FEATURE 20 EWAP MARCH 2023 could continue to be better,” he said. “There is always room for improvement to [reduce the] chance of sticking a device in the wrong place.” Dr. Francis said he’d like to see a suprachoroidal stent come back to the market. “I know there are a couple in the pipeline that are being studied right now; they’re in trials that are ongoing. I think that is an area that will be reopened in the near future. It’s not necessarily better than the other procedures but it’s different. We’re accessing a different outflow pathway A discussion on SMILE - from page 14 and noted that she’s very careful in looking for it. “If I see it ahead of time, I’ll rinse or wipe the surface,” she said. In terms of a learning curve for SMILE, Dr. Rostov said it’s a slightly different skillset than with LASIK. “I think for cornea-trained physicians, it’s straightforward. If you’re not cornea trained, it’s fine, too,” she said. There have also been updates to the laser platform to improve the SMILE treatment. It’s now faster, so suction break is less likely to happen, and tissue cutting is more powerful, she said. “I think it’s fun to be able to offer patients different options for refractive surgery, and I think SMILE is an excellent option. It’s not for every patient, just as LASIK isn’t for every patient. It expands the offerings for patients and gives a LASIK-like outcome while preserving greater corneal integrity.” EWAP Editors’ note: Dr. Kugler practices at Kugler Vision, Omaha, Nebraska, and declared no relevant financial interests. Dr. Rostov is in practice with Northwest Eye Surgeons, Seattle, Washington, and has interests with Alcon, Carl Zeiss Meditec, and Johnson & Johnson Vision. than the traditional trabecular outflow,” he said, adding “it can be nice to have access to a different outflow pathway to try to enhance the aqueous outflow rate.” EWAP Reference 1. Riva I, et al. Canaloplasty in the treatment of open-angle glaucoma: a review of patient selection and outcomes. Adv Ther. 2019;36:31–43. Editors’ note: Dr. Francis practices at the Doheny Eye Institute UCLA David Geffen School of Medicine Los Angeles, California, and has interests with Alcon, Allergan, BVI, Iridex, iSTAR Medical, MicroSurgical Technologies, and Santen. Dr. Noecker practices with the Ophthalmic Consultants of Connecticut Fairfield, Connecticut, and has interests with Allergan, Alcon, Glaukos, Iridex, MicroSurgical Technologies, New World Medical, Nova Eye Medical, Santen, and Sight Sciences.
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