Dr. Jason Stahl reviews the highlights of the 2008 ASCRS meeting in a conversation with Dr. Parag Majmudar. The global nature of the meeting allows for an international sharing of experience with these lenses. Though surgeons are interested in the technology, few have adopted the technology in their practice. Femtosecond laser LASIK flap creation, Intralase and others, is another hot area, especially in the creation of very thin flaps. This results in better corneal stability. Dr. Stahl explains his research: a contra-lateral study where the Intralase and Ziemer systems are tested in the same patient. Early results show that both produce predictable and accurate flap creation. Thin planar flaps are essential to corneal biomechanical stability, preferable to microkeratome. Sub-Bowman's Keratomileusis (SBK) vs. surface ablation. SBK biomechanical stability approaches that of surface ablation techniques. Dr. Stahl then reviews the nature of his practice which emphasizes academics and research: evaluation of new technologies - lasers, pharmacologic agents, IOLs, etc. The future of refractive surgery is presbyopic IOLs. Cataract and Refractive surgical disciplines are fusing to the point where surgeons really need to master both to meet patient expectations. Baby boom generation (fee for service patients) doesn't want to wait for cataract procedures. High expectations. Refractive Lens Exchange with presbyopic IOLs is really a four-in-one proposition: stabilizing vision (no presbyopia), obviating cataracts, correcting refractive error, good near vision, good distance vision. In the future, Dr. Stahl believes refractive error will by corrected primarily in a lens-based approach vs. LASIK, especially as the technology of accommodating IOLs improves.