EyeWorld Asia-Pacific September 2019 Issue

EWAP SEPTEMBER 2019 73 eyes (using the Tomey OA2000) and a planned acrylic XY1, Dr. -Õ̜ Ã>ˆ` ̅i >ÀÀiÌÌ 1˜ˆÛiÀÃ> º…>à È}˜ˆwV>˜ÌÞ LiÌÌiÀ «œÃ̜« - erative results” than the other two in getting eyes within ±0.5 D: with 78% of normal eyes, 84% of unusual eyes, and 93% of long eyes. º/…i >ÀÀiÌÌ 1˜ˆÛiÀÃ> was better than the SRK/T in the unusual group, and is useful regardless of the proportionality of ocular anatomy,” she said. Graham Barrett, MD , noted that predicting cataract surgery outcomes in the post-laser vision VœÀÀiV̈œ˜ 6 ® iÞi ˆÃ º“œÀi challenging; it’s as uncertain as rolling a pair of dice” because œv ̅i y>ÌÌi˜i` VœÀ˜i> ̅i 6 procedures create. His True vœÀ“Տ> º`œià Üi ܈̅œÀ without refractive history,” and he stressed that when selecting a toric lens the traditional toric vœÀ“Տ>à º>Ài ˜œÌ Û>ˆ`» ˆ˜ iÞià with previous refractive surgery. The True K Version II (http://calc. >«>VÀðœÀ}É >ÀÀiÌÌÚ/ÀÕiÚ Ú1˜ˆ - versal_2105/) also takes into account the posterior cornea. What about intraoperative aberrometry? Rosa Braga-Mele, MD, FRCSC ] ºœ˜Þ ÕÃiû ̅i IOLMaster 700 and the Barrett 1˜ˆÛiÀÃ> vœÀ“Տ> ˆ˜ «œÃ̇ 6 eyes, but also incorporates the ORA intraoperative aberrometry in the OR. She considers intra- œ«iÀ>̈Ûi >LiÀÀœ“iÌÀÞ ºÜœÀ̅ the effort” in post-LVC patients, high cylinder eyes, and where effective lens positioning could be more unpredictable; it also accounts for both the anterior and posterior corneal surface, and can help improve toric IOL alignment. Edward Manche, MD , said the Light Adjustable Lens (LAL) ˆÃ «Àœ`ÕVˆ˜} ºÌÀÕÞ «…i˜œ“i˜> outcomes,” but it does neces- sitate patients be committed to wearing sunglasses for 1-2 weeks before the surgeon opti- mizes the lens (if necessary) and it locks into place. º/…i Ƃ…>à VÀi>Ìi` > «>À - adigm shift in how we’re going to do cataract surgery in the future,” he said. Other panelists were not as convinced, as Dr. Barrett noted the lens needs to be locked in before refractive stability can be truly assessed. /…i wÀÃÌ Ã«i>ŽiÀ Ài«ÀiÃi˜Ì - ing Europe, Thomas Kohnen, MD, PhD, FEBO , offered advice on how to handle misaligned IOLs. If it’s a toric lens, recalcu- late the axis, then calculate the direction of rotation, and then reposition the toric lens by either ÀœÌ>̈œ˜ œÀ ÀiwÝ>̈œ˜]…i Ã>ˆ`° º,i«œÃˆÌˆœ˜ˆ˜} ŜՏ` Li performed 1 week after IOL implantation at the earliest, but preferable 10 days, or 1-2 weeks, postop,” he said. When refractive surprises occur, Oliver Findl, MD, MBA , said solutions include IOL exchange, add-on IOLs, or IOL “œ`ˆwV>̈œ˜Ã° i˜Ã ňvÌ `i - pends on the IOL haptic design, with 1-piece lenses completing their shift in about 1 week and ·«ˆiVi " à w˜ˆÃ…ˆ˜} ˆ˜ ӇΠmonths. º/…i LiÃÌ Ìˆ“i ̜ iÝV…>˜}i an IOL is earlier rather than lat- iÀ]»…i Ã>ˆ`] >à wLÀœÃˆÃ œVVÕÀà >Ì 2-3 months postop. In eyes with shallow anterior chambers, Dr. Findl recommends cutting the lens out to replace it. Film Festival Winner Finds Dreams DO Come True For Yao Ke, MD, PhD ] > º Ài>“ Comes True” combining mini- mally invasive glaucoma surgery (MIGS) and microincision cat- aract surgery (MICS). APACRS Film Festival judges Graham Barrett, MD, John Chang, MD, Guarav Luthra, MD, Pannet Pangputhipong, MD, Fam Han Bor, MD , and Hiroko Bissen-Mi- yajima, MD, PhD , agreed, hon- oring him with the Grand Prize. As Prof. Yao explained, ab interno canaloplasty (ABiC) is a new MIGS procedure for prima- ry open-angle glaucoma. ABiC Ü>à wÀÃÌ `iÃVÀˆLi` ˆ˜ Óä£x] >˜` can be combined with MICS. ABiC has been reported in the literature as being able to maintain the intraocular pres- sure (IOP)-lowering and safety Li˜iwÌ œv ÌÀ>`ˆÌˆœ˜> >L iÝÌiÀ - no) canaloplasty but uses a more ivwVˆi˜Ì] ȓ«ˆwi` ÃÕÀ}ˆV> approach. º/…i “iV…>˜ˆÃ“ œv Ƃ ˆ is to lower IOP by means of