Refractive Technology Takes Center Stage During the OCRT Symposium

OCRT’s Board of Directors assembled a leading panel of refractive experts for its 6th Annual Refractive Symposium.

The daylong symposium, featured a series of rapid-fire podium presentations and case reports that covered a broad spectrum of refractive care from laser treatments to intra-ocular surgeries to the business and politics of optometric involvement in the field—all in an interactive forum.

“OCRT provides a forum for refractive minded optometrists to share ideas, thoughts and raise issues,” said OCRT President Marc Bloomenstein, of Scottsdale, Ariz. “Having members from across the globe gives OCRT a unique perspective. We are excited about the future of refractive technology, and OCRT will be on the forefront.”

Michael Twa, OD, PhD, FAAO, Assistant Professor, University of Houston College of Optometry, kicked off the symposium with his presentation, “Emotional Well-Being and LASIK,” where he presented information on the HEaL Study, which evaluated the measures of psychological well-being among patients seeking LASIK prior to any surgical intervention.

“Patient advocates claim that poor surgical outcomes after LASIK surgery have the potential to devastate those affected, and in extreme cases, may even lead to suicide behavior,” Dr. Twa said. “The purpose of this study was to evaluate measures of psychological well-being among patients seeking LASIK prior to any surgical intervention and compare those measures with patients who were not.” The study concluded that, prior to surgery, there was no evidence that patients seeking LASIK have any greater than normal risk for suicide behavior than patients who are not seeking LASIK. Additionally, antidepressant use in this sample was very high and exceeded typical use in similar populations reported elsewhere.

Audience members also heard the latest in refractive research from Laney Brown, OD, FAAO, of the Minnesota Eye Consultants. Dr. Brown shared numerous research studies conducted at Minnesota Eye Consultants, including a study on intacs to treat keratoconus (KCN). This study concluded that Intacs treatment with a femtosecond laser was effective management of KCN in all stages. Dr. Brown also discussed other pertinent refractive research at her practice including corneal collagen crosslinking, IntraLase-enabled keratoplasty (IEK) and corneal inlay for presbyopia.

Then, Tracy Swartz, OD, MS, FAAO, of Huntsville, Ala., helped the audience navigate through topography, wavefront and ocular response analysis, during “Making Sense of Corneal Diagnostic Maps and Waves.”

Gregory S. Moore, OD, of the West Virginia Laser Eye Center, reminded audience members that “dry eye is a disease that optometry needs to own,” during “Non-traditional Treatments of Dry Eye.”

“Unfortunately, it goes against the grain of how most optometrists were trained,” he said. “The chief complaint seldom covers all the issues a patient may need addressed. Dry eye requires thinking outside the box.” Dr. Moore discussed the importance of embracing new treatment modalities. In addition to Restasis as his foundation of a dry eye treatment plan, he also covered other options including steroids, AzaSite, other oral options and autologous serum as other potential dry eye treatments.

Toric IOLs are premium IOLs, and the only contraindication for toric IOLs is non-astigmatism, Walt Whitley, OD, MBA, FAAO, told the crowd during “Toric or Not to Toric: Surgical Treatments for Astigmatism.” Dr. Whitley discussed the benefits of toric IOLs including quick recovery time, less induced astigmatism and predictable correct higher amounts of astigmatism.

He also shared the five pearls of toric IOL success: Astigmatism is more prevalent than previously recognized; Differentiate corneal cylinder from refractive astigmatism and astigmatism and accurate/consistent measurements; Differences exist between various IOL models; Surgeons must consider the effect of surgically induced astigmatism to determine the appropriate toric IOL and the correct axis for implantation; Proper alignment of the toric IOL is critical in optimizing the postoperative result.

Don H. Sipola, OD, FAAO, of Duluth, Minn., then presented “Glare and Halos….Still?” Industry sources have presented to the public and the FDA statistics on patient satisfaction with laser vision correction. These statistics include that more than six million procedures have been performed in the U.S. Of this total, 95% of patients are satisfied and 5% are not. Therefore, 300,000 individuals are unsatisfied now, and that number grows by 35-50,000 a year, Dr. Sipola said. Of course, one of the reasons for dissatisfaction after LASIK has been complaints of night vision disturbances (NVD). He discussed the main causes of NVD from LASIK and how pupil size affects NVD. He concluded, of the five causes of NVD from LASIK, large pupil size risk is predictable.

Then, Joseph Stamm, OD, FAAO, of the University of Rochester Eye Institute in Rochester, N.Y., took to the podium to present “Myth Busters 2009—PRK Edition: Why We Do What We Do.” Dr. Stamm’s detailed presentation included surface ablation and topical steroids, the post-ablation healing process, use of steroids after PRK, steroid use and refractive outcome, risk of using steroids long-term, mytomycin-C after surface ablation and corneal healing, and vitamin C and PRK. He concluded, “Just because we’ve always done it that way, doesn’t make it right. Question authority—read the literature, and stay current with your field, and assume nothing.”

Crowd favorite Paul Karpecki, OD, FAAO, finished up the symposium presentations with an informative discussion on “Clinical Research II: Innovation is the Future of Ophthalmic Technology.” The symposium concluded with presentations of case reports, moderated by OCRT past president Jim Owen, OD, MBA, FAAO, of Encinitas, Calif.

Sponsors for the OCRT symposium included Abbott Medical Optics, Alcon and Carl Zeiss Meditec.