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Innovations | May 2009

Transforming to the Next Level-But How?

In this month's cover focus, we provide an array of articles to help you improve your outcomes in cataract surgery. Many surgeons still struggle with the required changes in settings or phaco tips when transitioning to new technology or smaller incision surgery. This can result in increased complication rates (eg, posterior capsular rupture) that can be frustrating during your transitional process to a presumed better procedure.

It is fundamental to understand the basic principles of ultrasound and fluid dynamics before entering into the use of new technology. Therefore, we offer you a Back to Basics package, with contributions by David Allen, FRCOphth, of the United Kingdom, and Richard Packard, MD, FRCS, FRCOphth, of England. In these two articles, we revisit the basics of ultrasound and fluid dynamics in relation to new tips and sleeves. We intend to feature more Back to Basics articles in future issues. I think it is crucially important to understand the basics before reaching for the next level.

Certain issues of CRST Europe are dedicated to the latest technology and techniques, which many of us may not yet use. However, we also try to offer practical information. For this purpose, we invited a diverse group of renowned surgeons from around the world to offer their pearls on the removal of soft, medium, and hard cataracts. It is fascinating to read the individual contributions and learn about different strategies to deal with various grades of nucleus density. Beginning surgeons and more experienced surgeons alike will benefit from the vast knowledge and pearls provided by the invited panel. We are all always eager to learn tips and tricks from our peers. Not surprisingly, cataract surgery courses during the major congresses continue to draw many attendees.

A major contribution to the improvements of our surgical outcomes has been made by the technological advancements in phaco technology. In the "Primers for Phaco Machines" article, David F. Chang, MD, of California; Cristian Mircea Moraru, MD, of Romania; Maria Cruz CiprŽs, MD, of Spain; and Rupert Menapace, MD, of Austria, describe the latest innovations of phaco machines and how they are integrated into their surgical technique. There is no doubt that the new ultrasound modalities, fluidics software upgrades, lower compliance tubing, and innovative tips and sleeves have initiated and facilitated the transition to smaller incision surgery. In the future, we will definitely see an ongoing effort to bring phaco technology to an even higher level. I am sure that Cataract & Refractive Surgery Today Europe will keep you up to date on these advances.

In a very interesting article, Damien Gatinel, MD, of France, describes a device that objectively measures light scatter from early forms of cataract. This can be useful in relation to the increased demand for earlier interventions in (refractive) lens surgery.

Last but not least, our newly appointed Associate Chief Medical Editor Erik L. Mertens, MD, FEBOphth, of Belgium, introduces a series of contributions on how to enhance your refractive outcomes. Specifically, the role of the size, construction, and placement of the incision(s) in astigmatism correction is highlighted. Several authors also describe their IOL choice in relation to preexisting astigmatism.

This issue provides cataract surgeons of all levels with some new information—at the very least, you will walk away with one new pearl to use in your practice. I am confident that you will enjoy reading this issue and reiterate the invitation to give us feedback, positive or negative. Send your letters to the editor to lsuarez@bmctoday.com.