Ronald R. Krueger, MD, MSE

KOLOA, Hawaii — In this Healio Video Perspective from Hawaiian Eye 2023, Ronald R. Krueger, MD, MSE, discusses a stable post-LASIK patient who was unhappy with image quality.

WAIKOLOA, Hawaii — In this Healio Video Perspective from Hawaiian Eye 2022, Ronald R. Krueger, MD, discusses strategies for early detection of keratoconus and the benefits of performing cross-linking at an early stage.

NEW YORK — From OSN New York 2018, Ronald R. Krueger, MD, MSE, medical director of refractive surgery at the Cole Eye Institute at the Cleveland Clinic, gives his presentation on what is new in the quest for ectasia prevention.

El objetivo principal del tratamiento quirúrgico de las cataratas siempre ha sido el tratamiento de una enfermedad. Tanto los pacientes como los médicos aceptaron e incluso se esperaron los errores refractivos residuales, el retraso en la recuperación y las complicaciones. Después del desarrollo de los LIOs y la técnica quirúrgica de incisión pequeña, los pacientes y los médicos toleran cada vez menos los resultados imprecisos o inesperados. El impulso constante en nuestra profesión de mejorar la eficacia y la seguridad nos lleva a lo que probablemente se convertirá en el cambio de paradigma más importante en la cirugía de cataratas desde el desarrollo de la facoemulsificación ultrasónica: cirugía de cataratas refractiva asistida por láser de femtosegundo. Invitados en esta columna: Dr. Glauco Reggiani Mello, Dr. Jonathan H. Talamo y Dr. Ronald R. Krueger, MSE.

O principal objetivo da abordagem cirúrgica da catarata sempre foi o tratamento da doença. Erros refrativos residuais, recuperação retardada e complicações eram aceitos e até esperados por pacientes e médicos. Após o desenvolvimento das LIOs e da técnica cirúrgica de incisão pequena, pacientes e médicos ficaram menos tolerantes a resultados imperfeitos ou inesperados. A motivação da nossa profissão (aprimorar continuamente a eficácia e a segurança) está levando ao que provavelmente será a mudança de paradigma na cirurgia de catarata desde o desenvolvimento da facoemulsificação ultra-sônica: a cirurgia de catarata refrativa com laser femtosegundo. Meus convidados nesta coluna são o Dr. Glauco Reggiani Mello, o Dr. Jonathan H. Talamo e o Dr. Ronald R. Krueger, mestre em saúde.

Slide 1. Corneal topography after LASIK for severe myopia. (Image courtesy of Karolinne Maia Rocha, MD, PhD, and Ronald R. Krueger, MD, MSE.)

Originally posted on the OPHTHALMIC HYPERGUIDE August 14, 2008

The main objective in the surgical management of cataracts has always been the treatment of a disease. Residual refractive errors, delayed recovery and complications were accepted and even expected by both patients and physicians. Following the development of IOLs and small-incision surgical technique, patients and physicians became less tolerant of imperfect or unexpected results. The drive within our profession to continually improve efficacy and safety is pushing to what will likely become the greatest paradigm shift in cataract surgery since the development of ultrasonic phacoemulsification: femtosecond laser-assisted refractive cataract surgery. My special guests in this column are Glauco Reggiani Mello, MD, Jonathan H. Talamo, MD, and Ronald R. Krueger, MD, MSE, who have worked on this.

History: Patient is a 50-year-old male TV news anchor who had LASIK surgery for myopic astigmatism correction in both eyes 2 years ago. He complained of reduced quality of vision in his right eye with halos and glare at night and a slight shadow image. The patient was found to be a good candidate for an off-label wavefront-guided CustomCornea ablation.

Wavefront analysis is a tool that helps ophthalmic surgeons compare the optical quality of a patient’s eye with the optics of an ideal, perfectly focused eye. The depth of information provided by a wavefront analysis system, such as Alcon’s LADARWave, allows the surgeon to perform a customized ablation with the LADARVision 4000 to correct higher-order aberrations beyond the lower-order terms of defocus (sphere) and astigmatism (cylinder). The technology also allows surgeons to correlate specific types of aberrations with the visual complaints of the patient. Potentially, wavefront analysis can more accurately assess and correct many types of optical irregularities, even those after a refractive procedure that leaves the patient unsatisfied.