Jorge L. Alió del Barrio, MD, PhD

BARCELONA, Spain — In this Healio Video Perspective from the European Society of Cataract and Refractive Surgeons meeting, Jorge L. Alió del Barrio, MD, PhD, speaks about an AI-based project for the automated early diagnosis of keratoconus.

Phakic IOLs are a long-standing refractive surgical procedure that has experienced ups and downs since the early ’50s when the first implantations were performed by Strampelli and Barraquer. Three main pathways have been followed since the beginning of the development of phakic lenses. The longest and most sinuous and problematic has been the one followed by angle-supported phakic IOLs. A second, more straightforward, led to the development of iris-supported lenses, and the third, straightforward as well, is the one of posterior chamber lenses. At the start of and along each of these pathways, there are distinctive personalities that are to be acknowledged in the development of phakic implants.

Dry eye has always been a big nuisance for surgeons. Most of the time we are dealing with fast, straightforward decisions and with procedures that lead to an immediate result, usually positive. Complications may eventually develop, but most of them are acute and short term. Dry eye is just the opposite of this. It is a disease that may require long-term treatment, may respond poorly to medications, takes up a lot of our time and, most importantly, can make the patient extremely dissatisfied with even the most successful surgery.

To evaluate the safety and efficacy during 5-year follow-up of phakic intraocular lens (PIOL) implantation to correct high anisometropia in amblyopic children who were non-compliant with traditional medical treatment including spectacles or contact lenses.

The success of LASIK as a surgical tool to correct refractive errors has been a driving force for technology. Even though in Europe almost 80% of the total flaps are still made with mechanical microkeratomes, it should be acknowledged that most of the patients and refractive surgeons would prefer a femtosecond laser microkeratome to a mechanical one in LASIK surgery.

The IOL industry has been providing us with a number of innovations that are now crowding the scientific programs of meetings worldwide, creating pressure on surgeons and high expectations among both surgeons and patients. The question is: What do they offer to the up-to-date and constantly evolving cataract lens surgeon?

The upcoming European Society of Cataract and Refractive Surgeons meeting in Stockholm will cover a substantial number of important topics.

Presbyopia is defined as a progressive decay in accommodation related to the physiological aging process of the eye. To recover accommodation physiologically, we would need to restore the capability of the natural lens to increase its optical power relative to ciliary body contraction to focus vision for near. At the moment, we still are far away from attaining this physiological solution for presbyopia.

The practice of cataract surgery has come a long way in the last 20 years. The development of the small incision concept, the use of phacoemulsification to implement this concept and the success of IOLs have led to continuous progress in a procedure that has created a boon in the quality of life of millions of people around the world. Cataract surgery has been one of the most important, if not the most important, surgical procedures successfully developed in the 20th century. The question now is what is next.

As a member of the ESCRS, I would like to share some of the interesting presentations coming up at this year’s meeting, September 9 to 13, in London.