Eye care is an ever-evolving field, and 2019 brought with it several advances in approach and technique that surgeons need to keep in mind as they adopt the latest best practices in glaucoma surgery.
Josh Johnston, OD, FAAO, in Atlanta Justin Schweitzer, OD, FAAO in Sioux Falls, SD, offered an overview of what surgical updates have come to optometry in the past year, speaking at Vision Expo West 2019 in Las Vegas.
New ways of looking at cataracts
A primary shift in thinking has been focused on cataract surgery. ODs are seeing a paradigm shift where patients expect their cataract procedures to produce positive refractive outcomes, even in cases of astigmatism and presbyopia.
“Modern cataract surgery can do that,” Dr. Johnston says.
A new era of intraocular implants (IOLs) is here, with toric, multifocal, and presbyopic IOLs on the market offering better results than older generations of implants.
Also on the horizon are extended depth-of-focus diffractive IOL designs that elongate focus.
“That spacing and height variation here gives you a range of vision,” Dr. Johnston says.
Future IOL technology
The world of IOLs is about to see even more exciting advancements.
Light-adjustable lenses offer a new approach to IOL placement. The method uses ultraviolet (UV) light to lock in IOLs after surgery. This offers predictable correction of residual refractive error after lens implantation for optimal distance vision, and the IOLs are customizable to control for monovision, near adds, and asphericity.
The advancements give more control to both ODs and patients.
The ability to adjust that implant in the first month speeds up the process,” Dr. Schweitzer says.
Another emerging technology is a refractive capsule with potential applications for IOL exchanges and drug-emitting devices.
ODs can also expect to see more applications for femtosecond laser-assisted cataract procedures.
“The femtosecond laser is more accurate for treating astigmatism,” Dr. Johnston says.
Other strategies such as dropless cataract surgery and laser fragmentation were also mentioned.