EyeWorld India September 2018 Issue

EWAP REFRACTIVE 45 September 2018 [The Hague, the Netherlands] for my toric IOL calculations. The Cas- sini works using a completely differ- ent principle because it has colored LEDs that are reflected off the anterior corneal surface, and it has seven white LEDs whose reflection off the posterior corneal surface can be detected to measure poste- rior corneal astigmatism. As they continue to improve their software, I’m finding it to be an increasingly valuable way of measuring total corneal astigmatism,” he said. Abnormal corneal topography If the corneal topography is ab- normal, Dr. Koch said to look for the cause. “If it appears to be an ocular surface issue, I will look for ocular pathology, such as epithelial basal membrane disease or Salz- mann’s nodular dystrophy. I may do a dry eye evaluation and treat the dry eye. If it’s epithelial basal membrane disease or Salzmann’s nodular dystrophy, and I think it will affect either the accuracy of the calculations or the quality of the vision postoperatively, I will treat that first by scraping it and letting the patient’s eye heal for about 3 months. Then I will repeat the calculations,” he said. “At that point topography again is important because subtle irregularities can persist and need to be detected to assist in patient counseling and IOL selection.” EWAP Editors’ note: Dr. Dell has financial interests with Johnson & Johnson Vi- sion (Santa Ana, California), Bausch + Lomb (Bridgewater, New Jersey), Presbyopia Therapies (Coronado, California), Ocular Therapeutix (Bed- ford, Massachusetts), Optical Express (Glasgow, U.K.), Tracey Technologies (Houston), Advanced Tear Diagnostics (Birmingham, Alabama), and Lu- menis (Yokneam, Israel). Dr. Koch has financial interests with Alcon (Fort Worth, Texas), Carl Zeiss Meditec, and Johnson & Johnson Vision. Contact information Dell: steven@dellmd.com Koch: dkoch@bcm.edu