The excellent European Society of Cataract and Refractive Surgeons (ESCRS) meeting in Berlin last month prompted me to reflect on the future of cataract and refractive surgery. As expected, there were many presentations on the usual subjects, including multifocal IOLs, femtosecond lasers, and collagen crosslinking. It is great to see some worthy competitors to IntraLase (Advanced Medical Optics, Inc., Santa Ana, California), and with the recent announcement of a joint venture between Bausch & Lomb (Rochester, New York) and 20/10 Perfect Vision (Heidelberg, Germany), the future looks even more exciting.
Although all femtosecond lasers must be decent flap-creating devices to justify the cost, some are attempting to demonstrate a unique selling proposition. For instance, investigators for the VisuMax femtosecond laser (Carl Zeiss Meditec AG, Jena, Germany) are performing refractive correction by extraction of a piece of cornea (ie, femtosecond lenticular extraction). With the advent of Technolas Perfect Vision will come the promise of a minimally invasive solution for presbyopia, coined IntraCor. Whatever the case, flap creation is important, and reliable and accurate creation of smooth, planar thin flaps is vital. In this issue of Cataract & Refractive Surgery Today Europe, Michael Knorz, MD, discusses further benefits, including better adherence of femtosecond flaps and the rationale for a wider sidecut angle to improve biomechanical strength. I fully appreciate how a wide-angle sidecut can influence corneal strength in a grafting procedure; however I must confess my lack of understanding and doubt about how a 100-µm flap with a large angle could decrease the onset of ectasia. I shall keep an open mind and hope that gurus such as John Marshall, PhD, FRCPath, FRCOphth(Hon), can provide an explanation along with evidence of its benefits. Take this as an invitation to correspond (we are always interested in hearing from our readers). I am, however, the first to support innovation and new thinking, as I believe it is a significant manner by which we push boundaries and make progress for the benefit of our patients.
In our June issue of CRST Europe, we explored multiple commercial refractive and premium practices. We certainly touched a raw nerve, and the topic generated private correspondence with some of the authors. Reader opinions are welcome, and we urge you to correspond with us to provide your points of view—supportive or not. But please, no matter how you feel, we ask that you communicate with decorum reflective of our professionalism as eye care providers.
As professionals, we have a tremendous disadvantage in terms of understanding the commercial world of business. The earlier we understand the principles of business, along with its jargon, the better we shall be as competitors. It is interesting and welcome to see the ESCRS embrace this topic with its practice management program at the Berlin meeting. To support our readership and those looking to enhance their premium value practice, we include an article on the value and phases of introducing a new income stream, that of phakic IOLs. More articles will follow with the goal of providing the readership with understanding and confidence in embarking on newer avenues. We hope you enjoy this issue and appreciate your feedback. E-mail us your thoughts at firstname.lastname@example.org. Like every good business, ours is about giving our customers what they want, and we want to make sure we are catering to you.