JAN 2019

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

Issue link: https://digital.eyeworld.org/i/1063625

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Page 15 of 78

by Denise Monasterio ASCRS Marketing and Communications Manager ASCRS member spotlight: Parag Parekh, MD, MPA In the journal Phacoemulsification in co-existing corneal opacities Namrata Sharma, MD, Deepali Singhal, MD, Prafulla Kumar Maharana, MD, Rebika Dhiman, MD, Himanshu Shekhar, MD, Jeewan Titiyal, MD, Tushar Agarwal, MD For patients in which a cataract is accompanied by a corneal opacity, most practitioners opt to perform a triple procedure. But in some cases such as those with secondary glaucoma, healed viral keratitis and deep vascularization graft survival is poor. Instead, practitioners may be able to increase visual acuity and allow patients to function better day to day by performing cataract surgery alone. However, to attain maximum visual outcome in these cases practitioners need a comprehensive under- standing of the difficulties that can arise, they must go though proper patient selection and also opt for the right technique. Investigators here considered surgical modifications for phacoemulsification in cases of co-existing corneal opacity and tackled case selection. Optical and visual quality after small incision lenticule extraction (SMILE) Anders Gyldenkerne, MD, Anders Ivarsen, MD, Jesper Hjortdal, MD In this prospective study, investigators considered how SMILE patients with myopia or myopic astigmatism fared in terms of residual refrac- tion, higher order aberrations, and visual acuity. Prior to the SMILE procedure, the 51 eyes had a mean spherical equivalent of –7.08 D. At the 3-month postoperative mark uncorrected distance visual acuity was –0.03 logMAR, and the mean spherical equivalent had decreased to –0.17, while optical scatter was up by 0.22 and coma had increased by 0.1 micrometer. There were no significant changes in spherical aberration. Residual refraction was found to be significantly predictive of uncorrected distance visual acuity. However, uncorrected distance visual acuity was not associated with either scatter or corneal higher order aberration. Investigators concluded that even though both scatter and corneal higher aberrations significantly increased after SMILE, patient-reported visual symptoms decreased. They also determined that analysis of residual refraction can play an important role in predicting postoperative uncorrected distance visual acuity and that residual refrac- tion is important for visual quality. Evaluation of crystalline lens and intraocular lens tilt using a swept-source optical coherence tomography biometer Li Wang, MD, Rodrigo Guimaraes de Souza, MD, Mitchell Weikert, MD, Douglas Koch, MD Investigators in this retrospective case series used OCT to examine the tilt of both the crystalline lens and IOL. Included here were 333 pa- tients. Investigators found that for tilt magnitude the repeatability was 0.1 degrees and for tilt direction was 3 degrees. An anterior tilt of the nasal portion with a mean tilt magnitude of 3.7 degrees was found for both the crystalline lens and the IOL. Both eyes had mirror symmetry. IOL tilt magnitude was 1.2 degrees greater than the tilt of the crystalline lens. Investigators concluded that excellent repeatability of crystalline lens tilt measurements can be attained with an OCT biometer. Postop- erative IOL tilt could be determined by extrapolating from preoperative lens tilt. Magnitude of tilt is greater in eyes with larger angle alpha as well as short eyes. EW January 2019 A SCRS is, at its core, a member-led organization. Much of the education, information, and other offerings are developed by anterior segment specialists for anterior segment specialists. The success of the organization is highly impacted by the contin- ued dedication and volunteerism from the individuals who serve as educators. Every month, we feature one of these member volunteers. We intro- duce you to individuals who have contributed to the society's out- standing education and initiatives, helping our members strengthen their skills and sharpen their ex- pertise, and provide better care to patients. This month's spotlight member is Parag Parekh, MD, MPA. Dr. Parekh has been a member of ASCRS for more than 14 years and has been a regular contribu- tor to the ASCRS•ASOA Annual Meeting, teaching courses and skills transfer labs. He has also been highly active in its government relations activities for many years. In early 2018, he was nominated and confirmed as the chairman of the ASCRS Government Relations Committee. Last summer, Dr. Parekh testified before the U.S. House of Representatives Energy and Com- merce Health Subcommittee on behalf of ASCRS and the Alliance of Specialty Medicine and advocated for a continued viable Medicare fee-for-service option. The hearing was titled "MACRA and MIPS: An Update on the Merit-Based Incentive Payment System." EyeWorld report- ed on his testimony in the October 2018 issue. Dr. Parekh serves as an ASCRS representative for the American Medical Association's Relative Value Update Committee that recom- mends values for all CPT codes. He also serves on two Centers for Medi- care & Medicaid Services-appointed technical expert panels charged with developing cost measures for MIPS. He was involved in creating the new cataract surgery episode-based cost measure and was primarily con- cerned with ensuring that it did not hold ophthalmologists responsible for the cost of care they did not provide. "It is imperative that we [anteri- or segment surgeons] stay informed of the legislative and regulatory issues and policies affecting our patients and affecting us profession- ally," Dr. Parekh said. "These matters affect our day-to-day practice more than we can imagine." Dr. Parekh is the founder of ClearView Eye Consultants, based in State College, Pennsylvania. He earned a bachelor's degree in biolo- gy from Johns Hopkins University, Baltimore, and received his medical degree from the University of Penn- sylvania School of Medicine, Phila- delphia. Dr. Parekh earned a Master of Public Administration (MPA) at the Harvard University John F. Ken- nedy School of Government, Cam- bridge, Massachusetts. He completed his residency at the Johns Hopkins Wilmer Eye Institute and a fellow- ship in cataract, refractive, cornea surgery and glaucoma surgery at Minnesota Eye Consultants. Interested in becoming a volun- teer with ASCRS? Visit ascrs.org/ volunteer. For more information on the ASCRS Foundation and Oper- ation Sight, visit ASCRSFoundation. org. Not a member? Visit ascrs.org/ join for full information. EW Contact information Monasterio: dmonasterio@ascrs.org UPDATE 13 Parag Parekh, MD

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