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ASCRS 1999 maps new frontiers in refractive surgery, celebrates 50 years of IOL history
SEATTLE — It was apropos that the 25th anniversary meeting of the American Society of Cataract and Refractive Surgery (ASCRS) — which included a tribute to Harold Ridley, MD, FRCS, FRS, on the 50th anniversary of his invention of the intraocular lens — was highlighted by presentations on a new generation of lens implants and refractive corneal and lens surgery.
Speakers previewed a world where phacorefractive surgery, phakic IOLs and accommodating IOLs are standard practice and presbyopia has been conquered.
In addition, David J. Apple, MD, reviewed ways to prevent posterior capsular opacification and suggested that with what is now known about the phenomenon, it’s incidence will decline dramatically in coming years.
Cataract surgical topics certainly had a large presence on the program, but the greatest excitement seemed to be generated by avant-garde techniques of refractive surgery.
In fact, several surgeons based their presentations on the application of cataract surgery techniques for pure refractive correction. The great safety of lens extraction and IOL implantation make this a reasonable alternative, they argued.
The tribute to Mr. Ridley drew a very large crowd. An ASCRS-produced film, several lectures on IOL history and a speech by Mr. Ridley himself recalled the early, controversial days of IOL development.
For more on these stories, see page 4.
No piggyback with foldables, surgeon says
SEATTLE — Unanticipated adverse effects have led a previously vocal advocate of piggyback AcrySof IOLs to urge surgeons to stop using this lens or any other foldable IOL in this way.
Johnny L. Gayton, MD, said that he has noted refractive changes due to the flattening of non-PMMA lens optics over time, and an opacifying membrane formed between some piggyback AcrySof lenses. For more, see page 12.
Public, private health systems vie for funding
The public system cares for the poorest and sickest as budgets are cut.
Chile’s progressive health care system continues to evolve to meet health care needs for the nation’s 14 million inhabitants. Recently however, large managed care groups, which are responsible for much of the nation’s health care, have been accused of enrolling only the best patients, leaving the public system to contend with the poorest and sickest.
To relieve stress on the public system, the government is considering doing away with tax breaks to employers who support managed care, and channeling that money into the public system. Some fear that policy will hurt enrollment in managed care, but the government argues it is necessary to save the public health system.
For more on health care and ophthalmology issues in Chile, see page 32.
Viscocanalostomy techniques differ but results remain good
A panel of ophthalmologists finds that surgeons have personalized their techniques.
NANTES, France — Deep sclerectomy glaucoma surgery can be as effective as trabeculectomy, regardless of variations in technique introduced by different surgeons. This was a conclusion of a panel discussion here at the OphtaNantes ’99 meeting.
Starting from the viscocanalostomy technique described by Robert Stegmann, MD, surgeons have varied this pressure reducing procedure by changing incision sizes, implanting materials other than viscoelastic or doing away with viscoelastic entirely.
Despite variations, all these procedures share a common route to lowering IOP, said Philippe Sourdille, MD, in an interview with Ocular Surgery News.
All the techniques feature dissection at the trabeculum. However, surgeons create varying reservoir shapes and sizes. Some techniques include new materials such as the STAAR (Monrovia, U.S.A.) Glaucoma Wick or the SKGel, a tablet of cross-linked hyaluronic acid made by Corneal (Paris).