Journal of Refractive Surgery

GUEST EDITORIAL 

Introduction to the 10th NIDEK International Refractive Surgery Symposium: A Tale of Two Cities

Paul J Dougherty, MD

Abstract

Welcome to the Proceedings of the 10th NIDEK International Refractive Surgery Symposium held April 6, 2005, in Dubai, United Arab Emirates and the NIDEK Asia-Pacific Refractive Surgery Symposium held June 2, 2005, in Beijing, China. These two cities represent the contrast of the new and the old. Dubai is the crown jewel of the United Arab Emirates; a mecca of new, shiny glass buildings arising out of the desert over the past 20 years. Beijing is the political and social capital of the 5000-year-old Chinese culture; the home of such historic, world-famous landmarks as the Great Wall, the Forbidden City, and the Summer Palace. These two meetings included participation by some of the brightest minds in refractive surgery together with surgeons from virtually every continent in the world to discuss the latest developments in refractive surgery. As an American surgeon, international refractive surgery symposia such as this provide a glimpse into the future of our practices as the latest technologies receive US FDA approval. Not only was I witness to cultural and social history being made in the UAE and China, but also witness to what George O. Waring III, MD, referred to as a watershed moment in refractive surgery. Some of the new techniques and technology presented at the symposium represent historical changes in the way we practice refractive surgery.

This is the 10th such meeting sponsored by NIDEK Co Ltd. Although this company is based in Gamagori, Japan, it truly has a global perspective when it comes to ophthalmology and refractive surgery. This company, founded and owned by visionary engineer and entrepreneur Hideo Ozawa, has a commitment to refractive surgery like no other company in the world. Sponsorship of these stand-alone global refractive surgery symposia on a yearly basis demonstrates the commitment this company has to both educating surgeons and bringing refractive surgery technology into the 21st century.

Although NIDEK has been hampered by slow regulatory approvals in the United States, it is the leader worldwide in developing new and unique diagnostic and therapeutic technologies for use in laser vision correction. The brilliant engineers at NIDEK have developed refractive technologies that are amongst the most commonly used by surgeons around the world. NIDEK is responsible for developing the concept of the transition zone in excimer laser ablations and has furthered the refined quality of refractive excimer ablations by developing aspheric treatment algorithms that are incorporated into all of the software used in international lasers. While reviewing many of the papers in this supplement, note that although "optical zones" used with the newer software of 4.5 to 5.5 mm (combined with transition zones out to 10 mm) seem smaller than other lasers, the newer ablation profiles result in some of the largest effective optical zones and best quality of vision in the industry. With NAVEX technology, traditional definitions of optical and transition zones need to be cast aside as the two zones seamlessly join into one another to create what one would call a "treatment zone" of up to 10 mm.

Unlike virtually any other laser commercially available worldwide, the surgeon has the ability to modify multiple aspects of the NIDEK laser ablation including optical and transition zone sizes, residual keratometry, and amount of irregularity ablation, allowing the surgeon to sculpt the target postoperative topography. These features put control of the customized ablation back into the hands of the surgeon, rather than depending on "black box" engineering to determine each patient's individual custom treatment algorithm. With all of this precision and control, I look at the NIDEK NAVEX system as one of the most sophisticated refractive laser systems in…

Welcome to the Proceedings of the 10th NIDEK International Refractive Surgery Symposium held April 6, 2005, in Dubai, United Arab Emirates and the NIDEK Asia-Pacific Refractive Surgery Symposium held June 2, 2005, in Beijing, China. These two cities represent the contrast of the new and the old. Dubai is the crown jewel of the United Arab Emirates; a mecca of new, shiny glass buildings arising out of the desert over the past 20 years. Beijing is the political and social capital of the 5000-year-old Chinese culture; the home of such historic, world-famous landmarks as the Great Wall, the Forbidden City, and the Summer Palace. These two meetings included participation by some of the brightest minds in refractive surgery together with surgeons from virtually every continent in the world to discuss the latest developments in refractive surgery. As an American surgeon, international refractive surgery symposia such as this provide a glimpse into the future of our practices as the latest technologies receive US FDA approval. Not only was I witness to cultural and social history being made in the UAE and China, but also witness to what George O. Waring III, MD, referred to as a watershed moment in refractive surgery. Some of the new techniques and technology presented at the symposium represent historical changes in the way we practice refractive surgery.

This is the 10th such meeting sponsored by NIDEK Co Ltd. Although this company is based in Gamagori, Japan, it truly has a global perspective when it comes to ophthalmology and refractive surgery. This company, founded and owned by visionary engineer and entrepreneur Hideo Ozawa, has a commitment to refractive surgery like no other company in the world. Sponsorship of these stand-alone global refractive surgery symposia on a yearly basis demonstrates the commitment this company has to both educating surgeons and bringing refractive surgery technology into the 21st century.

Although NIDEK has been hampered by slow regulatory approvals in the United States, it is the leader worldwide in developing new and unique diagnostic and therapeutic technologies for use in laser vision correction. The brilliant engineers at NIDEK have developed refractive technologies that are amongst the most commonly used by surgeons around the world. NIDEK is responsible for developing the concept of the transition zone in excimer laser ablations and has furthered the refined quality of refractive excimer ablations by developing aspheric treatment algorithms that are incorporated into all of the software used in international lasers. While reviewing many of the papers in this supplement, note that although "optical zones" used with the newer software of 4.5 to 5.5 mm (combined with transition zones out to 10 mm) seem smaller than other lasers, the newer ablation profiles result in some of the largest effective optical zones and best quality of vision in the industry. With NAVEX technology, traditional definitions of optical and transition zones need to be cast aside as the two zones seamlessly join into one another to create what one would call a "treatment zone" of up to 10 mm.

Unlike virtually any other laser commercially available worldwide, the surgeon has the ability to modify multiple aspects of the NIDEK laser ablation including optical and transition zone sizes, residual keratometry, and amount of irregularity ablation, allowing the surgeon to sculpt the target postoperative topography. These features put control of the customized ablation back into the hands of the surgeon, rather than depending on "black box" engineering to determine each patient's individual custom treatment algorithm. With all of this precision and control, I look at the NIDEK NAVEX system as one of the most sophisticated refractive laser systems in the world. Just as Japanese technology outpaced other automotive manufacturers in the 1970s, data from these symposia imply that Japanese engineering has brought NIDEK to the forefront of modern refractive surgery.

This supplement to the Journal of Refractive Surgery represents the proceedings of both symposia and includes articles that represent the highlights of the 62 presentations given at the meetings. The presentations are screened by peers to appear in the program but are not formally peer-reviewed. However, each of the papers published in this supplement were editorially reviewed by Dr Waring and myself. Because of this, these manuscripts are published as a supplement to the Journal of Refractive Surgery with "S" pagination.

The papers in this supplement were written by both world leaders in refractive surgery as well as lesserknown surgeons. Surgeons from countries around the globe including China, United Arab Emirates, Saudi Arabia, the United Kingdom, Spain, the Republic of Georgia, Mexico, Canada, Argentina, and the United States collaborated to make this supplement a reality. The supplement is broken down into sections including New Laser Techniques, New LASIK Techniques, Diagnostic Techniques, Hyperopia, LASIK Complications, Wavefront Ablation, and Microkera tomes.

The first symposium was held in April 2005 at the Shangri-La Hotel in Dubai, UAE. Dubai is the second largest of the seven emirates that make up the UAE. During one of his talks, Dr Alaa El-Danasoury presented a photograph of Dubai as it looked 15 years ago; it was a desert trading post located along the confluence of the Dubai Creek and Gulf of Arabia with minimal development. Today, hundreds of modern, glass-walled skyscrapers line the busy streets of the "Las Vegas of the Middle East." Dubai is home to numerous worldclass hotels and restaurants. The Burj Al Arab Resort, the only seven-star hotel in the world, is located on a man-made island created in the shape of a palm tree. The popularity of this exclusive resort was confirmed when the concierge informed me that the next available reservation for any meal was four months away.

The second symposium was held in Beijing, the capital of The People's Republic of China. China is poised to be both the economic as well as the military superpower in our lifetime. With a population of 1.4 billion, China is enormous. The Great Wall, an amazing architectural feat that required millions of people to build, was constructed to keep out invading Mongolians and has signified China's isolationist past. After driving by Pizza Hut and Starbucks in a Peugeot taxi on the way back to the Marriott Hotel, I realized that China is definitely no longer an isolated country. As the city prepares to host the 2008 Summer Olympics, the influence of the rest of the world is easily palpable.

I would like to extend special thanks to everyone who helped me with the production of this supplement. Aileen Wiegand, the managing editor, did a wonderful job of organizing and editing the manuscripts for spelling and grammar as well as checking references. If it were not for her persistence, the supplement would not have been finished on time. I would like to thank Rich Bains, director of Clinical Education from NIDEK, for all of his hard work in collecting and doing the initial edit of the manuscripts. Also, thank you for being the recipient of the majority of our animar s animosity on the day that we went on the camel safari in Dubai. I would also like to recognize Kuntal Joshi, the director of marketing for NIDEK, for all of his hard work and expertise in putting together two great symposia with a world-class faculty and excellent presentations. Kuntal served as an amazing tour guide and resource when we were in the UAE and China. Last, but not least, I would like to thank George O. Waring III, MD, Editor-in-Chief, for inviting me to be Guest Editor for this supplement. His advice in the choosing of papers to be included in the publication and editing were invaluable. Although communicating with Dr Waring in Beijing was, at times, hampered by Jack the tailor from the Oldest Famous Store who was trying to get the perfect fit for his custom-made suits, his mentoring on the project was greatly appreciated.

The process of working with surgeons from around the world to put together this supplement has been both stimulating and fun. I hope you find the following articles informative and thought-provoking.

10.3928/1081-597X-20050902-05

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