ESCRS opens to large crowds

At ESCRS, held Sept. 1-5 in Amsterdam, ophthamologists viewed the latest wares from equipment manufacturers.

AMSTERDAM — Thousands of ophthalmologists and those involved in the ophthalmic industry converged upon this "Venice of the North" for the XIX Congress of the European Society of Cataract and Refractive Surgeons, being held here Sept. 1-5. Among the highlights from the first day:

New technology contributes to refractive market growth

Anticipated improvements in surgical outcomes as a result of recent technological advances will drive the refractive surgery growth market and was the prevailing theme here at the September 1 symposium, “New approaches to refractive surgery: LASIK, lenses & more.”

The comprehensive course, organized by Ocular Surgery News and supported by an educational grant from Allergan Surgical, discussed the latest techniques and options available in refractive surgery.

Chaired by Richard L. Lindstrom, MD, Ocular Surgery News chief medical editor, topics included advances in the LASIK procedure by Y. Ralph Chu, MD; refractive lensectomy by Richard B. Packard, MD; targeting emmetropia by Thomas Kohnen, MD; and refractive lens choices (phakic, monofocal and multifocal), presented by Stéphane Ganem, MD, H. Buckhard Dick, MD, and Kevin L. Waltz, OD, MD.

Zyoptix better than standard LASIK, says B&L

Bausch & Lomb made its Zyoptix Personalized Vision Correction refractive laser system the highlight of its ESCRS presentations. Zyoptix — a combination of the company's Orbscan II and Zywave — has been shown "conclusively" that patients who undergo LASIK using the system have better vision postop than those undergoing standard treatments. B&L conducted a double-masked study on 488 patients, randomized with 1 eye receiving standard LASIK surgery and the other receiving Zyoptix surgery. B&L executives report that patients at 1 month postop self-evaluated with 19% claiming better vision in normal light from the eye that had undergone the Zyoptix procedure, 25% saying they have better vision in bright light, 27% stated they had better vision in dim light and 31% had better ability during night driving. The same patients reported 5% better vision 1 month postop in normal light when the gold standard had been performed; 10% reported better vision in bright light, 13% reported better vision in dim light with standard LASIK, and only 18% reported better sight during night vision after standard LASIK. Stephen Slade, MD, lead investigator for the device, expects Food and Drug Administration approval "in about a year."

Phacolaser: the next step in the evolution of cataract surgery

Phacolaser will eventually replace phacoemulsification as the primary cataract procedure, said Mateo Piovella, MD.

Dr. Piovella shared results of his experience with 9 eyes of 8 patients on which he performed phacoemulsification with topical anesthesia, lateral clear-corneal incision, erbium laser (ELF) and IOL implantation.

From his experiences, Dr. Piovella discovered a procedure that he says will eventually make ELF the preferred method of phacoemulsification. These advantages include the elimination of thermal stress, corneal burns and endothelial cell damage that can occur with ultrasonic emulsification. While it takes longer than ultrasonic emulsification, ELF offers less cutting power, and it cannot emulsify hardened lenses, Dr. Piovella maintained that once the procedure is perfected, the benefits will outweigh the negative consequences.

Dr. Piovella said that in his experience with ELF for phaco, the most difficulty he has encountered with the procedure has been with fluidics. He stated that initially "too much attention was paid to the laser adjustments at the expense of fluidics." His 34% complications rate was related to problems with the fluidics flow rate and not the laser, he said.