A lifetime quest

A new book gathers together several decades of work by Prof Noel Alpins that seeks to improve astigmatic outcomes

Dermot McGrath

Posted: Saturday, September 1, 2018

Single-angle polar plots as they appear on an eye based on the Alpins Method of astigmatism analysis


Noel Alpins

In the mid-1980s, around the time that Ronald Reagan was in the White House and extracapsular cataract surgery was still being widely performed, a young Australian ophthalmologist called Noel Alpins gave his first talk on astigmatism to a gathering of colleagues in Melbourne. The topic of Alpins’ talk was dynamic vector analysis, inspired by long hours spent removing sutures after cataract extraction so as minimise or rotate the astigmatism for optimal outcomes.

Looking back at that moment, Prof Alpins said that he “realised then that there was a significant amount of mathematical and scientific evaluation required to quantify and improve astigmatic outcomes”.

What he didn’t perhaps realise, however, was just how much time he would devote to unravelling the deeper mysteries of vector analysis and astigmatism calculation.

Since his first scientific paper on the topic in 1993, Prof Alpins has continued to expand and refine his thinking on the subject in numerous peer-reviewed articles. Although his methodology slowly gained traction among colleagues, it still took several decades for the “Alpins Method” to reach its current level of recognition as the “best all-round interpretation” (in the words of Dan Z Reinstein) for analysing astigmatic outcomes.

Official establishment recognition has also followed suit. The Alpins Method has now been adopted by the major journals, including the Journal of Cataract and Refractive Surgery, the Journal of Refractive Surgery and Ophthalmology, as the standard means for the reporting of astigmatic results published in them.

Prof Alpins is the first to acknowledge, however, that understanding the Alpins Method is no easy task. “I believe that far more ophthalmologists do not understand it versus the number who do,” he says.

To help redress the balance, Prof Alpins has now gathered together all of his published papers, book chapters and other articles into one comprehensive volume, , which has just been published. The 24-chapter compendium is designed to serve as a definitive, comprehensive and accessible reference document on the Alpins Method and all of the developments that have followed from it.

Prof Alpins said that the book is designed to give ophthalmologists a deeper understanding of the techniques underpinning the Alpins Method and how they interrelate with each other.

“I do feel that I have taken analysis of vectors to new heights for both the corneal and refractive measures of astigmatism, and that my work helps put the eye-care community on the same page when it comes to planning and analysing astigmatism associated with both refractive and cataract/intraocular surgery,” he said.

After a lifetime of searching for answers, Prof Alpins is confident that the current version of the Alpins Method will ultimately stand the test of time.

“I simply do not feel that a better way will be found for astigmatism analysis. I believe that the Alpins Method will continue to grow in importance in concert with an increasing awareness of the method within the eye-care community,” he said.

Noel Alpins:

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