Eyeworld

8 • 2018 ASCRS Clinical Survey Key findings Low to moderate intraocular inflammation after cataract surgery can have a significant impact on visual quality, recovery, and patient comfort/satisfaction, according to nearly 90% of respondents. As such, 86% of respondents think that prescribing both corticosteroids and NSAIDs can treat postop inflammation and control pain. Most anti-inflammatory and pain control agents are not given intraoperatively, though nearly 40% said they would consider intraoperative instillation within the next 12 months. Fifty percent of respondents, overall, are giving intracameral or transzonular/intravitreal antibiotics or a combination agent with an antibiotic (43% U.S. and 62% non-U.S.), with moxifloxacin being the preferred agent followed by cefuroxime. "I think this strong agreement regarding the impact of inflammation shows there is a consensus among surgeons that inflammation after cataract surgery is important, and it can affect not only visual quality but the time it takes to recover vision and even patient comfort. With regard to the use of both NSAIDs and corticosteroids to treat postoperative inflammation, this survey shows strong surgeon agreement with this therapy, which is in line with research that has found NSAIDs and corticosteroids provide signifi- cantly better prevention of cystoid macular edema after cataract surgery. "The survey found that while anti-inflammatory agents are not ones that surgeons are likely to administer intraocularly, many are likely to use intracameral or transzonular/intravitreal injections of antibiotics. The reason for the difference here is there is clear evidence that intracameral antibiotics are effective in preventing infections after surgery compared to even well-used topical antibiotics. The use of intracameral antibiotics in the U.S. is still lower than elsewhere, and I think one of the major reasons is there is not an approved antibiotic for intracameral use in the U.S. This issue prompted ASCRS to put together a prospective study to com- pare intracameral antibiotics to topical antibiotics. If this study shows positive results like we think it will, we might be able to get an approval from the FDA, and I think that will push the numbers higher." —Nick Mamalis, MD ASCRS Cataract Clinical Committee Inflammation How confident are you that combining BOTH corticosteroids and NSAIDs can reliably treat postoperative inflammation and control pain following routine cataract surgery? • 86% of respondents are Very Confident or Confident • U.S. respondents are 7% points higher than Non-U.S. respondents, 89% to 82% • Only 4% of respondents are Unconfident or Not confident at all n=298 98 COPYRIGHT 2018 AMERICAN SOCIETY OF CATARACT AND REFRACTIVE SURGERY (ASCRS). ALL RIGHTS RESERVED. NO PART OF THIS SURVEY MAY BE REPRODUCED WITHOUT WRITTEN PERMISSION FROM ASCRS, 4000 LEGATO ROAD, SUITE 700, FAIRFAX, VA 22033. DRAFT OF 2018 ASCRS CLINICAL SURVEY - DO NOT PUBLISH/DISTRIBUTE How significant of an impact do you think that substitution by a pharmacy of generic ophthalmic drops in place of brand name drops has on patient outcomes and safety? • 55% of respondentsthink substitution has a Significant or Very Significant impact on patient outcomes and safety • 19%think it is Insignificant or Very Insignificant n=324 99 COPYRIGHT 2018 AMERICAN SOCIETY OF CATARACT AND REFRACTIVE SURGERY (ASCRS). ALL RIGHTS RESERVED. NO PART OF THIS SURVEY MAY BE REPRODUCED WITHOUT WRITTEN PERMISSION FROM ASCRS, 4000 LEGATO ROAD, SUITE 700, FAIRFAX, VA 22033. DRAFT OF 2018 ASCRS CLINICAL SURVEY - DO NOT PUBLISH/DISTRIBUTE Do you currently use intracameral or transzonular/intravitreal injections of antibiotics or a combination agent containing an antibiotic? • 50% Yes • U.S.: 43% • Non-U.S.: 62% n=437 102 Which is your preferred intraoperative antibiotic injectable agent? • 80% of respondents prefer Moxifloxacin or Cefuroxime • Moxifloxacin: 47% • Cefuroxime: 33% • Majority of U.S. prefer Moxifloxacin, 53% • Majority of Non-U.S. prefer Cefuroxime, 47% n=220 105

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