EyeWorld Asia-Pacific June 2016 Issue

June 2016 64 EWAP NEWS & OPINION Graham Barrett, MD, receives the Charles D. Kelman Innovator’s award from Mrs. Kelman. Asia-Pacific highlights at the 2016 "4$34•"40" 4ZmQoTJum $onHSeTT by EyeWorld staff Live reports from EyeWorld’s coverage of the 2016 ASCRS•ASOA Symposium and Congress held in New Orleans Charles D. Kelman Innovator’s Lecture discusses astigmatism correction and the roots of creativity C uriosity, inspiration, and persistence. These are the three things that Graham Barrett, MD , Perth, Australia, thinks are the main ingredients that underlie a person’s creativity. It is creativity that underlies innovation, Dr. Barrett said, giving the 2016 Charles D. Kelman Innovator’s Lecture Monday morning. Dr. Barrett is a clinician and innovator who more than meets that definition. In his lecture “Searching for Symmetry: Reducing Astigmatism at the Time of Cataract Surgery,” Dr. Barrett brought the audience back to the roots of his interest in astigmatism. “There are many things that have fascinated me in cataract and refractive surgery over the years, but when I think back, the common thread that extends back right to the beginning when I started ophthalmology was an interest in astigmatism.” Dr. Barrett related the principles of keratometry to “all the wonderful instruments that we still have today.” “Back when I was a resident, I was intrigued about prospect of using intraoperative keratometry, and the devices available then were somewhat complex and time consuming to use, and I thought ‘A semi-quantitative device would be something that would be useful,’” he said before showing an image of the first keratometer he built and going on to reveal later iterations all the way to his development of a keratoscopic lens. In addition to measuring astigmatism, Dr. Barrett said also of interest to him is the correction of astigmatism at the time of surgery, particularly the impact of the incision and the issue of toric IOL alignment. Dr. Barrett discussed research involving different incision sizes and said he has found “there is some merit in smaller incisions.” When it comes to positioning a toric IOL, Dr. Barrett highlighted his toriCAM app. “All you need is your iPhone and a felt-tipped marking pen,” he said, demonstrating how the app helps determine the axis of corneal limbal marks for ideal IOL alignment. Dr. Barrett conducted a prospective study to evaluate the error in alignment when marking is done using a slit lamp, a slit lamp with toriCAM, free hand, and free hand with toriCAM. “Even with slit lamp marking, the app improves the accuracy by about 50%, and with free-hand marking it reduces the error … by about 68%,” he said. “The bottom line is if you use the app and free- hand marking, it is more accurate than if you use slit lamp alone.” His final concern with astigmatism is the prediction of it after cataract surgery. Dr. Barrett has developed many formulas to aid in IOL calculations. With his, and many other, calculators available as well as technologies to help measure astigmatism and accurately place IOLs, Dr. Barrett said he believes “astigmatism prediction with toric IOLs is just about as accurate as spherical power prediction.” Bringing his lecture back to the idea of innovation itself, Dr. Barrett pulled out a newspaper clipping that he has carried around for years. It’s an article about Isaac Asimov, PhD, an author and biochemist who was approached by the U.S. government to work on a project during the Cold War that would, as Dr. Barrett put it, “encourage innovation.” Dr. Asimov declined but this moment, Dr. Barrett said, stimulated him to write an essay on creativity, one that suggested creativity was not something that you could encourage in someone. “It’s something that comes from inward reflection by people who are sometimes a bit odd and eccentric,” Dr. Barrett said.