Richard Packard delivers Binkhorst Medal Lecture

Issue: October 2015

BARCELONA — Richard Packard, MD, FRCS, FRCOphth, was honored as the Binkhorst Medal lecturer, “probably one of the greatest honors that can be given to an ophthalmologist in their career,” he said.

Packard, who has been performing phacoemulsification since 1979, related the evolution of the capsulotomy in his lecture at the European Society of Cataract and Refractive Surgeons meeting.

Richard Packard

The introduction of femtosecond lasers in cataract surgery in 2008 represented a “fundamental change” in the making of the capsulotomy, Packard said. “For the first time we could make capsulotomies of a given size, in a given position with no risk of tear out of the capsulotomy and without the variables of the manual technique, but there were some caveats,” he said. Surgical flow, size of the equipment, cost and relative advantages are all considerations in adopting the femtosecond laser.

For those who have adopted the technology, though, Packard said, “The majority of femtosecond laser users for cataract surgery value the capsulotomy above any other function.”

Technologies for creating perfectly round, consistent, central capsulotomies continue to evolve, for example, with continuous rather than pulsed laser and with mechanical thermal devices. Size and centration of the capsulotomy matter for all IOL placements, but in particular when multifocal or toric lenses are used, and IOL manufacturers are considering the capabilities of the new technologies in their IOL designs, according to Packard, who chairs the Ocular Surgery News Europe Edition Editorial Board.

“As surgeons we should soon have a range of options available to make our capsulotomies more circular, predictably sized and positioned,” Packard said. — by Patricia Nale, ELS

Disclosure: Packard reports he is a consultant to Alcon, Core Surgical and Shire Pharmaceuticals and is an equity shareholder in Excellens.