EyeWorld Asia-Pacific September 2016 Issue

September 2016 70 EWAP NEWS & OPINION 29 th APACRS - from page 69 result in more flattening. Opening ceremony highlighted history of APACRS The APACRS annual meeting officially opened with the Opening Ceremony followed by the APACRS LIM Lecture. Johan Hutauruk, MD , Jakarta, Indonesia, the organizing chairman of the meeting, kicked off the ceremony with a welcome address. On behalf of the organizing committee, he expressed his pleasure in welcoming attendees to Bali, “one of the world’s most beautiful islands” and the 29th APACRS meeting. This meeting was last held in Bali 12 years ago in 2004. Following Dr. Hutauruk , Nila Moeloek, MD , Jakarta, Indonesia, the Minister for Health of Indonesia and president of the Indonesian Ophthalmologists Association, spoke. More than 90% of the world’s visually impaired are in developing countries, she said, and it’s a challenge for both governments and eyecare providers. There has been progress in the country over the last 20 years in reducing cataract-related blindness, but despite that success, the cataract blindness rate in Indonesia is still among the highest in Southeast Asia, Dr. Moeloek said. “We need to be doing even more to help those suffering from cataracts,” she said. Ronald Yeoh, MD , Singapore, the president of APACRS, also spoke at this time, discussing his first meeting as APACRS president and the previous years under Arthur Lim, MD , and Graham Barrett, MD , who Dr. Yeoh said are the “two people who created our society.” Dr. Yeoh said he had the good fortune of being guided and mentored by these “giants in ophthalmology.” Dr. Lim’s driving forces that started APACRS were an obsession with research, training, and education; an obsession with quality cataract surgery; an obsession to eliminate cataract blindness; and an obsession to elevate the standards in Asia to match those of Europe and Asia. Dr. Lim used his own wealth very constructively to further ophthalmology and cataract surgery in Asia. He ran APACRS in his own private clinic with his own staff, self-funded, and with no secretariat. Dr. Barrett served as president of APACRS from 2000 to 2015. He undertook important initiatives, including the launch of EyeWorld Asia-Pacific, an inclusive policy for all regional cataract and refractive societies, and a full-time secretariat located in the Singapore National Eye Centre. APACRS will continue to strive to provide better and more relevant meetings, Dr. Yeoh said, as well as to strengthen the relationship with regional and international partners. ‘Achieving nirvana’ in cataract surgery, making better predictions A symposium co-hosted by the IOL Power Club focused on “achieving nirvana” or making the “perfect prediction” in cataract surgery for better refractive outcomes. Oliver Findl, MD , Vienna, Austria, led the session, speaking about the impact of the capsulorhexis on the predictability of IOL power. Specifically, Dr. Findl said the “burning question” is whether the femtosecond laser, with the ability to create a more predictable capsulorhexis, is resulting in better outcomes regarding refraction. Dr. Findl went through several studies in which manual capsulorhexes were compared to those created with femtosecond laser. One study had just a small significant difference in favor of the femto-created capsulorhexes, but was that enough to be relevant? he asked. Another study could not read the femtosecond laser-created capsulorhexes as being better than manual. His own study, which looked at only manual capsulorhexes in 635 eyes, grouped them into categories as either normal (4.5 to 5.5 mm, 360-degree overlap), eccentric (larger than 5.5 mm), and small (less than 4.5 mm). Tecnis lenses (Abbott Medical Optics, Abbott Park, Illinois) were used most often. Change in capsulorhexis size, IOL axial position, IOL decentration, and IOL tilt were evaluated. What they found was that there was no significant difference in change in rhexis size between the different capsulorhexis groups, no difference in change in IOL axial position, and no significant difference in IOL tilt. The eccentric group was slightly more likely to have a higher tendency for IOL decentration. As such, Dr. Findl said he thinks the “rhexis effect is weak.” “Does femtosecond laser- assisted cataract surgery result in more predictable IOL position? My answer at this point is no,” Dr. Findl said. Other panelists agreed with this conclusion. What about preexisting phakic IOLs and their impact on cataract surgery outcomes? Jaime Aramberri, MD , San Sebastian, Spain, presented on research that evaluated how phakic IOLs could affect biometry for IOL calculations in cataract surgery. Different materials—acrylic or silicone, for example—can affect the wavelengths for ultrasound or optical biometry, which can thus affect the axial length