EyeWorld India December 2014 Issue

3 EWAP CONTENTS December 2014 Dear Friends T he 27th APACRS annual meeting in Jaipur was an amazing meeting with hobnobbing between some of the greatest academicians of the Asia-Pacific region and the rest of the globe. It also showcased Incredible India famed for its hospitality and gastronomic delights. I am sure all of you who attended the meeting had an incredible experience. To those who missed it, EyeWorld Asia-Pacific has captured its essence in this issue and you will also find delightful momemts captured vividly on display on our website. This issue has something for everybody. Handing the challenge of a small pupil in cataract surgery is useful for all. The pharmacological aspects of certain drugs should be kept in mind as one plans surgery as much as the intraoperative procedure planning. The Bhattacharjee ring is another alternative being studied as an alternative to the Malyugin ring. Presbyopes, innovations are coming your way! This issue has highlighted the options available for presbyopes—corneal inlays, laser refractive surgery, and IOL surgery which have the potential to play a significant role in the future of presbyopia correction. It also takes a wide view of anti-VEGF injections which have changed the paradigm of treatment of retinal diseases. Upcoming agents also need to be evaluated, keeping in mind the economics of the long drawn treatment more so as most insurance companies do not cover the cost of this treatment. Hope you enjoy reading this and do relive the moments of APACRS Jaipur as we plan the next meet in Kuala Lumpur! Here is my customary nugget of wisdom from the Tirukkural , an ancient text by the sage poet Tiruvalluvar : As discipline leads to dignity in life Guard discipline above life - Tirukkural 131 Warmest Regards, S. Natarajan, MD Regional Managing Editor EyeWorld Asia-Pacific Letters from the Editors Dear Friends B e prepared! The theme of our final issue of EyeWorld Asia-Pacific for the year 2014 is the management of complex cases requiring cataract surgery. The outcomes of modern cataract surgery are excellent and serious complications are rare. It is a misconception, however, that the procedure has become simpler. The reality is that the success of the procedure is the development of sophisticated technology and training requiring dexterity and skill. The ability to manage complex situations is even more demanding and requires an understanding of the particular issues that need to be overcome when faced with circumstances such as pseudoexfoliation, small pupils, and extremely dense cataracts. Perhaps the most challenging cases are those patients who present with dislocated cataracts requiring pars plana fixation. All these situations are covered in depth and our experts provide their thoughts on how to manage these complex cases. While reading the articles I realized that common to all these situations is the need for the surgeon to be prepared for all the possible scenarios that may arise when faced with a complex case. This begins with the choice of anesthesia, as topical may not always be optimum. Additional devices such as iris hooks, alternative viscoelastic, and vision blue should be available. I always prepare additional lenses that may be suitable for sulcus or scleral fixation in addition to the single-piece toric IOL that may be the first choice. Capsular tension rings or segments should be on hand and specific iris prostheses may need to be ordered in advance. Appropriate planning includes the need to put aside sufficient time to complete a complex case and occasionally having vitreoretinal backup allows the case to be completed with one procedure. Being prepared with the appropriate devices and skills is key to managing these situations and may make a significant difference in restoring sight to a one-eyed patient as is often the case. I hope you enjoy our final issue of EyeWorld Asia-Pacific for 2014 but also take the time to relax and take a well-earned rest over the holiday period. Wishing all our readers all the best and a healthy, happy, and prosperous new year. Warmest regards Graham Barrett Chief Medical Editor EyeWorld Asia-Pacific