Emerging efforts: technological wizardry in the pipeline

Source: Jonathan M. Davidorf, M.D., and Richard L. Lindstrom, M.D.

Two years following Synchrony IOL Implantation Source: Jonathan M. Davidorf, M.D., and Richard L. Lindstrom, M.D.

Honing in on the most anticipated cataract, refractive technologies All eyes will be on the hottest devices on many ophthalmologists’ wish lists during the upcoming session on “New and Emerging Technologies in Cataract and Refractive Surgery” at the 2010 ASCRSASOA Symposium and Congress in Boston. At the session to be held on Sunday, April 11 at 8 a.m., a panel led by Jonathan M. Davidorf, M.D., Jules Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, will bring to light the most anticipated technologies in cataract and refractive surgery.
In this course, which has become an ASCRS staple, the technology discussed is cutting edge. Dr. Davidorf hopes it will once again garner an audience from around the world. The panel of experts is slated to include Michael Colvard, M.D., Ike Ahmed, M.D., Anthony J. Aldave, M.D., Brian S. Boxer Wachler, M.D., Richard L. Lindstrom, M.D., Mark Packer, M.D., Daniel M. Schwartz, M.D., and James J. Salz, M.D. Each of these experts will give a presentation. “After a few presentations of a similar kind, we will have a panel discussion with questions from the attendees interspersed,” Dr. Davidorf said.

Lenses with a twist

Dr. Davidorf sees all of the technologies to be highlighted as promising, with several edging closer to practical use. “Some of these technologies we’ve followed for awhile and they’re coming closer to FDA [Food and Drug Administration] approval, which makes it exciting,” he said. “For example, for the Synchrony Dual Optic accommodating IOL [Abbott Medical Optics, Santa Ana, Calif.], the data has been submitted to the FDA and is being evaluated.” This technology, which includes a high plus-powered anterior optic and a high negative-powered posterior one, is poised to potentially become the next accommodating IOL to gain FDA approval. With this dual lens technology, the optics move apart when the ciliary body contracts, providing for near acuity, and come together when the ciliary body relaxes, for distance. Another lens heading closer to fruition that attendees will be hearing about during the session is the Light Adjustable Lens (Calhoun Vision, Pasadena, Calif.). This lens, which is currently in Phase II FDA clinical trials, is comprised of a partially polymerized material which, with the aid of ultraviolet light, can be reshaped post-op to correct any residual refractive error. “The Light Adjustable Lens is further along in the FDA process, as are the intracorneal lenses for presbyopic treatment,” Dr. Davidorf said. The small diameter intracorneal inlays such as the AcuFocus (Bausch & Lomb, Rochester, N.Y.) and the PresbyLens (ReVision Optics, Lake Forest, Calif.) are designed to correct presbyopia without intraocular surgery. The AcuFocus lens relies on a pin-hole effect to improve depth of focus, while the PresbyLens is placed under a LASIK flap and used to change the anterior surface of the cornea. In addition, the PresbyLens provides a central near add zone and a paracentral intermediate zone to aid in near and intermediate vision.
In the presbyopic vein, Dr. Davidorf foresees session discussions on the latest presbyopic lens working their way through channels. “Surgeons can decide which presbyopic lens is best for them,” he said. “It’s always changing because in the U.S., we have a few different options and we’re going to have more.” For example, the TetraFlex Accommodating IOL (Lenstec Inc., St. Petersburg, Fla.) is currently in Phase III trials with one year of follow-up, and the company is hoping it will join the armamentarium soon. “We always get into a discussion about looking at the latest data, the latest lenses, and we try to provide the attendees with our view point on selection criteria for the different lenses,” Dr. Davidorf said. “We’ll discuss what the advantages and drawbacks are of the various lenses.”

The femtosecond coming

Intrastromal presbyopic laser treatment with the femtosecond will also be one of the new technologies to receive attention during the session. “The question here is one of permanence and of patients’ acceptance of any type of multifocal corneal treatment,” Dr. Davidorf said. “Also, there are questions of the options for patients who are intolerant of a multifocal cornea.”
Another related approach slated to be in the spotlight will be femtosecond cataract extraction. Dr. Davidorf expects to discuss the perceived place of this new technology in cataract surgery. “It’s awesome to look at technology that has taken an already great procedure and is adding ergonomic hurdles to it by introducing the femtosecond laser,” Dr. Davidorf said. “We’re looking forward to learning where that technology is currently and what we can anticipate from it in the future.”

Editors’ note: Dr. Davidorf did not indicate any financial interests related to his comments.

Contact information

Davidorf: 818-883-0112, DrJ@davidorf.com