Francesco Carones, MD

BARCELONA, Spain — In this Healio Video Perspective from the European Society of Cataract and Refractive Surgeons meeting, Francesco Carones, MD, shares his clinical experience with the Tecnis PureSee IOL.

PARIS — At the European Society of Cataract and Refractive Surgeons meeting, Francesco Carones, MD, speaks about his early results with the new Tecnis Synergy IOL (Johnson & Johnson Vision) for presbyopia. He also explains why this lens is able to provide unique advantages in terms of continuous, wide range of vision with no fluctuations from 30 cm to far distance, even in dim light conditions.

Looking at the present state of refractive surgery, in which the correction of refractive errors such as myopia, hyperopia and astigmatism has become safe, accurate and precise with outstanding results for most patients, I feel that presbyopia correction still involves challenges and compromises. Think of the procedures we use to correct, let’s say, 2 D of myopia. I can count three, maybe four, surgical techniques that are currently used — LASIK, PRK, advanced surface ablation, SMILE — and all of them provide similar, excellent results. Think now of the procedures we use to correct the same amount of presbyopia, 2 D. I can count at least 10 different approaches, and none of them gives the same results. This, however, does not mean that presbyopia cannot be safely and successfully corrected. It means that each single approach has potential advantages but also downsides leading to compromises, and our challenge as surgeons is to identify for each single patient what is the best acceptable combination between advantages and compromises.

MAASTRICHT, Netherlands – At the European Society of Cataract and Refractive Surgeons winter meeting, Francesco Carones, MD, speaks about the impact of residual and induced astigmatism on the performance of multifocal IOLs.  In a study, he analyzed how different multifocal IOL models are more or less sensitive to astigmatism, suggesting a “tolerable” threshold for each of these models. 

Haze formation represents excessive wound healing in response to corneal tissue ablation and is characterized by stromal reaction, keratocyte activation, collagen and amorphous material deposition. Certain circumstances tend to magnify both the density of haze and the chance of its appearance. Among them, the amount of intended correction is probably the most important — the higher the correction, the worse the haze. But other factors such as sun exposure, delay in re-epithelialization and irregularity of the ablation surface are also implicated in haze formation. Dense haze may significantly impair vision by reducing best corrected visual acuity, inducing regression, inducing irregular astigmatism and provoking visual symptoms such as blurred vision, halos, glare and ghost images. Treatment of severe haze involves the use of pharmaceuticals applied topically. Corticosteroids produce some controversial results and are frequently ineffective. The second category of drugs employed are antimetabolites, of which mitomycin-C (MMC) is used the most. My special guest in this column is Francesco Carones, MD, of Carones Ophthalmology Center, Milan, Italy, to explain the use of this powerful agent.

Haze formation represents excessive wound healing in response to corneal tissue ablation and is characterized by stromal reaction, keratocyte activation, collagen and amorphous material deposition. Certain circumstances tend to magnify both the density of haze and the chance of its appearance. Among them, the amount of intended correction is probably the most important — the higher the correction, the worse the haze. But other factors such as sun exposure, delay in re-epithelialization and irregularity of the ablation surface are also implicated in haze formation. Dense haze may significantly impair vision by reducing best corrected visual acuity, inducing regression, inducing irregular astigmatism and provoking visual symptoms such as blurred vision, halos, glare and ghost images. Treatment of severe haze involves the use of pharmaceuticals applied topically. Corticosteroids produce some controversial results and are frequently ineffective. The second category of drugs employed are antimetabolites, of which mitomycin-C (MMC) is used the most. My special guest in this column is Francesco Carones, MD, of Carones Ophthalmology Center, Milan, Italy, to explain the use of this powerful agent.

The results of our first patients treated with the Alcon LADAR 6000 confirm my expectation of achieving outcomes as good as those from the LADARVision 4000. The system’s new design, however, makes achieving those results much easier.