In this episode of the Eye Views podcast, our host Lorcan Butler speaks with Masara Laginaf, a consultant ophthalmologist specialising in cornea, cataract and refractive surgery. In this deep dive into anterior segment care, they explore the transition to private practice, the latest in femtosecond laser technology, and the management of presbyopia and ocular surface disease. From LASIK and lenticule extraction to implantable contact lenses (ICL) and refractive lens exchange (RLE), this episode covers the essential surgical and diagnostic tools for modern eyecare professionals.
Dr Laginaf shares her "fortuitous" journey into the refractive space, highlighting the critical role of mentorship and high-volume surgical training. She details her experience in the Kent, Surrey, and Sussex Deanery and fellowships at Frimley Park and Luton and Dunstable, where she gained exposure to complex corneal transplants and refractive procedures. For trainees (ST3–ST7), she recommends leveraging resources like the Royal College of Ophthalmologists e-learning, ESCRS and ISRS modules.
A turning point in Dr Laginaf’s career was undergoing LASIK surgery herself in 2020 at OCL Vision. She discusses how being on the other side of the laser enhanced her ability to counsel patients on the sensations of surgery, such as the pressure of the suction ring, and the immediate visual recovery. This personal perspective allows her to relate deeply to patient fears regarding optical appliances and the life-changing impact of vision correction.
The conversation shifts to the rapidly evolving tech landscape, including lenticule extraction, comparing SMILE with newer platforms like the Schwind ATOS (SmartSight), which Dr. Laginaf notes can lead to fewer dry eye symptoms. Premium IOLs are discussed and Dr Laginaf's early adoption of the Rayner Galaxy spiral-optic lens. Dr Laginaf also covers presbyopia management and navigating the "longest conversation" in clinic by balancing monovision, blended vision, and emerging technologies like scleral laser micro-perforation or EDOF ICLs.
Dr Laginaf emphasises that every refractive surgeon must also be a dry eye specialist. She outlines her strict preoperative protocols to optimise the tear film, including zest (okra-based) lid cleaning and IPL (Intense Pulsed Light) therapy to treat blepharitis and MGD. The importance of repeat biometry and K-readings when the ocular surface is unstable to ensure refractive accuracy.
With the rise of 'Zoom gloom' and heavy digital device use, patient demands for intermediate and near vision have never been higher. The episode concludes with a discussion on managing expectations around night driving and the 'governmental inquiry' into levels of glare from modern car headlights, reassuring patients that neuroadaptation typically improves these symptoms over 6–12 months.Eye News is the longest-running print and digital magazine dedicated to ophthalmology in the UK, with an international and domestic readership of healthcare professionals, both within the NHS and private healthcare practices. Season 2 of Eye Views is proudly sponsored by Mainline Instruments. Visit their website here: https://eu1.hubs.ly/H0rc4Th0 To reach their team, email: [email protected]