EyeWorld India March 2013 Issue

14 March 2013 EWAP FEATURE Modalities - from page 13 *SUPRACOR is CE marked. SUPRACOR for myopic, emmetropic, and post-LASIK patients is currently in clinical evaluation. SUPRACOR is NOT approved for use in the US. Technolas Excimer 217P is NOT approved for use in the US. Some of the products and/or specific features as well as the procedures featured in this document may not be approved in your country and thus may not be available there. Design and specifications are subject to change without prior notice as a result of ongoing techncal development. Please contact our regional representative regarding individual availability in your respective market. SURPACOR is a trademark of Bausch & Lomb Incorporated or its affiliate. kbcomunicacion. BLT-007/02-2013 ©2013 Bausch & Lomb Incorporated. All rights reserved. Varifocal excimer treatment for presbyopia Excellent far, intermediate, and near vision* Treats a wide range of patients As simple as a LASIK procedure Expanding LASIK to the presbyopia market TECHNOLAS Perfect Vision GmbH – A Bausch + Lomb Company Messerschmittstr. 1+3, Munich, Germany Regional Office Asia-Pacific Technolas Singapore Pte Ltd 101 Thomson Road, #27-03A United Square Singapore 307591 Tel: +65-6592-0792 www.technolas.com – www.bausch.com allows surgeons to create the incision but not fully open it until deemed necessary, either intraoperatively or post-op, allowing the surgeon to adjust the results. “You don’t have to open the incisions at the time of surgery,” Dr. Tipperman said. “One of the biggest advantages of the femto incision is that it’s adjustable and titratable.” He treats at 9 mm, and “I use 90% of the nomogram and about 85% depth.” Dr. Nichamin has worked with the LensAR (Orlando, Fla., USA) laser and although FDA approval for relaxing incisions is still pending, in the laboratory “we have been able to create near perfect incisions all the way out to the limbus in most cases.” ASCRS is working on developing nomograms for the different femtosecond lasers/ arcuate incisions. Toric IOLs Toric IOLs are still the preferred treatment if patients have undergone previous refractive surgery, have higher levels of astigmatism, or have thin corneas, Dr. Nichamin said. “Toric IOLs have been our game changer in astigmatism management” because of their stability and predictability, Dr. Tipperman said. “I like toric lenses,” Dr. Donnenfeld said. “They don’t have the incisions, they don’t induce dry eye, and they’re more accurate for higher amounts of astigmatism.” He routinely combines arcuate incisions with toric IOLs and uses the former as a template for where to place the lens; he opens the incisions post-op “if I need to do any fine-tuning.” Dr. Tipperman suggests marking at 6 o’clock using a circular marker and ensuring the viscoelastic is removed at the end of the procedure to avoid post-op rotation. “For surgeons to achieve optimal results, they need to be familiar with all of these treatment modalities,” Dr. Nichamin said. “You can’t hang your hat on just one.” The decision of which technique to use “is quite complex, and there’s not one quick, simple answer. It depends on the surgeon’s comfort level, what technologies are readily available, cost, and perhaps most importantly, specific patient characteristics.” EWAP Editors’ note: Dr. Donnenfeld has financial interests with Alcon and AMO. Dr. Nichamin has financial interests with LensAR. Dr. Tipperman has financial interests with Alcon and Marco (Jacksonville, Fla., USA). Contact information Donnenfeld: 516-766-2519, ericdonnenfeld@gmail.com Nichamin: 814-849-6547, ldnichamin@aol.com Tipperman: 484-434-2716, rtipperman@mindspring.com