April 03, 2014
1 min read

Bioptics still a viable concept, with broader meaning and scope

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TOKYO — Twenty-five years after the term “bioptics” was first introduced by Roberto Zaldivar, MD, and José L. Güell, MD, it is still a viable concept with an even broader meaning and scope.

“Originally, bioptics involved reducing most of the refractive error with a phakic IOL followed by a procedure on the cornea to top up for whatever correction was still needed. I also introduced the idea of adjustable refractive surgery, where a flap was performed at the time of phakic IOL implantation and re-lifted some months later to perform laser ablation,” Güell said at the World Ophthalmology Congress.

Over the years, precutting of the flap has been shown to make no difference. LASIK is performed on corneas that have undergone a keratoplasty procedure or in trauma cases, in which the creation of the flap can induce significant refractive changes.

However, the value of the dual procedure has not been lost over time. Most refractive surgeons still use bioptics in a variety of combinations.

“It started because of the limitation of the technology of those years, and today it is a way to optimize results by synergistically combining different technologies,” Güell said.

“Enhancements are becoming so common after keratoplasty — phakic IOL implantation to address presbyopia. All this is bioptics, or trioptics in some cases,” he said.

Disclosure: Güell is a consultant to Ophtec and Carl Zeiss Meditec.