Eyeworld

OCT 2012

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

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October 2012 EW NEWS & OPINION In the journal … Eye Surgery Education Council helps connect patients with ASCRS member eye surgeons October 2012 by Cindy Sebrell ASCRS•ASOA Director of Public Affairs Transitioning to femtosecond laser flap creation Dan Z. Reinstein, M.D., Glenn Carp, M.B. B.Ch., Timothy J. Archer, M.A.(Oxon), Marine Gobbe, Ph.D. In most cases surgical experience is hard to trump. But how important is this when creating LASIK flaps with the femtosecond laser? In this recent comparative case series, investigators set out to determine how results garnered by a veteran mechanical microkeratome user compared with a fellowship-trained surgeon when both began using the femtosec- ond laser for LASIK flap creation. The two surgeons used the VisuMax femtosecond laser (Carl Zeiss Meditec, Jena, Germany) followed by a standardized myopic LASIK protocol. One of the two had previously performed 637 LASIK procedures involving a mechanical microker- atome. The other, a fellowship-trained surgeon, had limited experience, having performed just 155 supervised LASIK procedures. Results from the first 200 myopic femtosecond LASIK cases performed by the two showed that there was no statistically significant difference in outcomes attained. Post-op, both the experienced surgeon as well as the novice attained 20/20 or better acuity in 96% of cases. For the experienced surgeon one line of CDVA was lost in 3.5% of cases, while for the novice this occurred in just 1.5% of cases. Investigators concluded that when transitioning to a femtosecond laser for LASIK flaps, outcomes for an expert surgeon and one who is fellowship trained were comparable with a standardized surgical protocol. Online search tool helps patients identify qualified ophthalmologists I Intracameral dexamethasone in pediatric cataract Asimina Mataftsi, F.R.C.Ophth., Ahmad Dabbagh, F.R.C.Ophth., Will Moore, F.R.C.Ophth., Ken K. Nischal, M.D. In this retrospective case series, the aim was to consider the incidence of post-op glaucoma in pediatric patients undergoing cataract surgery in which intracameral preservative-free dexamethasone was used. The age range of the 18 patients included here was from 1 to 11 months. Investi- gators found that at the mean follow-up mark of 38 months, no eyes had developed glaucoma, although in four eyes antihypertensive med- ication was needed for a transient period. In addition they determined that no anterior membranes developed in any of the cases, although a second procedure to clear the visual axis was required in 15 eyes, as a result of posterior visual axis opacification. Investigators concluded that there was no increased risk of glaucoma from intracameral preservative- free dexamethasone. They also postulated that when it came to anterior membrane formation, the drug had a protective effect. t's been written many times that the quickly changing U.S. population demographics will result in expanded demand for cataract services in the coming years. While the rising tide might be expected to lift all ships, the internet has enabled patients to become increasingly savvy and selective in their choice of surgeons. The ASCRS Foundation's Eye Surgery Education Council (ESEC) is working hard to connect these pa- tients with qualified ASCRS member surgeons and to provide answers to many commonly asked patient ques- tions. Developed and funded by the Foundation, all ESEC activity is supervised by a medical advisory board of prominent independent ophthalmologists and draws upon a nationwide bureau of medical ex- perts to spearhead its educational initiatives. It is a trusted source that patients can rely on when they have questions about eye surgery or need to find an eye surgeon. Through the ESEC website (www.eyesurgeryeducation.org), patients have access to accurate, non-branded information developed by some of the nation's leading ophthalmologists. They can also find nearby ASCRS member sur- geons with the help of a search tool. In addition to providing an- swers to commonly asked questions, the site contains in-depth inter- views, testimonials, surgical anima- tions, and definitions of medical terms, along with related links and downloads. The "Find a Surgeon" search tool enables patients to search for ASCRS member ophthal- mologists simply by entering their zip code. ASCRS believes that its member services, including the annual Sym- posium & Congress, publications, listservs, and MediaCenter, offer its member surgeons an educational advantage in the marketplace. The ESEC and its Find a Surgeon func- tion provide an opportunity to demonstrate that advantage to prospective patients. How can being a member of ASCRS help your practice? continued on page 14 13 Review/update: Management of intraoperative iris prolapse Naing L. Tint, F.R.C.Ophth., Amritpaul S. Dhillon, Ph.D., Philip Alexander, F.R.C.Ophth. This review centered around the all-too-familiar occurrence of iris prolapse and how this manifests itself, both in cases with no known predisposition, as well as those linked to floppy iris syndrome. The movement of fluid in the eye and its effect on iris position, as explained by the Bernoulli principle, is used to elucidate the mechanism of iris prolapse here. Also highlighted were elements such as iris configuration, position and construction of the corneal tunnel, and anterior chamber depth, which were all pegged as predisposing factors. The authors also discussed how to use ophthalmic viscosurgical devices, iris retractors, and pharmacological agents to prevent iris prolapse, as well as to manage this if it does occur. www.eyesurgeryeducation.org

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