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Innovator's lecturer sees IOL styles improving
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PHILADELPHIA — Improved IOL designs have greatly reduced the incidence of posterior capsular opacification, which may soon be on its way to extinction, according to David J. Apple, MD.
Dr. Apple gave the Innovator's Lecture here at the American Society of Cataract and Refractive Surgery meeting. His topic was "The Future of Ophthalmic Biodevices: The Scene Is Changing."
During his lecture, Dr. Apple discussed what he called the "wonderful" progression in IOL technology. He said there is currently a trend of returning to older IOL designs. As an example he cited the sharp edges on the optics of IOLs from a number of manufacturers that are reducing rates of PCO. He noted that sharp optic edges were a common characteristic of IOLs in the early 1980s.
Dr. Apple noted that reduction in PCO, while partially dependent on advances in IOL design, is also dependent on good cortical clean up and the surgeon's skill and technique.
Dr. Apple gave credit to earlier innovators and their achievements in ophthalmology. He made specific mention of Charles Kelman and Harold Ridley, MD, the first surgeon to implant an IOL.
Dr. Ridley changed the focus in ophthalmology from "taking things out of the eye to putting things in the eye. He unlocked the posterior capsule for all the things we are now doing," Dr. Apple said.
Dr. Apple said modern ophthalmology requires surgeons to master three things: general ophthalmology, ocular pathology and IOL pathology.
Dr. Apple said the techniques and principles of general pathology are also important in ocular pathology, and an understanding of general biological processes helps in an understanding of ocular processes.
"All the techniques used to analyze plastics in general medicine are also useful to evaluate IOLs in the eye," he said.
Dr. Apple however said he sees the future of ocular pathology as "dim" due to the closing of pathology laboratories throughout the country. He said he wants to stay involved and help keep work in ocular pathology going. He suggested the creation of an entity to keep investigation in pathology advancing.