The annual AUSCRS ‘Chat’ session focussed on hot topics in ophthalmic surgery. Overseas and local speakers,  as well as representatives from sponsors discussed issues such as the influence of device and pharmaceutical companies on surgeons.

In many countries (including New Zealand), toric IOLs are expensive compared to the state and insurance funded versions in Australia. In Australia, where it costs the patient no more to obtain a better outcome from a toric IOL compared to a standard IOL, patients benefit significantly.

As a result, there is widespread toric prescribing here – around 50 per cent of IOLs are toric, compared to only around  10 per cent in the USA and Europe.

Graham Barrett commented that he does around 80 per cent toric IOLs. He pondered whether that would change if there was a difference in price between torics and non-torics for the patient.

The accurate prediction of results and an obsession with ‘getting it right’ drives most surgeons. Some surgeons noted that they spend a lot of time thinking about and calculating ideal outcomes; almost as much time as actually performing the surgery. 

It’s understandable then that conference sessions that deal with IOL calculations and fine-tuning outcomes are now very popular. At AUSCRS we heard that experienced surgeons who regularly audit their outcomes and tweak their techniques and calculations tend to achieve excellent levels of accuracy. Respected, proven calculators are greatly beneficial. Furthermore, they are evolving and providing ever better results.

 Evolving IOL designs have also significantly reduced unwanted optical phenomena such as dysphotopsia. During the Chat session, it was mooted that EDoF lens use has peaked, however panellists argued that EDoF technology will continue to evolve, driven by lifestyle vision needs. EDoF is about surgeon choice and it was suggested that non-presbyopic surgeons just don’t fully understand the issues!

Article reproduced from 14 December 2018 edition of mivision.