• Refractive Indexing: Potential Applications

    At Refractive Surgery Subspecialty Day, George Waring IV, MD, gave a “bench look” at several potential applications of refractive index shaping (also known as refractive indexing).

    This technology, which uses a particular femtosecond laser, “does not affect the external structure” of an intraocular lens (IOL), he said. “It’s purely internal.”

    The technology can add or remove the defocus power of an IOL, modify toricity, create custom asphericity, and create extended depth of focus. In addition, it can create multifocality (refractive and diffractive) in a monofocal lens, and it can be used to customize—and even to reverse—multifocality. Many of these treatments can be performed sequentially and be repeated.

    In addition, the technology appears to perform well “across different acrylics,” Dr. Waring said. “There are acrylics that may be better suited, but across the board, if you look at different acrylic IOLs that are on the market, you can see that the standard deviation is actually quite low among different brands.”—Jean Shaw.

    Financial disclosures. Abbott Medical Optics: C,L; ACE Vision Group: C; AcuFocus: C,L; Alcon: C,L; Allergan: C,L; Avedro: C,L; Gerson Lehrman Group: C; GlassesOff: C; Glaukos: C,L; Johnson & Johnson: C,L; Minosys: C; Oasis Medical: C,L; Oculus: C,L; Omega Ophthalmics: C; Perfect Lens: C; Refocus Group: C; Strathspey Crown: O; Visiometrics: C,O.

    Disclosure key. C = Consultant/Advisor; E = Employee; L = Speakers bureau; O = Equity owner; P = Patents/Royalty; S = Grant support.

    Next story from AAO 2018—Dissatisfied Patient? A Refractive Surgeon’s Advice: Vance Michael Thompson, MD, provided his advice for how to manage unhappy patients.