EyeWorld Asia-Pacific December 2016 Issue

December 2016 EWAP refractive 49 Improving outcomes Dr. Waring thinks only by changing what outcomes are being measured and valued will there be an impetus to analyze data differently. Plus, he said, “with advanced diagnostics to digitally evaluate for stage 2 dysfunctional lens syndrome where patients may be better served with a lens-based procedure, we have improved our screening process over the years, and this has also increased overall satisfaction.” “I still challenge people to spend more time with their own patients preop and not to rely on optometric referrals,” Dr. Durrie said. “Don’t rely on someone else in the office to do screening exams. If patients are going to be taking that step to have better vision for a lifetime, they deserve to be talking to the surgeon.” Dr. Waring said refractive surgery is a subspecialty with “a very good understanding of when something works and when it doesn’t, and we support it with data.” Refractive surgeons use CALENDAR OF MEETINGS 2017 DATE Meeting VENUE March 1-5 32nd Asia-Pacific Academy of Ophthalmology Congress (APAO) www.apaophth.org/ Singapore May 5-9 ASCRS-ASOA Symposium and Congress (ASCRS) www.ascrs.org Los Angeles USA June 1-3 30th Asia-Pacific Association of Cataract and Refractive Surgeons Annual Meeting (APACRS) www.apacrs.org Hangzhou China June 23-25 32nd Annual Meeting of the Japanese Society of Cataract & Refractive Surgery (JSCRS) www.jscrs.org Fukuoka Japan October 7-11 XXXV Congress of European Society of Cataract and Refractive Surgery (ESCRS) www.escrs.org Lisbon Portugal November 11-14 Annual Meeting of American Academy of Ophthalmology (AAO) www.aao.org New Orleans USA “In my mind, any patient with a refractive error resulting from corneal ectasia and keratoconus is a good candidate for the Athens protocol [topography-guided PRK followed by crosslinking]; having PiXL in our hands, we can employ [it] in combination with the partial topography-guided PRK in order to achieve a better refractive correction of the cornea and also being able to remove less tissue and/or being able to apply this even in corneas where no tissue can be removed due to limitations from cornea thinning that go along with ectasia,” he said. Where to go from here Dr. Kanellopoulos said PiXL is his treatment of choice for patients with corneas too thin to consider an excimer or femtosecond laser procedure and for post-cataract surgery patients left with only a small amount of ametropia. Still, he said more needs to be learned about cornea biomechanics and variability among patients. He also said a dose effect nomogram needs to be developed. Dr. Pinelli thinks PiXL should be improved when it comes to the time and energy currently required in the procedure. “Sometimes the treatment is too long; we should stay within the accelerated crosslinking parameters,” he said. Dr. Behndig said more research is needed to optimize treatment parameters of PiXL for both keratoconus and myopia patients. EWAP Editors’ note: Drs. Behndig and Pinelli have no financial interests related to their comments. Dr. Kanellopoulos has financial interests with Alcon (Fort Worth, Texas), Allergan (Dublin), A.R.C. Laser (Nuremberg, Germany), Avedro, KeraMed (Orange, California), Optovue (Fremont, California), and Carl Zeiss Meditec (Jena, Germany). Contact information Behndig : anders.behndig@umu.se Kanellopoulos : ajkmd@mac.com Pinelli : pinelli@serilugano.ch data to improve their outcomes daily, he said. “LASIK is excellent. It’s one of the most predictable, successful surgical procedures performed in the world, and we have the data to support it, and we need more,” he said. “We can’t rest on our laurels. We can’t stop improving.” EWAP References 1. Schallhorn SC, et al. Patient-reported outcomes 5 years after laser in situ keratomileusis. J Cataract Refract Surg. 2016;42:879–889. 2. Kezirian GM, et al. Prevalence of laser vision correction in ophthalmologists who perform refractive surgery. J Cataract Refract Surg . 2015;41:1826–1832. Editor’s note: Dr. Durrie has financial interests with Abbott Medical Optics (Abbott Park, Illinois) and Alcon (Fort Worth, Texas). Dr. Cummings has financial interests with Alcon. Dr. Waring has no financial interests related to his comments. Contact information Cummings : abc@wellingtoneyeclinic.com Durrie : Ddurrie@durrievision.com Waring : georgewaringiv@gmail.com Predictable - from page 46