TOKYO — Corneal refractive surgery has lost ground over the past few years for reasons that should be better analyzed, but new developments are under way that might put it back on track in upcoming years, a pioneer of refractive surgery said in an interview at the World Ophthalmology Congress.
“We had years of overproduction of refractive procedures, of great enthusiasm and growth. Now the economy has gone down, and the demand has dropped dramatically,” Bo T. Philipson, MD, told Ocular Surgery News.
The decline of laser techniques, and particularly of LASIK, has been also related to complications such as dry eye and iatrogenic ectasia.
Bo T. Philipson
“New technologies, such as the femtosecond laser for thinner flaps and cross-linking for strengthening the cornea, may have the potential to make it safer,” Philipson said. “Cross-linking may do the whole refractive procedure one day.”
Lens refractive surgery, on the other hand, has been on the rise recently. Lens exchange has advantages, but the ideal lens for vision at all distances has not yet been found.
“Multifocal lenses will never be perfect. Some amount of light scatter is inherent to the technology. Trifocal lenses might be promising, and toric lenses are a good solution for astigmatism. The accommodative option is what we are all looking for, but a suitable mechanism of action has not yet been discovered,” Philipson said.
The Visian ICL (STAAR Surgical), he said, is an option that has delivered better on its promise and should be used more often.
Disclosure: Philipson has no relevant financial disclosures.