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Surgeon: Future of refractive surgery looks promising
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Emanuel S. Rosen, FRCS, FRCOphth, of Manchester, England, delivered the Ridley Medal Lecture at the German Ophthalmic Surgeons meeting. |
NUREMBERG, Germany — The future of refractive surgery looks promising for ophthalmologists and patients, according to Emanuel S. Rosen, FRCOphth, of Manchester, England.
Introduced by meeting president Armin Scharrer, MD, as “possibly the most influential ophthalmic surgeon of the past 30 years,” Mr. Rosen delivered the Ridley Medal Lecture here at the German Ophthalmic Surgeons meeting.
“The future of refractive surgery is assured due to increasing safety and effectiveness of treatment, the developing range of options and ever-increasing acceptance by the public,” Mr. Rosen said.
“The future will be customized vision,” he continued. “We’re coming to the era of customized vision for all. Personalized choice is the true legacy of Harold Ridley.”
Of particular note, Mr. Rosen said, is that lenticular approaches to refractive surgery are now “catching up with corneal options.” Mr. Rosen predicted that a future trend in refractive surgery will be to address a patient’s refractive error initially with a lenticular approach and to refine the result with laser corneal techniques.
He cited the recently released 2003 Leaming survey of the American Society of Cataract and Refractive Surgery to compare current trends with past “quantum leaps” in technological innovation.
Among recent technological advances is the phakic IOL, but Mr. Rosen stressed that “the search is on for the presbyopic solution.”
While he noted that LASIK remains the most commonly used refractive technique, Mr. Rosen said that was because current multifocal and “pseudoaccommodating” IOLs for presbyopia are only an interim solution. He explained that he calls the current crop of accommodative lenses “pseudoaccommodating” because the accommodation occurs by changing the location of a fixed-power lens.
“Truly accommodating IOLs will be those with actual accommodation achieved by change of the curvature of the lens,” he said. “We’re looking for an uncompromised presbyopic solution. When a permanent solution such as this is discovered, the flood gates will open for (refractive lens exchange).”
For the time being, he said, monofocal IOLs will remain the standard.