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    The latest tool for photo-refractive comanagement

    When a colleague or a patient utters the phrase “intelligent design” (ID), it is challenging for me to not roll my eyes as far back as some patients’ contact lenses get lost up there. If we really think about it, the design of the ocular system is far from intelligent.

    In fact, I was just explaining to a patient (who was lamenting his inability to see 20/10) about the proximity of rods and cones when I was detoured by the fact that the axons of these nuclei actually are backward. Moreover, why is the visual system so far in the back of the brain and away from the eyes? That is like putting a handicapped parking spot in the back of a building. Don’t even get me started on the crystalline lens—I mean really, four decades in and the lens is retiring! However, there is an ID worthy of notoriety in the ophthalmic field, and that is the iDesign Dx from Abbott Medical Optics.

    More from Dr. Bloomenstein: Integrated care means integrating the best care

    The evolution of refractive surgery

    As primary care providers to the ophthalmic system, we are tasked with educating our patients with their best options. Over the last two decades, the landscape for the treatment of an emmetropic patient has grown. In fact, I don’t think it would be hard to argue that refractive surgery is as safe as contact lenses and safer than cataract surgery. Born from the ashes of a photo-refractive procedure that is still efficacious and safe, laser assisted in-situ keratomileusis (LASIK) is now synonymous with refractive surgery.

    In true Darwinian fashion, LASIK has replaced radial keratotomy (RK) or photo refractive keratectomy (PRK), much like a DVR to a VHS recorder or a cassette player for a digital audio player. Managing patients with LASIK has been reduced to making sure your patient has his artificial tears or is taking his Restasis (cyclosporine, Allergan). Yet, much like the media-related advancements we have seen in our lifetimes, there are still some potential glitches. Although we don’t see a spinning wheel when we are managing a LASIK patient, we can encounter the occasional diffuse lamellar keratitis (DLK), striae in the flap, epithelial cell down growth, and Loch Ness Monster of complications: the infection.

    Those who bring us this photo-refractive surgery technology do not just rest at this level of excellence. Did Apple stop at iPhone 3? Did George Lucas stop at Star Wars Episode 2? No! The iDesign Dx is like 3M, it is just making the surgical procedure better.

    Next: iDesign Dx

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    Optometry Times A/V