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OSN Editorial Board to present refractive lens exchange course at ASCRS
Course aims to help surgeons make smooth transition from refractive cataract surgery to RLE.
Members of the Editorial Board of Ocular Surgery News will conduct a course on refractive lens exchange at this year’s meeting of the American Society of Cataract and Refractive Surgery in San Diego.
“Refractive Lens Exchange: A Practical Guide for Cataract Surgeons” will be presented on Saturday, May 1, from 10 a.m. to 11:30 a.m. at the San Diego Convention Center. It will be taught by course director William F. Maloney, MD, and other experts in the field of RLE, Richard L. Lindstrom, MD, R. Bruce Wallace III, MD, and Louis D. Nichamin, MD.
“Refractive lens exchange is rapidly assuming a central role in the refractive arena. It is the beginning of phase 2 of Ridley’s IOL revolution,” said Dr. Maloney, author of the monthly Ocular Surgery News column Lens-Based Refractive Surgery. “Phase 1 brought us to refractive cataract surgery. This course is designed for those ready to cross the 20/20 threshold into refractive lens exchange.”
The course will focus on material presented by OSN editorial board members, with an emphasis on educating cataract surgeons about the techniques and technology of RLE.
“Our course will detail indications, preoperative planning, astigmatism management, surgical technique pearls, complications prevention and anticipated outcomes,” said Dr. Lindstrom, chief medical editor of Ocular Surgery News.
Dr. Maloney added, “The goal of this course is to outline the specific techniques … so that attendees can anticipate a smooth transition to RLE.”
Treating presbyopia
An important application for RLE is the presbyope, Dr. Maloney said.
“There is no happier patient than a presbyope whose reading has been restored,” he said. “They feel whole again.”
Presbyopia is treatable with RLE using blended vision with monofocal implants or multifocal IOLs, Dr. Maloney said. “I am amazed at surgeons who do not yet appreciate just how powerful these modalities are in treating presbyopia,” he said.
The recent approval of the Crystalens from eyeonics — the only accommodating IOL currently approved in the United States — will add a new modality to RLE, Dr. Lindstrom said.
“The … accommodating IOL expands the potential patient benefit of this procedure,” he said.
Treating astigmatism
Dr. Nichamin said RLE depends on effectively addressing the patient’s astigmatism.
“If a patient has enough astigmatism to warrant reduction (generally 1 D or more), then additional surgery may be superimposed, concurrently or at a later time, on the astigmatically neutral clear corneal temporal incision,” he said.
He said limbal astigmatic relaxing incisions are commonly used to correct astigmatism during or after RLE.
Dr. Maloney said that one of the requirements for crossing the 20/20 threshold is that “astigmatism must be reduced to less than 1 D.” He said the concept of the 20/20 threshold, as well as what is needed to cross it, will be addressed in the course.
IOL calculation
Another aspect of RLE that will be discussed during the course is IOL calculation. Dr. Maloney said that in RLE, IOL calculation has to be on target every time.
To achieve success, IOL power calculations must be within ± 0.25 D of target for most patients and within ± 0.5D for patients with ametropia of more than 8 D.
Dr. Maloney said the potential of RLE lies in the fact that it uses familiar techniques and technologies and that it potentially offers better refractive accuracy than corneal refractive surgical approaches.
“Assuming state-of-art surgery, the IOL remains the safest and most effective means of providing stable, long-term correction of refractive error,” Dr. Maloney said. “The greatest appeal of refractive lens exchange today is that the procedure utilizes only well-established techniques and materials, like IOLs, that can restore vision with near-perfect results.”
For Your Information:
- William F. Maloney, MD, can be reached at 2023 West Vista Way, Suite A, Vista, CA 92083; 760-941-1400; fax: 760-941-9643; e-mail: williammaloney2000@yahoo.com.
- Richard L. Lindstrom, MD, can be reached at Minnesota Eye Consultants, 710 E. 24th St., Suite 106, Minneapolis, MN 55404; 612-813-3600; fax: 612-813-3660; e-mail: rllindstrom@mneye.com.
- Louis D. Nichamin, MD, can be reached at Laurel Eye Clinic, 50 Waterford Pike, Brookville, PA 15825; 814-849-8344; fax: 814-849-7130; e-mail: nichamin@laureleye.com.
- R. Bruce Wallace III, MD, can be reached at 4110 Parliament Drive, Alexandria, LA 71303; 318-448-4488; fax: 318-448-9731; e-mail: rbw123@aol.com.