EyeWorld India March 2017 Issue

March 2017 EWAP FEATURE 17 Tip 1: Get tech-savvy—and have your best technicians get savvy as well Use of advanced refractive technology requires a solid working knowledge of things like femtosecond lasers and the interaction between preoperative and intraoperative systems. Get the proper training for everyone involved. Tip 2: Have backup plans in place Even the best technology can fail, and that’s why Dr. Weinstock has patients marked ahead of time with the RoboMarker (Surgilum, Wilmington, North Carolina), in case laser technology does not work or does not give a good reading. “Sometimes, the corneal marking is your fallback,” he said. Tip 3: Consider the role of the posterior cornea Cataract surgery leaders have recently reported on the importance of posterior cornea measurements, which can be done in several different ways. Dr. Findl and staff always perform corneal topography and tomography and use the latter to assess the posterior cornea versus anterior cornea. “The posterior cornea will contribute much less, but there are some odd eyes where it can be quite different [from the anterior cornea],” he said. In those cases, they will consider it in their calculations. There are online calculators such as the Barrett Toric Calculator (available at ascrs.org) that account for posterior cornea measurements, Dr. Weinstock said. Tip 4: Beware of too many measurements “There’s always a tradeoff,” Dr. Findl said. “[If you measure more], you can also introduce noise, and that doesn’t necessarily make things better.” When it comes to the posterior cornea, Dr. Findl takes more of a qualitative look at data to decide what changes, if any, should be made for astigmatic correction. Surgeons also need to consider if certain measurements (beyond just the posterior cornea) seem out of place due to dry eye, an irregular cornea, or other factors. Tip 5: Let patients know that adjustments may take place Even with the best technology, refractive enhancements or IOL exchanges may be needed, Dr. Findl said. If patients know ahead of time, they likely will be more open to the possibility. EWAP Editors’ note: Dr. Findl has financial interests with Abbott Medical Optics (Abbott Park, Illinois) and Carl Zeiss Meditec. Dr. Lane has financial interests with Alcon, Bausch + Lomb (Bridgewater, New Jersey), and other ophthalmic companies. Dr. Weinstock has financial interests with Alcon, Bausch + Lomb, and LENSAR (Orlando, Florida). Contact information Findl: oliver@findl.at Lane: sslane@associatedeyecare.com Weinstock: rjweinstock@yahoo.com www.haag-streit.com IMAGING SOLUTIONS From the leader in slit lamp imaging Outstanding image quality Equipped with an ultra-sensitive camera the new IM 900 produces images of exceptional quality even under difficult light conditions. Simple image capturing Fast and accurate automatic exposure control allows simple image capturing while you are concentrating on the patient. Perfect network integration EyeSuite makes your slit lamp networkable both with other Haag-Streit devices and your practice network.