Eyeworld

DEC 2012

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

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54 EW MEETING REPORTER Reporting live from AAO/APAO 2012, Chicago December 2012 suggested suturing the IOL to the peripheral iris using a modified McCannel technique. ���Doing this through a 3.5-mm incision gives the surgeon greater flexibility in treating patients with no capsule support,��� he said. Sadeer Hannush, M.D., Philadelphia, prefers gluing a posterior chamber IOL to suturing it, using a modified technique originally described by Amar Agarwal, M.D. ���There���s less risk of iris prolapse,��� he said, but acknowledged the technique does require surgical expertise. ���Glued IOLs are a novel approach for PC IOL implantation,��� he said. ���It avoids complications related to sutures, large incisions, and hypotony.��� Editors��� note: Dr. Nichamin has financial interests with Abbott Medical Optics, Allergan,, Bausch + Lomb, and other ophthalmic companies. Dr. Stark has financial interests with VueCare Media. Majority of patients would bene���t from laser refractive surgery Editors��� note: This Meeting Reporter contains original reporting by the EyeWorld news team from AAO/APAO 2012, Chicago. According to Michael C. Knorz, M.D., Mannheim, Germany, the current published data ���seems to support the suggestion that most patients would benefit from laser refractive lens surgery.��� During an overview addressing which patients would be most likely to benefit from this type of surgery, he said using a femtosecond laser ���has a lot more potential than former lens surgery approaches.��� A laser capsulorhexis is ���better than a manual one,��� he said, citing several studies on the topic. Using a femtosecond laser also results in fewer anterior capsule tears than manual procedures, and it seems to be ���at least as good and possibly better��� than manual procedures, he said. Patients most likely to benefit from a femtosecond laser refractive lens surgery include those with large pupils, ���which will give the laser access to the lens capsule and nucleus,��� he said. Editors��� note: Dr. Knorz has financial interests with Alcon, ForSight Labs, and Optical Express. Laser refractive lens surgery called ���crucial��� to successful cataract surgery Zoltan Nagy, M.D., Budapest, Hungary, widely credited as the first surgeon to use a femtosecond laser in refractive lens surgeries, said a ���precise and well-centered capsulorhexis��� is ���crucial��� to successful cataract surgery. The effect of having such a predictable capsulotomy is called ���photodisruption,��� he said. ���This technology has the potential to reduce the risk of capsular tear and other complications such as inflammation and endophthalmitis, creating self-sealing corneal incisions,��� Dr. Nagy said. Editors��� note: Dr. Nagy has financial interests with Alcon. Melles provides top reasons for performing DMEK Gerrit RJ Melles, M.D., Rotterdam, the Netherlands, provided an overview of the ���Top 10 Reasons Why You Should Be Performing Descemet���s Membrane Endothelial Keratoplasty (DMEK) in 2012.��� Dr. Melles is the inventor of the procedure, and he prefaced his list by saying that endothelial keratoplasty has been evolving over the years. In joking that all the best things come from Holland, Dr. Melles��� first point was this is a Dutch technique. Many of his other reasons pertained to the surgery���s impacts on both patients and doctors, as well as the generally good outcomes and follow-ups. ���It���s a safe technique,��� he said. In addition, you will usually have happy patients and happy doctors because of the smooth aftercare, Dr. Melles said. ���There are low risks of complication and from a clinical view, this is really nice,��� he said. There are also no major investments required for this technique, and it���s feasible in virtually every clinical setting, Dr. Melles said. DMEK generally has very good visual outcomes, which was also a reason Dr. Melles stressed more widespread use of the procedure. Surgeons warn about being aware of con���icts of interest when receiving information George O. Waring III, M.D., Atlanta, and Samuel Packer, M.D., Great Neck, N.Y., countered each other on a panel discussing professional development and ethics. Both dealt with potential conflicts of interest and how to evaluate what you are hearing from those who may be presenting to an audience. Dr. Waring first addressed who should be at the podium. ���The question is, how do we regard those people who are presenting to us?��� he said. He said a presenter needs to have access to companies and know what���s going on, and he stressed the importance of being suspicious. Another thing to consider is company and industry affiliation. Industries enable physicians, Dr. Waring said, and this is how there are devices and pharmacology to help physicians. However, he said it���s a matter of how a presenter manages the relationship as a professional with company interests. He also said it���s important to check a presenter���s presentation slides for any sort of company logo or affiliation, as well as to see how the data is handled. Meanwhile, Dr. Packer discussed who should not be at the podium. He questioned who it is that should actually be deciding on a presenter. ���Money isn���t the only conflict of interest,��� Dr. Packer said. Industry can present a conflict of interest, too, he said. In addition, one thing to consider when listening to a presenter is whether or not there is new knowledge or knowledge to improve patient care being presented. Dr. Packer said it is important to know who a speaker represents because factors such as self-interest can cause bias. Editors��� note: Dr. Melles has financial interests with DORC International. Dr. Waring has financial interests with

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