Eyeworld

EW MEETING REPORTER 72 December 2018 EyeWorld/ASCRS reports from the 2018 AAO Annual Meeting, October 26–30, Chicago ing Forum, several presenters gave updates on the Cornea Preservation Time Study (CPTS). Jonathan Lass, MD, Cleveland, presented "Predic- tive Factors for Graft Dislocation and Outcomes After DSAEK in the Cornea Preservation Time Study." Dr. Lass highlighted several mes- sages from the primary CPTS papers on graft success. Preservation time up to 11 days had little influence on graft success after 3 years following DSAEK, and there was a 94% success rate. The objective of the study Dr. Lass discussed was to examine the donor, recipient, and operative factors associated with graft disloca- tion and the consequences in regard to graft success and endothelial cell density (ECD) 3 years after DSAEK. Graft failures could be early or late, Dr. Lass said, and he detailed the two types of graft malpositions examined (graft dislocation and partial detachment). There were graft dislocations in 104 of 1,330 (8%) eyes, and of the 104 eyes, 98 had an air injection. For air injections, 152 of the eyes without graft dislocation had at least one occurrence of interface fluid. Of these eyes, 41 (27%) had air injections (39 with one injection, one eye with two injections, and one eye with three injections). He Editors' note: Dr. Thompson has no financial interests related to his presentation. When to use PRK, LASIK, or SMILE Laser vision correction is faster and has better nomograms compared to 15 or 20 years ago, said Jodhbir Mehta, MD, Singapore. Surgeons now have two decades of data on PRK, high patient satisfaction with LASIK, and a growing amount of data on SMILE (Carl Zeiss Meditec, Jena, Germany). That said, each pro- cedure has its idiosyncrasies, and Dr. Mehta shared a chart to help indi- cate when he selects one procedure over another. For instance, PRK is his top choice for a nervous patient, followed by LASIK, then SMILE. For a patient at risk for dry eye, PRK and SMILE are his top choices, with LASIK in third place. In a patient with moderate to high myopia, Dr. Mehta leans toward SMILE, while PRK and LASIK are equally ranked after that. Editors' note: Dr. Mehta has financial interests with Carl Zeiss Meditec. Updates on the Cornea Preservation Time Study (CPTS) During the Cornea and Eye Bank- Better management of unhappy refractive surgery patients The difference between a good practice and a great practice is the way it handles unhappy patients, said Vance Thompson, MD, Sioux Falls, South Dakota. Dr. Thompson shared pearls at Refractive Surgery Subspecialty Day on how to handle dissatisfied refractive patients but noted that his advice could apply to any unhappy patient. Dr. Thompson spends time listening to his staff's input on patients preoperatively to help identify those who may have surgical or other challenges. He also will not perform surgery until he feels he has made a personal connection with the patient—and he is upfront with patients when this happens. Although there are various physicians at his practice, all dissatisfied patients must be seen by him. Dr. Thompson encourages physicians to be empathetic when listening and to stay calm. Two preoperative pearls that help at his practice are consistently and repeat- edly giving out patient education instructions and handing out a busi- ness card with his email and office phone. Dr. Thompson will write his cell phone on the card, a move that patients seem to appreciate. EyeWorld/ASCRS reports from the 2018 AAO Annual Meeting Sponsored by

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