Eyeworld

28 | EYEWORLD | AUGUST 2019 ATARACT C Contact information Tipperman: rtipperman@mindspring.com by Liz Hillman EyeWorld Senior Staff Writer Best of ASCRS 2019: Cataract In general, women and patients who self-reported as Asian or Pacific Islander were correlated with being more likely to provide a non-5 score. Having subjective eye pain of mild to severe was also correlated with scores less than 5. The researchers concluded that there are no conclusive studies demonstrating the rela- tionship between patient satisfaction and clinical outcomes and lower Press Ganey scores were often related to factors outside the practitioner's and clinic staff 's control. "Are perioperative NSAIDs really necessary in preventing cystoid macular edema if IOP is adjusted immediately after MICS or FLACS?" John Jarstad, MD, Van Nguyen, MD, Carli Wittgrove Dr. Tipperman said this paper provides infor- mation that attendees can use immediately in practice. While the main purpose of the study was to evaluate whether NSAIDs prevented CME if IOP was adjusted immediately after cataract surgery, Dr. Tipperman focused on a different facet of the study. The researchers evaluated the accuracy of manual palpation on the eye in predicting and adjusting for the correct IOP at the end of cataract surgery. The researchers found that an experienced surgeon going by feel alone, thinking IOP was normal, had IOPs that ranged from 9–67 mm Hg. Thirty-three percent of patients who did not have IOP adjusted in the OR required adjustment postop day 1, com- pared to less than 5% of those who did have an immediate adjustment after surgery. Eyes with immediate postop adjustments were four times less likely to develop CME. Dr. Tipperman also highlighted additional results from the study: (1) estimated $44,000/ year/doctor in savings with immediate IOP ad- justment in the OR; and (2) reduced likelihood of needing postop day 1 pressure adjustment if adjusted immediately after surgery. T he Best of ASCRS 2019 is a general session at the ASCRS ASOA Annual Meeting where members of the EyeWorld Editorial Board select what they think were the best papers in different categories from the meeting. They choose from the papers that were awarded Best Paper of Session in each individual paper session throughout the meeting and explain why they made their selections. Here we recap what those papers were in the Cataract category and why Richard Tipper- man, MD, a member of the EyeWorld Cataract Editorial Board, thought they were noteworthy. "Characteristics of cataract surgery patients influencing Press Ganey patient satisfaction scores" Michele Lee, MD, Stephanie Chen, MD, Tiffany Chen, Ann Caroline Fisher, Charles Lin, MD, Kuldev Singh, MD, Robert Chang, MD Dr. Tipperman said he chose this paper because it covers a topic that's gaining more importance in the field. "Ophthalmology does a great job of eval- uating metrics in terms of patient outcomes, but insurers and payers are going to start rating us more and more, and some of those ratings end up online," Dr. Tipperman said, explaining that this paper looks at factors that affect how people rate doctors on validated scales. After clinic visits in Lee et al.'s cross-sec- tional study, patients were asked to answer ques- tions from the Press Ganey Hospital Consumer Assessment of Healthcare Providers and Sys- tems tool and the National Eye Institute Visual Function Questionnaire 25. One hundred and forty-three patients were included in the study, and the main outcome was the proportion of scores less than 5 (5 being "very good") and the patient's likelihood of recommending the prac- tice to others. As Dr. Tipperman put it, a rating of less than 5 is considered a negative rating by many standards. The investigators looked at patient demographics, patient subjective out- comes, clinical outcomes, trainee involvement, wait times, and time with the provider. About the doctor Richard Tipperman, MD Wills Eye Hospital Philadelphia Financial interests Tipperman: None

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