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More refractive surgery options seen in 2005


Refractive IOLs, fine-tuning of excimer laser surgery, and shifts in the choices of refractive surgeries, among other developments, have all been highlighted as the primary advances in 2005.

Refractive IOLs, ring segments

"This is the year that we really started to scratch the surface of the advantages of phakic multifocal and accommodative IOLs," said Eric D. Donnenfeld, MD, a founding partner of Ophthalmic Consultants of Long Island, Rockville Centre, NY, and associate professor of ophthalmology, New York University Medical Center, New York.

"This technology is changing the way that all ophthalmologists practice refractive surgery," Dr. Donnenfeld said. "The vision achieved with these IOLs is stable, the optics are better than with ablative procedures, the lenses can be removed, and they can treat degrees of myopia, astigmatism, and presbyopia that are untreatable with conventional corneal surgery."

"However, all have a place in my armamentarium, and I appreciate them all for different reasons," Dr. Donnenfeld said.

The new generation of IOLs

The new generation of accommodative IOLs, according to Dr. Donnenfeld, should be very exciting.

"The Synchrony IOL (Visiogen Inc.) looks promising," he said. "The ability to have monofocal quality of vision with accommodative optics is a big step. While multifocal IOLs provide the best range of vision now, in the future the accommodative IOLs will probably be the best bet for correcting presbyopia after cataract surgery."

Peter S. Hersh, MD, also acknowledged the contribution of refractive lenses, but noted that, interestingly, phakic IOLs have not gained huge acceptance, which may be due partly to the newness of the technology.

"Surgeons have not embraced them at the rate that one might expect," said Dr. Hersh, director, Cornea and Laser Eye Institute-Hersh Vision Group, Teaneck, NJ, and clinical professor of ophthalmology and chief, Cornea and Refractive Surgery, UMDNJ-New Jersey Medical School, Newark.

Hiroko Bissen-Miyajima, MD, considers the correction of presbyopia to be a very hot topic.

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