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Across the Pond | Jul 2015

Across the Pond


The Role of Manual LRIs in Today’s World

By Eric D. Donnenfeld, MD

Are manual LRIs an underutilized tool for correcting primary astigmatism at the time of surgery and for postoperative residual astigmatism? Dr. Donnenfeld argues that, although there is inherent surgeon variability and predictability in creating LRIs, there is also enormous value in using them in modern cataract surgery. To achieve consistent results, he suggests practicing the basic techniques for placement before developing one’s own nomogram.


Update on Marking Tools: Conventional and Digital

By Kunal Merchang, MD; and Tal Raviv, MD

As a crucial component of achieving good refractive outcomes after toric IOL implantation, numerous tools are available to surgeons to ensure the precise alignment of the lens. According to Drs. Merchang and Raviv, the majority of surgeons use conventional marking tools; however, a number of handheld digital devices have been developed to aid surgeons in this step of the procedure.



Point/Counterpoint: Will I Use the FDA-Approved Corneal Inlay?

By George O. Waring IV, MD; and James C. Loden, MD

Dr. Waring says that he will consider using the Kamra corneal inlay (AcuFocus) in patients with stage 1 dysfunctional lenses and in those with congenital ametropia now that the device is approved in the United States. He acknowledges, however, that all surgical options for presbyopic correction involve a tradeoff. On the other hand, after researching the procedure and collecting the confidential opinions of corneal refractive surgeons around the world, Dr. Loden says that he will not be implanting the recently approved inlay because the costs to his practice are too great.


Personal Experience With a Corneal Inlay

By Sondra Black, OD; and Jeffery J. Machat, MD, FRCSC, DABO

Since undergoing corneal inlay implantation in front of 60 optometrists watching from a waiting room 2 years ago, Dr. Black shares that she has not had to put on reading glasses. She acknowledges use of Restasis (Allergan) to manage her dry eyes postoperatively. Dr. Machat, who performed the procedure, has also had the inlay implanted in his eye and says that the device allows him to continue to feel young. n