6 EyeWorld Asia-Pacific | December 2024 EDITORIAL Abhay Vasavada Regional Managing Editor EyeWorld India I have read our latest issue with great interest, and encourage our readers to consider in detail the debates on current hot topics, such as LASIK versus lenticule based procedures, femtosecond laser assisted cataract surgery versus phacoemulsification, and others. Pioneers and experts in these techniques talk about the limitations and advantages of each technique. Take for example the light adjustable intraocular lens (LAL). Dr David Chang and Dr Graham Barrett, both worldrenowned experts in the field of refractive cataract surgery discuss the advantages, disadvantages and ideal candidates for these IOLs today. One of the major arguments against the LALs is the fact that biometry devices and IOL calculation are getting better every day, and currently-reported outcomes appear to be equivalent with both technologies. We are now able to set a target and achieve it in most pristine eyes. Also, in today’s format, the LALs incur additional visits, laser procedures, and a significant additional cost. However, the ability to put in a monofocal IOL and then change the refractive target postoperatively to a desired level, in certain specific subsets of eyes (eg. post refractive, those with out of the average corneal parameters) or individuals (eg. moderate myopes, those with very particular demands and those not willing to compromise both on quality of vision and spectacle need) may be a very valuable tool. Similarly, LASIK, which had until very recently been the gold standard for corneal refractive surgery is now being supplemented, if not replaced with corneal lenticular based procedures. Another example is the femtosecond laserassisted cataract surgery, which is gaining considerable coverage across China. What is fascinating to understand in these debates is the fact that there is always more than one way of approaching a problem. Once you understand a particular technology, it is always possible to find the right indication to apply the technique or technology. Several factors will govern widespread adoption and use, including economic factors and cultural differences, but eventually good science always shines through. It is, therefore, very important to be open to newer ideas and to critically evaluate the established norms. Had we never challenged the existing success of phacoemulsification techniques, there would have been no femtosecond laser assisted cataract surgery, or minimally invasive glaucoma procedures. Therefore, instead of being very pragmatic about a particular approach to dealing with a problem, we must be curious as scientists and researchers. Even if a new technology feels raw and irrelevant today, one must give it a chance to evolve and understand how it can enhance the current gold standard.
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