavetec Ora), an intraoperative aberrometer, is a good tool to have for toric IOL implantation and post-LASIK cataract surgery. It veri es the nal IOL power in these patients. However, its accuracy can be affected by various factors. In the long term, I think this is an exciting technology. We are beginning to understand the impact of posterior corneal astigmatism. We can expect to see more diagnostics that are more robust in posterior corneal astigmatism. This, no doubt, will also lead to better postoperative outcomes. We are living in exciting times. Cataract management has never been so comprehensive and precise. The journey continues. Editors’ note: Dr. Fam is a consultant for Abbott Medical Optics (Abbott Park, Ill.) Zeiss, Ocumetics (Surrey, Canada), Ziemer, and Nidek (Fremont, Calif.). and the newer fluidics on the Centurion “have improved our outcomes by allowing us to use less energy during phaco.” Intraoperative aberrometry Intraoperative aberrometry has some potential, Dr. Hoffman said, but mostly when he’s placing IOLs in post-LASIK or post-PRK patients. In the post-RK eye, however, “you’re stretching these incisions, and you’re changing the curvature of the cornea when you’re doing your phaco. So if you measure the wavefront aberrometry in a post- OCULUS Asia Ltd. Hong Kong Tel. +852 2987 1050 • Fax +852 2987 1090 www.oculus.de • info@oculus.hk OCULUS Pentacam ® / Pentacam ® HR 欧 洲 科 学 之 路 Advance your IOL power calculation and Premium IOL selection with Pentacam ® The Pentacam ® Cataract Pre-Op Display Evaluate the cornea’s optical quality prior to cataract surgery to select the right patients for premium IOLs in four simple steps: • Step 1: Evaluation of corneal irregular astigmatism • Step 2: Detection of abnormal corneal shape • Step 3: Evaluation of corneal spherical aberration • Step 4: Evaluation of corneal cylinder