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A Brief History of MIGS

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AUGUST 2015 # 21 Upfront In Practice NextGen Profession Dissolving cataracts The misnomer Making YAG capsulotomies What the “experience with eyedrops? of monovision a thing of the past economy” means for you 10 34 – 36 44 – 45 52 – 54 A Brief History of MIGS Ike Ahmed shares the story behind his pioneering – and controversial – journey into microinvasive glaucoma surgery. 18 – 25 A NEW ERA HAS BEGUN, AND IT LOOKS AMAZING. Introducing TECNIS®,2/WKHÀUVWDQGRQO\ SUHVE\RSLDFRUUHFWLQJ ([WHQGHG 5DQJH RI 9LVLRQ ,2/ $WODVW\RXUSDWLHQWVFDQHQMR\LQFUHDVHGVSHFWDFOHLQGHSHQGHQFHZLWK DWUXHH[WHQGHGUDQJHRIYLVLRQ1 $IXOOUDQJHRIFRQWLQXRXVKLJKTXDOLW\YLVLRQLQDOOOLJKWFRQGLWLRQV2 ,QFLGHQFHRIKDORDQGJODUHFRPSDUDEOHWRDPRQRIRFDO,2/1 • TECNIS® Symɑony7RULF,2/DOVRDYDLODEOH 7KH ZRUOG ZLOO QHYHUORRNWKHVDPH For more information, contact your Abbott Medical Optics sales representative. 1. 166 Data on File_Extended Range of Vision IOL 3-Month Study Results (NZ). 2. TECNIS® Symfony DFU TECNIS® Symfony Extended Range of Vision Lenses are indicated for primary implantation for the visual correction of aphakia and preexisting corneal astigmatism in adult patients with and without presbyopia in whom a cataractous lens has been removed by extracapsular cataract extraction, and aphakia following refractive lensectomy in presbyopic adults, who desire useful vision over a continuous range of distances including far, intermediate and near, a reduction of residual refractive cylinder, and increased spectacle independence. These devices are intended to be placed in the capsular bag. For a complete listing of precautions, warnings, and adverse events, refer to the package insert. TECNIS andandT TECNISECNIS SYMFONY SYMFONYa arere trademarkstrademarkso ownedwnedb byyo orrl licensedicensedt tooA Abbottbbott Laboratories,Laboratories itsits subsidiariessub or affiliates. ©2014 Abbott Medical Optics Inc., Santa Ana, CA 92705 www.AbbottMedicalOptics.com PP20140012 Online this Month Last Month’s Top Tweets What’s got you talking? @OphthoMag www.theophthalmologist.com Preserving #photoreceptor cells following #retinalinjury: Five Things We Learned This Month: Stop advocating “micropulse” laser http://ow.ly/Q1GAf http://bit.ly/1Ipr8iY without proper comparison with 5:30 PM - 25 Jul 2015 CW laser! Stop teaching and advocating CW Compare the effect of “micropulse” Researchers pinpoint where the brain laser within the macula laser to the effect of CW laser of the unites our eyes’ double vision: CW laser has been used for more than same power and duration. For example, http://ow.ly/Q1zNu 35 years without the understanding “micropulse” burst of 800 mW, 10% 1:15 PM - 24 Jul 2015 of the harm it creates by “focal duty cycle and 100 ms duration photocoagulation”, a completely should be compared to CW laser of New eye drops dissolve the deposits that misunderstood application, because 80 mW and 100 ms duration. As we cause cloudy vision: of the use of visual acuity to measure have shown (Retina, 32(2): 375–386 http://ow.ly/PZmCd outcomes. Burning the retina in an (2012)), the average temperature and 3:44 PM - 23 Jul 2015 attempt to control retinal or choroidal Arrhenius integral in these two cases vascular leakage within 1 DD of the are very similar. Until this comparison Meet Ray Flynn: dry AMD patient, fovea produces unacceptable paraxial is performed clinically, the claim of the Argus II recipient, and the world’s first scotomata that impair vision within 3-5 benefits of the micropulse laser is just a person with natural and artificial vision. degrees of fixation which expand over marketing gimmick! 6:00 PM - 22 Jul 2015 time and impair visual task function. What is really important is to treat Macular laser should be performed the macula below the tissue damage only with micropulse technology threshold. This can be done well with that results in no physical burns but properly titrated CW laser. See for controls leakage with equal success. example: Retina. 35(2):213-22 (2015). – Stephen Sinclair, USA – Daniel Palanker, USA Ike Ahmed’s MIGS Surgery Videos In this issue, Ike Ahmed discusses the development of microinvasive glaucoma surgery (MIGS) and the part he played in the field (including coining the term MIGS). Read the full article on page 18, and go to top.txp.to/0715/MIGS to view Ike’s videos of the Cypass, Hydrus, and Xen45 microstents, and how he implants three iStents into one eye. Contents 58 Feature 18 A Brief History of MIGS The man that coined the term “MIGS”, Ike Ahmed, recounts his 18 adventures in interventional glaucoma surgery to date, and the next steps in his quest to retire the trabeculectomy. 03 Online This Month Upfront 10 Eyedrops to End Reports Cataract Surgery? 07 Editorial 26 Who Benefits from Preservative- The Closest Thing to The Six 12 The Argus II: Thirty Patients Free Glaucoma Therapy Million Dollar Man, with RP, Three Years Later Taking the time to talk with your by Mark Hillen patients and performing a few 13 Minimally Invasive, quick assessments of ocular Maximally Successful surface disease could make all the difference. 08 Contributors 14 Sight in a Single Cell 46 Look into the Intelligent Onn ThThee CCo Coverveer 15 Standardizing Stem Approach to Cataract Surgery Cell Selection The LENSAR with Streamline AUGUST 2015 # 21 A nod to Peter G. Peterson’s Upfront In Practice NextGen Profession femtosecond laser is designed to Dissolving cataracts The misnomer Making YAG capsulotomies What the “experience with eyedrops? of monovision a thing of the past economy” means for you 10 34 – 36 44 – 45 52 – 54 A BrBrief History of MMIGS Ikke Ahhmed shares the story behehind hihis piooneering – and controversisial – journney into microinvasivee gllaucomoma surgery. “I Like Ike” artwork, with a dash of 118 – 255 16 Wireless Drug Dosing simplify refractive and cataract Canada added into the mix. surgery. Three surgeons explain how. ISSUE 21 - AUGUST 2015 Editor - Mark Hillen [email protected] Editorial Director - Fedra Pavlou [email protected] Associate Editor - Roisin McGuigan [email protected] Associate Editor - Michael Schubert [email protected] Senior Designer - Marc Bird [email protected] Junior Designer - Emily Strefford-Johnson [email protected] Chief Executive Officer - Andy Davies [email protected] NextGen Chief Operating Officer - Tracey Peers [email protected] 40 For Surgeons, By Surgeons Publishing Director - Neil Hanley [email protected] Michael Mrochen and surgeons Audience Insight Manager - Tracey Nicholls Arthur Cummings, Eugene Ng, [email protected] and Ronan Byrne explain how Traffic and Audience Associate a new ocular biometer, Mirricon, - Lindsey Vickers might eliminate IOL power [email protected] formulae... and refractive surprises. Traffic and Audience Associate - Jody Fryett [email protected] Digital Content Manager - David Roberts 44 Lessons from the Deep [email protected] Can PCO be prevented by Mac Operator Web/Print - Peter Bartley 52 using IOLs that take design cues [email protected] from sharkskin? asks Chelsea Magin. Tablet Producer - Abygail Bradley [email protected] Social Media / Analytics - Ben Holah [email protected] In Practice Profession Change of address 30 Trying Out Trifocals [email protected] The arrival of trifocal IOLs 52 Patient Care at a Premium Tracey Nicholls, The Ophthalmologist, Texere Publishing Limited, Booths Hall, Booths Park, has changed how many Laura Hobbs explains what the Chelford Road, Knutsford, Cheshire, WA16 8GS, UK ophthalmologists think about “Experience Economy” is, what it Single copy sales £15 (plus postage, cost available on functional (and intermediate) means for cataract/refractive request [email protected]) vision. Florian Kretz recounts surgeons, and how mastering it his patients’ experiences with a can deliver success to your practice. General enquiries: www.texerepublishing.com new trifocal IOL, and how he [email protected] assesses their post-procedural 56 Social Media: What’s the Point? +44 (0) 1565 752883 satisfaction. Daya Sharma argues that you have [email protected] to embrace social media, otherwise Distribution: 34 The Misnomer of Monovision you’re invisible to Generation Y. The Ophthalmologist (ISSN 2051-4093), is Monofocal IOLs allow patients to published eleven times a year, by Texere Publishing retain good near and distant Ltd and is distributed in the USA by UKP Worldwide, 1637 Stelton Road B2, Piscataway, vision, with the majority of NJ 08854. patients being satisfied with their Sitting Down With Periodicals Postage Paid at Piscataway, NJ and additional mailing offices vision afterwards. Ray Radford POSTMASTER: Send US address changes to asks: why, then, isn’t monovision 58 Joan Miller, Chief and The Ophthalmologist, Texere Publishing Ltd, more popular with cataract surgeons? Chair of the Department of C/o 1637 Stelton Road B2, Piscataway NJ 08854 Ophthalmology, Massachusetts Eye and Ear, Boston, MA. NEW! AcrySof ® IQ ™ PanOptix Presbyopia-Correcting IOL Designed for more natural adaptability Featuring ENLIGHTEN (ENhanced LIGHT ENergy) Optical Technology to mimic the performance of a healthy crystalline lens, the AcrySof® IQ PanOptix™ IOL is the natural choice for advanced presbyopia correction: • Optimized light utilization in a presbyopia-correcting IOL. Transmits
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