EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/115557
144 EW MEETING REPORTER Reporting live from ASCRS•ASOA Winter Update 2013, Aventura, Fla. March 2013 He said culturing may be advised when there is suspected Acanthamoeba, with severe infections or with ulcers that are progressive and are not responding to treatment. Editors' note: Dr. Holland has no financial interests related to this talk. Medicare payment reform bipartisan, "not going away" Editors' note: This Meeting Reporter contains original reporting by the EyeWorld news team from ASCRS•ASOA Winter Update 2013. Multiple issues remain in modifying the Affordable Care Act (ACA), with the priorities for ophthalmologists aimed at repealing the Sustainable Growth Rate (SGR), Independent Payment Advisory Board (IPAB), eRx, electronic health record (EHR) and Physician Quality Reporting System (PQRS) penalties and value-based payment modifier. Nancey K. McCann, director of government relations for ASCRS•ASOA, discussed the future of healthcare reform in a legislative and regulatory update. She said following the November 2012 election, the status quo remains in Washington, D.C., with President Barack Obama being reelected and Democrats gaining two seats in the senate. Because the U.S. Supreme Court upheld the ACA, it is the law of the land, she said, with "basically the ball [remaining] in Congress' court." "We're going to have to deal with it and talk about how we can make changes to it as we go forward into the future," she said. Ophthalmologists need to be aware of the future of healthcare reform because it is an increasingly bipartisan issue in Congress and not simply going to disappear or return to the way it was in the past, she said. One example is over the last decade, the House and Senate have created short-term patches to fix Medicare's SGR. The American Taxpayer Relief Act, the recent fiscal cliff negotiation, prevented a SGR cut for another year. It also allows for physicians to participate in clinical registries to meet Medicare PQRS. "Really the ultimate goal of the government, bipartisan I might add, is for physicians to adopt [electronic medical records] EMR and to use the EMR to report on quality. And then they're going to measure that qual- Attendees interact during the exhibit hall breaks while having a light snack. ity and efficiency, and that's how you're going to get paid in the future," she said. This year, key Congressional committees are examining repealing the SGR and its replacement policy, with a repeal proposal, the House Ways and Means/Energy and Commerce Joint SGR Repeal and Reform Proposal, gaining momentum. Even though it is still in the proposal stage, the language used in it is promising, she said, maintaining fee-for-service and allowing specialties to develop their own quality measures and metrics for future updates, both of import to ophthalmologists. She encouraged physicians to take part in future political decisions by becoming an advocate for the specialty, starting by visiting www.ascrsgrassroots.org. Editors' note: Ms. McCann has no financial interests related to this article. Saturday, February 16 Valuable pearls and tips for cataract, refractive management, treatment From a useful smartphone application to tips for dealing with complications in cataract surgery and addressing ocular surface disease, a panel of physicians shared pearls in short presentations in a "Rapid F-Eye-R" session. "My pearl to you is to understand the patients and ques- tion them on any underlying disease; you want to optimize their systemic treatment and look for blepharitis and meibomianitis because that can lead to dry eye and make it harder to treat them," said Dr. BragaMele, who told the audience that 90% of her patients have dry eye. To manage dry eye and the ocular surface, she recommends patients take flax seed oil and omega-3 pills and mild steroids if there is any underlying inflammatory disease. Dr. Lane also discussed his recommendation to patients about taking omega-3 oils, but his pearl was to be aware of the different formulations available on the market for those supplements. "The problem is, as you recommend omega-3s and fish oils for your patients, they're not all created equally. There are differences in the various omega-3s in terms of not only the concentrations of the omega-3 components themselves, but also in the processing and absorption of it," he said. He said the omega-3 formulation from PRN (Plymouth Meeting, Pa.) appears to be an effective and pure form. In the section called "Complications Management: Best Save of the Year," Dr. Braga-Mele's tip was to not withdraw your irrigating hand during phacoemulsification until stabilizing the posterior capsule if a complication occurs like the one that she showed in a video: The tip of her chopper came off and was in