Guiding progress

It is with great pleasure that I write this editorial for the May issue of EuroTimes. This issue has a special focus on the use of technology in cataract and refractive surgery. Cataract surgery has improved significantly in terms of visual outcomes, complications and ease of the procedure. Our patients benefited from improvements in surgical technique and the development of more advanced phaco machines, OVDs and intraocular lenses with advanced optical characteristics. I believe that recent advances are also based on improvements in optical biometry and the inclusion of factors such as posterior corneal power in IOL formulae. The use of these newer formulae including those based on artificial intelligence is also helping to improve accuracy. Some of them may be particularly useful for post-refractive surgery cases and extremely long or short axial lengths. There have also been major advances in intraoperative imaging technologies such as 3D and OCT. The latter helped us to better understand the fluidics and anatomical causes of Infusion Misdirection Syndrome (IMS). Typical characteristics of IMS are the posterior capsule bulging forward, accumulation of lens particles behind the PC and anterior chamber flattening at the final steps of phacoemulsification and during irrigation-aspiration. That is not infrequent in eyes with advanced and mature cataracts and loose zonules and coming from irrigation fluid accumulating behind the posterior capsule due to the Wieger’s ligament rupture. Since the outbreak of the COVID-19 pandemic, we have also had to re-evaluate the way we perform our surgeries and deal with our patients. In future years, we can look forward to more exciting developments in the field of telemedicine. In this issue of EuroTimes, Dr Iain Livingstone discusses his experience helping to set up a pioneering virtual emergency teleophthalmology programme covering a large part of Scotland in response to the COVID-19 emergency. In conclusion, let me leave a final reflection from my friend and colleague, Professor Rudy MMA Nuijts, President of the ESCRS. In the EuroTimes Cover Story Prof Nuijts points out that whatever the future holds, the focus must continue to be on addressing patient needs. He asks will it make sense to continue to push visual outcomes within 0.5D of target beyond the 80-85% achievable today? “I have not seen any study that addresses that,” he says. With limited resources and difficulties to eye care access in many countries we really are in great need of breakthrough innovations that will increase our efficiency and the quality of care for the many patients in need.

Tags: technology