EyeWorld Asia-Pacific December 2018 Issue

September 2017 3 EWAP EDITORIAL Dec 8 EYEWORLD ASIA-PACIFIC EDITORIAL BOARD C HIEF MEDICAL EDITOR Graham BARRETT, Australia MEMBERS Abhay VASAVADA, India CHAN Wing Kwong, Singapore CHEE Soon Phaik, Singapore Hiroko BISSEN-MIYAJIMA, Japan Hungwon TCHAH, South Korea ASIA-PACIFIC CHINA EDITION Regional Managing Editor YAO Ke Deputy Regional Editors HE Shouzhi ZHAO Jialiang Assistant Editors SHENTU Xing-chao ZHOU Qi ASIA-PACIFIC INDIA EDITION Regional Managing Editor S. NATARAJAN Deputy Regional Editor Abhay VASAVADA ASIA-PACIFIC KOREA EDITION Regional Managing Editor Hungwon TCHAH Deputy Regional Editor Chul Young CHOI John CHANG, Hong Kong Johan HUTAURUK, Indonesia Kimiya SHIMIZU, Japan Pannet PANGPUTHIPONG, Thailand Ronald YEOH, Singapore S. NATARAJAN, India Sri GANESH, India YAO Ke, China Y.C. LEE, Malaysia In the Pipeline Graham Barrett Chief Medical Editorial EyeWorld Asia-Paci c D ear friends, products that could change how you “practice” is a headline that demands attention. In this issue of EyeWorld Asia-Pacific we have drawn from many different areas in the field to highlight examples of new technology which could alter the way we practice cataract and refractive surgery. The technologies range from improved methods of capsulotomy to goggles that could be of assistance in managing low tension glaucoma in a noninvasive fashion, using the goggles to alter the balance between intraocular pressure and cerebrospinal fluid (CSF) pressure. The topic of a light adjustable lens is certainly one area that could have a dramatic impact on cataract and refractive surgery. The issue also contains further discussion on new formulae to improve predictability as well as addressing the increasing use of toric lens to correct astigmatism. Unexpected refractive outcomes after cataract surgery are becoming less common but a simple solution to correct residual refractive error without resorting to corneal refractive procedures is indeed attractive. A light adjustable lens based on a photopolymer has finally received FDA approval. The refractive power of this lens can be adjusted with the use of UV light to adjust sphere and cylinder, improving refractive accuracy. The specific technology however may be challenging in that patients do need to avoid exposure to UV light with appropriate sunglasses until the final refraction is locked in and may require more than one treatment. In addition, this technology does not address an issue which is far more common than unpredictable refractive outcome in the immediate postoperative period, which is the change in refraction which often ensues in the years following cataract surgery. We are all familiar with the tendency to develop against-the-rule astigmatism in the years following cataract surgery and indeed the spherical refraction can alter with time. The potential for technologies that could adjust the power of an intraocular lens in situ any time after cataract surgery is therefore attractive. Although investigational, early laboratory work suggests that this may indeed be possible with femtosecond laser technology as reported by Liliana Werner and Nick Mamalis in their award-winning video recently at our APACRS meeting in Chiang Mai. Another avenue that is being explored is intraocular lenses with optics that can be exchanged for different powers even in the late postoperative period. Piggyback lenses placed in the ciliary sulcus are already available and can be utilized to correct both sphere and cylinder errors. In addition, piggyback lenses incorporating multifocal implants are now available as reported in this issue. The latter allows potential removal of the multifocal element with greater facility than an intraocular lens exchange. It is gratifying to note that new technologies and techniques that have always characterized the field of cataract and implant surgery continue to develop. This aspect is one of the reasons why cataract and implant surgery has always been fascinating and rewarding as we continue to enhance the visual outcomes of our patients. EWAP