1.What do you find most challenging in the field of refractive surgery?
We have achieved a lot in the field of refractive surgery over the past several decades, but achieving precise and predictable outcomes without losing quality of vision is important for our patients. With the aging population and people remaining active later in life, treatment for presbyopia with reliable outcomes is challenging.
2.Tell us about your research on IOL power calculation formulas.
We have been able to test a new optical low coherence reflectometry (OLCR)-based device for biometric measurements of the eye. The introduction of optical biometry at the beginning of the millennium was a dramatic step forward in the area of IOL calculation for cataract and refractive surgery. Thanks to this technique and the work of several excellent colleagues in the field, our patients can benefit from more precise and predictable refractive outcomes. With the development of more sophisticated corneal ablation procedures, further work on IOL power calculation is still necessary to achieve similar outcomes as those after corneal refractive surgery.
3. Based on multicenter study outcomes to date, how do you select patients for the Intracor procedure?
Our current experience with Intracor (Technolas Perfect Vision Gmbh, Munich, Germany) extends up to 3.5 years follow-up. Thus far, we have learned that careful patient selection is a crucial step for the success of this procedure. In addition to a slight hyperopic spherical equivalent between 0.50 and 1.25 D and a subjective astigmatism not exceeding 0.50 D, a cycloplegic refraction is also necessary. It is advisable to look at preoperative near UCVA, because we know that a mean gain of 4 to 5 lines can be expected after surgery. If a patient has a very low preoperative near visual acuity, he or she might not be able to read newspaper print after the treatment; this must be discussed with the patient before surgery. It is also important to start with the nondominant eye and wait about 3 weeks between procedures. Therefore, there is time to discuss outcomes with the patient before deciding whether the dominant eye should undergo treatment or not. We have had good outcomes with only a limited number of unhappy patients following these guidelines.
4. Can you provide some pearls for surgeons transitioning to Intracor?
As with any new refractive procedure, surgeons must try to find a relaxed personality and take their time discussing the procedure with patients. Do not promise too much, and make sure to follow the general guidelines. Take time when centering the laser pattern on the cornea and stop and start again until the position of the suction ring and the laser pattern is satisfactorily placed on the cornea. Once the treatment starts, the procedure is quick and painless for patients. They are quite surprised about the speed of the treatment.
5.What is your favorite way to spend a day off?
My perfect day off is spending time with family and enjoying a long breakfast or a nice dinner together. Now that I have managed to pass my single-engine pilot license, I enjoy taking off, flying, and realizing the beauty of the landscape from several hundred feet above ground.