ASCRS News
December 2022

by Vance Thompson, MD
Refractive Editor

This issue of EyeWorld is special to me for a number of reasons. For one, it represents the last issue of my term as Refractive Editor, and wow, I have enjoyed this journey. Being a passionate refractive surgeon who loves his specialty, I have learned so much from the people we have asked to be a part of this section and share their expertise. They have made me better as a comprehensive refractive surgeon who evaluates every patient with the question “What would I do if I were them with my knowledge and situation?”

This issue is full of hot topics to help us deliver quality refractive surgical care. We get to learn from Lance Kugler, MD, and Audrey Talley Rostov, MD, about how SMILE fits into their practice. SMILE has been considered one of the fastest growing refractive surgeries in the world over the past decade, and these doctors teach us why. This beautiful procedure combines what we love about PRK (no flap) with what we love about LASIK (fast vision return and increased comfort). Having been in the FDA-monitored trials of PRK, LASIK, and SMILE, I am excited to learn their philosophy of what is great about SMILE and how to deal with various situations important to the SMILE surgeon.

With the approval of the EVO ICL (STAAR Surgical) that eliminates the need for a peripheral iridotomy, we learn from Evan Schoenberg, MD, Neda Shamie, MD, Bennett Walton, MD, Blake Williamson, MD, and Roger Zaldivar, MD, about the nuances of using this exciting lens and who the candidates are. The advantages of the EVO ICL over previous generations of the ICL are also discussed. I have enjoyed placing this lens as both an FDA-monitored investigator and post-approval. When I place it in the second eye, I call it (in my head) the “EVO” twin. It is a wonderful addition to our refractive surgery offerings and helps in those situations where corneal refractive surgery would be pushing the limits too much.

We also have the honor of learning from Arjan Hura, MD, Dan Reinstein, MD, Neda Shamie, MD, and William Trattler, MD, about the role epithelial mapping plays as a diagnostic that is helpful for detecting early keratoconus and for aiding in important refractive surgery decisions. I find it so helpful to map the epithelium in questionable topographies where the physician is wondering if corneal refractive surgery is safe or not. If a physician does not have epithelial mapping, a choice is to simply not do corneal refractive surgery in questionable topographies, but I know patients appreciate how epithelial mapping provides a clearer picture of whether they have an increased risk of ectasia in the long run, with or without surgery. I love the technology. 

Finally, I would like to welcome our new Refractive Editor, Karolinne Rocha, MD, PhD, a world-class person and refractive surgeon who I am so excited to learn from with her vast knowledge and experience. Thank you, EyeWorld readers, for a great run. I have really enjoyed this journey with you all. I have enjoyed having a front row seat in selecting topics and experts to have the wonderful EyeWorld staff interview and write about. Thank you to the EyeWorld staff for making this position so rewarding. I am excited to stay on the EyeWorld team in the emeritus role and help with ideas on how to best cover the future hot issues in our wonderful specialty. I hope you enjoy this issue that covers some of the most important topics in refractive surgery today.