EyeWorld India September 2016 Issue

September 2016 68 EWAP NEWS & OPINION MEETING reporter 29 th APACRS annual meeting ‘inspired’ in Bali by Chiles Aedam R. Samaniego EyeWorld Asia-Pacific Senior Staff Writer continued on page 8 Reporting from the 29th APACRS annual meeting, 27-30 July 2016, Nusa Dua, Bali, Indonesia Essential pearls from MasterClass on biometry The APACRS offered its “Essential Biometry” MasterClass again this year, with the aim of making the complexities of IOL power calculation and biometry comprehensible to attendees. The course faculty provided pearls for optimizing refractive outcomes in a variety of challenging situations. “Biometry is far more important than we give it attention to,” said Fam Han Bor, MD , Singapore. “We always start with refraction. With LASIK, if we don’t have a good refraction, we don’t expect a good refractive outcome. The same with cataract surgery—if you don’t do good refraction, you can’t expect a good refractive outcome.” “IOL formulas are just like drugs—prescribe the wrong drug and you get the consequences,” Dr. Fam said. In fact, in some ways IOL formulas can lead to “far more disastrous consequences” because while you can always change a drug during the treatment, once you’ve used the wrong biometry, it may be too late to do anything. Dr. Fam offered some pearls for achieving good biometry. First, he said, it is “beyond doubt” that optical biometry is “far superior” to ultrasound. In his practice, they have increased the penetration of optical biometry from using it in 70% of their patients to practically all their cases. Second, the biometry machine must be calibrated. Just about all new optical biometry machines require you to calibrate whenever you switch them on, Dr. Fam said. “If you do not calibrate, you may not get good outcomes,” he said. “Calibrate as frequently as you can.” Third, for good keratometry practice, “make sure you have a good corneal surface before you measure,” he said. “Do keratometry first,” before instilling any drops. If patients are using contact lenses, make sure they stop before performing keratometry. Dr. Fam recommended having patients stop contact lens use two weeks prior to measurement for hard contact lenses and at least a week for soft contact lenses. For data validation, Dr. Fam said that surgeons should repeat keratometry if the difference of average corneal power is greater than 1.0 D between eyes. “Not that this is not possible, but check to make sure anyway,” he said. Good axiometry practice requires ensuring fixation, checking for good signals/waveforms, and excluding staphyloma. “Repeat if axial length is too short or too long especially if they do not correlate with the other eye.” Fifth, and following on his point regarding correlation between the two eyes of each patient, Dr. Fam said surgeons should always perform bilateral biometry, even if the patient is only asking for surgery on one eye. Sixth, always use the right formula. Finally, Dr. Fam said that surgeons should always check the ocular status. “Don’t forget to ask