EyeWorld India June 2013 Issue

3 EWAP June 2013 Letter from the Editors Dear Friends F emtosecond cataract surgery is increasingly becoming accepted as a worthwhile addition to traditional phacoemulsification. The improvement in outcomes, however, is incremental, and discussions on the merits of the procedure will continue. These issues are canvassed in this month’s edition of EyeWorld Asia-Pacific . I would also like to draw your attention to another article in this edition discussing whether extracapsular cataract surgery is still necessary. For many years, residents beginning cataract surgery were initially taught extracapsular cataract surgery before commencing phacoemulsification. In many centers in the world this is no longer practiced and it is not unusual for a trainee to leave the program skilled in phacoemulsification but never having had the opportunity to perform extracapsular cataract surgery.Unfortunately, this reduces the opportunity to obtain a wider range of manual dexterity and skills including suturing so that procedures such as glaucoma surgery and keratoplasty become more challenging. One wonders whether a similar phenomenon may occur with increasing acceptance of femtosecond cataract surgery and whether the next generation of surgeons will be as adept in performing manual capsulorhexis and even manual phaco fracture techniques. Perhaps dealing with complicated cases where femtosecond surgery may not be appropriate will be limited to a smaller group of surgeons similar to the loss of expertise in manual extracapsular cataract surgery. Although progress is inevitable, I am personally pleased to have been part of the generation exposed to intracapsular and extracapsular phacoemulsification, and now femtosecond cataract surgery. Progress, however, is inevitable, and time will determine whether the improvement in safety and efficacy of femtosecond cataract surgery is such that it will replace manual phacoemulsification as the preferred method of cataract surgery in the future. I am sure you will enjoy the contents of this thought provoking issue of EyeWorld Asia-Pacific . Warmest regards Graham Barrett, MD Chief Medical Director EyeWorld Asia-Pacific • China • India • Korea EYEWORLD ASIA-PACIFIC EDITORIAL BOARD C HIEF MEDICAL EDITOR Graham BARRETT, Australia MEMBERS Abhay VASAVADA, India ANG Chong Lye, Singapore CHAN Wing Kwong, Singapore CHEE Soon Phaik, Singapore Choun-Ki JOO, Korea Hiroko BISSEN-MIYAJIMA, Japan ASIA-PACIFIC CHINA EDITION Editors-in-Chief ZHAO Jialiang ZHAO Kan Xing Deputy Editor HE Shouzhi Assistant Editor ZHOU Qi ASIA-PACIFIC INDIA EDITION Regional Managing Editor S. NATARAJAN ASIA-PACIFIC KOREA EDITION Regional Editor-in-Chief Hungwon TCHAH Regional Managing Editor Chul Young CHOI Hungwon TCHAH, Korea John CHANG, Hong Kong Johan HUTAURUK, Indonesia Kimiya SHIMIZU, Japan Pannet PANGPUTHIPONG, Thailand Prin ROJANAPONGPUN, Thailand Ronald YEOH, Singapore S. NATARAJAN, India YAO Ke, China Y.C. LEE, Malaysia Dear Friends W e have come to that exciting time of the year when our travel schedules are packed and we eagerly await the international conferences, particularly the 26th APACRS annual meeting that is being held in Singapore. This issue has a specific focus on the upcoming annual meeting of the APACRS, which I can proudly say is one of the fastest and most widely growing societies in ophthalmology today. Having survived a whole decade already, premium IOLs have become the new growing passion of anterior segment surgeons the world over. The cutting-edge technology and rapid advancement in IOLs makes sure that no patient is left aphakic, no matter what the roadblocks faced during surgery. Although these IOLs come with newer complications like dysphotopsia, there is a spectrum of corrective technologies available in these lens implants to eliminate these complications. This issue highlights the newer advances in lenses and technological breakthroughs in tackling the complications they create. Counseling a patient for premium IOLs has always been the starting point to increase the use and practice of premium IOLs. An emphasis has been made on patient expectations, how to meet them and also where to exercise caution. Postoperative refractive errors and higher-order aberrations are now being understood to a level where management of these conditions equip the ophthalmic surgeon to leave every patient satisfied with postoperative vision, contrast sensitivity, and minimal blurring and haloes. The excitement and buzz created by cataract surgery using femtosecond lasers is indescribable. The simple idea that in the future, ultrasound and phacoemulsification could be a thing of the past has created ripples in the cataract and refractive surgery world. Femtosecond lasers are also being used successfully in limbal relaxing incisions for astigmatism. Newer diagnostic and therapeutic options available for dry eye disease and ocular surface disorders help in targeting the underlying etiology to the extent of detection of levels of MMPs which can help the ophthalmologist to use the exact substitutes and formulas that can make the patient comfortable. The exponential increase in technology and constant updates and advancement is so alarming and overwhelming that we need to brace ourselves and be ready for the changes in our field and exciting new possibilities. Friends, I am certain you are as enthusiastic and eager to see this changing trend in technology in ophthalmology as I am. I would like to quote a Tirukkural as is my custom: One’s own deeds and behavior will be the touchstone, Which determines greatness or Littleness. – Tirukkural no. 505 I look forward to meeting you all at the 26th APACRS annual meeting in Singapore, to exchange ideas and knowledge, and make more friends from around the world. Warmest Regards, S. Natarajan, MD Regional Managing Editor , EyeWorld Asia-Pacific