Our cover story this month—the Annual IOL Issue—includes information on IOL options in 2007 as well as what to do in the case of zonular weakness or subluxated capsular bags. In a roundtable discussion, US experts consider various monofocal, multifocal, and accommodating IOLs as well as mixing and matching these implants.

It is fascinating to learn how surgeons choose their strategy. Factors like population mix, age, and cataract/refractive surgery indication greatly influence their respective choices. It is also motivating to see how experienced colleagues deal with some of the limits and side effects of each optical design. It is clear, and well mentioned in this discussion, that a good understanding of the influence of pupil size on the optical performance is very important.

Throughout the roundtable, many advantages and disadvantages of the available IOLs are discussed in an interesting manner. Cataract and Refractive Surgery Today US Chief Medical Editor, David F. Chang, MD, of California, has done a magnificent job moderating this discussion! Finally, I think that everyone agrees that patient selection and education are key factors to success. Each respective panelist discusses his method of patient selection and education.

We have also included a CRST Europe Editorial Board poll on presbyopia-correcting IOLs and mixing and matching. It shows limited interest in this particular strategy to presbyopia correction. The initial arousal about mix and match seems to have calmed down. Nevertheless, intermediate vision (ie, computer use in particular) should—and will—receive more attention in the near future.

New IOL designs are expected to address the need for good vision at all distances, however, excellent vision for all distances will not be provided by any implant for some time to come. The young emmetropic eye cannot be easily imitated, and I doubt I shall see the ideal accommodating implant during my active career as an ophthalmic surgeon.

A big difference between the United States and some European countries is that American surgeons have the possibility to charge more for more complex surgery (ie, presbyopic, toric IOL implantation). In some European countries, including my homeland of the Netherlands, the financial hurdles are too high for most surgeons to implement multifocal and/or toric IOL implantation into their daily practice. This issue should be resolved quickly, but some of the European health care systems may not allow such a swift solution.

Last year, CRST Europe published a series on blue-light–filtering IOLs. Stephen H. Sinclair, MD; Albert J. Augustin, MD; Augustinus V. Schulte, MD, PhD; and Dirk Van Norren, PhD, debated the pros and cons of this technology. We have decided to revisit this topic, and two very well-known experts, Martin A. Mainster, MD, PhD, FRCOphth, and John Marshall, PhD, FRCPath, FCOptom (Hon), FRCOphth (Hon), continue the controversy in this issue. The debate will probably still remain after these articles. On an editorial note, I would like to confirm that it is appropriate for authors to disclose their consultancy positions. Readers may then judge the content more fairly on its scientific merit.

The other focus in this issue is on zonular weakness and subluxated capsular bags. Authors share their thoughts on dealing with this difficult and complicated problem. Ehud I. Assia, MD, proposes his novel device to stabilize a partially loose capsular bag. Weak zonules and subluxated lenses remain one of the hardest cases to solve. Hopefully, there will be continued efforts and progress to further improve the treatment of these tricky cases.