by Paul Batson, O.D. Center Director VisionAmerica of Birmingham What was the post-op refraction of the first IOL patient implanted by Sir Harold Ridley in 1949? His second patient wasn't much better at -15 but then things started improving as they modified the lens design. Although he continued with his work, Ridley was ostracized by many throughout the ophthalmology community for years. It's hard to believe that it wasn't until the mid-1980's that he began to receive the recognition he deserved for his accomplishments and IOL implantation after cataract extraction really started to gain acceptance. He was eventually knighted by the Queen of England in 2000 not long before his death in 2001. It's hard to believe how far we have come in that short time. I just finished attending the American Society of Cataract and Refractive Surgery (ASCRS) Meeting in Washington, D.C., earlier this week. I've come to really enjoy this meeting as an opportunity to gain a wealth of information about the current and future trends of cataract and refractive surgery (as well as glaucoma). We have come a long way in the last 30-40 years and have a lot of incredible things in the pipeline. Our current monofocal IOL's have continued to evolve to improve lens stability, posterior capsule opacification rates and quality of vision with the adoption of different spherical aberration levels (more on this in the future). With toric IOL's, multifocal IOL's and Extended Depth of Focus (EDOF) lenses, the options for our patients are tremendous. The recent approval of the Light Adjustable Lens also has a tremendous amount of promise. Using a laser, these lenses will allow you to modify residual post-op refractive sphere and cylinder and are looking to create EDOF optic patterns as well. The future holds some pretty incredible things such as trifocal IOL's to improve the full range of vision or accommodating IOL's like the LensGen or FluidVision lens which contains fluid to change the shape of the IOL to mimic our natural accommodation. Or, what if we could use a femtosecond laser to reshape the millions of IOL's already implanted to provide an improvement in residual refractiveerror, aberrations or create multifocal patterns? (P.S. It's already being done). It really is an exciting time for patients undergoing cataract surgery. Our current technologies provide great results and it's going to just continue to improve as it has over the past 20-30 years.
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August 2019
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