As this issue goes to press, health-care workers around the world remain stunned by the dichotomy of the old (2020) vs the new order (2021). In the United States, daily cases of COVID-19 have been plummeting from 100,000 cases/day to nearly 25,000 cases/day in the past several months. Yet, places like Brazil and India recorded more than 400,000 cases in a single day recently. Emergence of mutant strains and limited vaccine availability fuel new concerns abroad, and we are anxious to see that they can emerge from the old order into a brighter future.

While we are seeing the light at the end of the tunnel in the United States (looking forward to the so-called “new order” of things), we are still dealing with vaccine hesitancy and must be careful to maintain our vigilance, especially as we test the efficacy of the vaccines against the more prevalent mutant strains of SARS-Co-V.

IN WITH THE OLD AND NEW

It seems as though the theme of old vs new applies to our field as well. In this issue, we explore some older, more established concepts in cornea, as well as highlight recent advances in technology and technique that can help our patients prosper.

Corneal ulcers and keratoconus are old as time, yet Mark Milner, MD, and Ken Beckman, MD, FACS, remind us that it’s important to have an updated framework when discussing these entities with patients. Also, we must stay current and hone our ability to treat these conditions with the alacrity of a modern ophthalmologist.

Perhaps no other area of cornea has seen such rapid advances over the past decade as endothelial keratoplasty. Just as we are getting familiar and comfortable with DMEK, a new contender may be emerging: Descemet stripping only (DSO). Kathryn Colby, MD, PhD, and Dylan Stevens, MD, discuss the nuances of DSO, which may confer some advantages for our patients with early Fuchs’ dystrophy.

Topography-guided refractive surgery has also been gaining traction recently. While we in the United States still lack basic and critical results tools such as transepithelial ablation, we have seen advances in diagnostic and planning software. Mark Lobanoff, MD, Aleksander Stojanovic, MD, PhD, and Yue Feng, MD, explore these technologies, all of which will enable us to continually refine and improve our outcomes in refractive surgery.

Finally, an exciting albeit niche product was recently approved for anterior segment reconstruction. Michael Snyder, MD, discusses the HumanOptics artificial iris and delivers pearls for success with this potentially life-changing technology for patients who suffer from congenital, acquired or traumatic abnormalities of the iris and anterior segment.

THE WARP AND WOOF OF EVERY MOMENT

Ralph Waldo Emerson once said that “Old and new make the warp and woof of every moment. There is no thread that is not a twist of these two strands.” It’s great to see that this rings true in this issue of Ophthalmology Management. Happy reading, and have a safe, enjoyable and, dare I say, “normal” summer 2021! OM

Parag A. Majmudar, MD, is the president and chief medical officer of Chicago Cornea Consultants, Ltd., where he practices cataract, corneal and refractive surgery. He also serves as associate professor of ophthalmology at Rush University in Chicago. Dr. Majmudar is an active member of the ASCRS and AAO, and he has received the Academy’s Achievement Award and Senior Achievement Award. He is the former chair of the AAO Refractive Surgery Program Committee and is a former member of the ASCRS Refractive Surgery Clinical Committee.