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Cover Focus | Jan 2016

The Burning Question

Finding answers to some of the most debated concerns in IOL use.

I gave birth to my second child—my second daughter—in late October of this past year. One might think that, since my children are less than 3 years apart and both girls, I wouldn’t have any questions about caring for a newborn. I quickly found that I have just as many questions as I did the first time around. The questions I have this time, however, are different.

With my first daughter, because I had nothing to compare with, my questions were basic: Is she getting enough breast milk? Is she sleeping enough? Isn’t she too cold without a blanket overnight? Now that I have built confidence as a mother, my questions are more focused: How do I make sure her older sister’s needs and actions don’t overshadow her own? How do I safeguard against comparing her progress with that of her sister at the same age? When will I understand her as well as I understand my older?

As ophthalmologists, I am sure that your own lines of questioning have also matured from the time you began practice. For this reason, this January issue of CRST Europe is devoted to answering some of the hardest-hitting questions surrounding IOLs today: How much does IOL material matter? Are some IOLs more predisposed to Z syndrome? When is the ideal time for an IOL be explanted? Toric IOL or limbal relaxing incisions? Is there a verdict on IOLs in pediatric patients? Should negative dysphotopsia be discussed with patients preoperatively? What is extended depth of focus?

Peruse thoughts from Randall J. Olson, MD; Manfred R. Tetz, MD; Matthew R. Jorgensen, PhD; and Liliana Werner, MD, PhD. Read an answer from Jonathan D. Solomon, MD, on the relationship between certain IOLs and the occurrence of Z syndrome. Freshen up your knowledge on the best time to explant an IOL. Review the insights of Edoardo Ligabue, MD; and Cristina Giordano, OD; or Vinod Gangwani, MD, on the choice between toric IOLs and limbal relaxing incisions. Review the remaining questions in pediatric IOL use from the viewpoint of Michael Amon, MD. Learn whether Robert L. Kost, MS, and Rajesh K. Rajpal, MD, discuss negative dysphotopsias with their patients preoperatively. Find out from Pablo Artal, PhD, the answer to the latest question in IOLs: What is extended depth of focus?

Questions are a normal part of everyday life, and even the most seasoned veterans in any field of endeavor—whether parenting, ophthalmology, or any other occupation—will never truly stop asking them. Considering that the gold-standard definition of the ideal IOL will continue to evolve, what other IOL-related questions should you be asking?

— Laura Straub, Editor-in-Chief