EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/115557
March 2013 Phakic IOLs Patients with very high myopia, even those with a spherical equivalent well above –16, can do well with phakic IOLs and should not be excluded from having them. Patients with very low myopia also can get excellent results, said Karl G. Stonecipher, M.D., Greensboro, N.C., adding that this use is offlabel. "We can get good predictability, good outcomes with doing them," he said. Editors' note: Dr. Stonecipher has no financial interests related to his talk. Assessing ectasia risk Though he lauded the ectasia risk scoring system (ERSS) of J. Bradley Randleman, M.D., and Doyle Stulting, M.D., Atlanta, for providing a basic framework, Dr. Pepose said more work needs to be done to find more reliable assessment. Overall these factors play a role—high topography, thinner corneas, thinner residual bed, lower age, higher manifests. "Age does seem to be important," Dr. Pepose said. "Without considering topography, the ERSS criteria have relatively little predictive value. "[Drs. Randleman and Stulting] should be congratulated for providing the first statistically validated structured approach to this problem. Further iterations and refinements are necessary," Dr. Pepose said. Editors' note: Dr. Pepose has no financial interests related to his talk. Survey the surgeons It is often noted that engineers make the most persnickety patients, but what about surgeons? Wondering that himself, Ronald R. Krueger, M.D., Cleveland, did a survey of all M.D.s on whom he performed laser vision correction at the Cleveland Clinic from 2000 to 2011. He pointed out that clinical data over time varied because of the laser platform, profile and keratome. Dr. Krueger assembled physician specific satisfaction rates by using an anonymous, online experiential survey. What he found was that "96% would repeat the procedure given their experience and knowledge of outcomes." Eighty-five percent reported that their quality of vision improved over their best corrected pre-op vision, and 38% reported that they saw improvements in their ability to perform procedures accurately. On the other hand, 1.6% reported increased difficulty. "Despite the demands, physicians do experience good outcomes, visual satisfaction, quality of life improvements. and improvements in the quality of their work, which leads to better patient care," Dr. Krueger said. SEE US AT ASCRS AT BOOTH 122 Editors' note: Dr. Krueger has no financial interests related to his talk. Laser cataract surgery Many surgical centers adopting laser cataract surgery are doing well financially, with three out of four breaking even or even paying off the laser in less than two years. "The others are getting there," said Shareef Mahdavi, president, SM2 Strategic, Pleasanton, Calif. Mr. Mahdavi's company did a survey of laser cataract surgery users. In the first year they surveyed 30 of the 46 eligible centers that had the laser an average of six months. "This covered roughly 6,000 laser cataract cases; surgeons were doing 900 cases a year and 23% in the premium channel," he said. "The good news is that adoption of the laser in practice is happening very quickly—within several months." Mr. Mahdavi said the big surprise came in the conventional channel when they learned that more than 40% of the cases were using a monofocal implant. "This shows that if you look in absolute numbers, 13% of conventional implants outweighs the number of presbyopic implants done with the laser. This is another opportunity in ophthalmology in refractive cataract surgery," he said. "The biggest problem we found is that there are 29 different ways of naming the procedure. That is a disaster waiting to happen," he added. EW Editors' note: Mr. Mahdavi is president of SM2 Strategic. Increase patient flow and overall practice efficiency. Increase profits. Varitronics can show you how! See more patients in the same amount of time without increasing staff. Var Varitronics, the leader in Non-Verbal Inte Interoffice Communications for over fou four decades, offers the most feature-rich sys systems on the market today. Our custom designed Call Systems will streamline des the way you work so that you can decrease your patient's waiting time d while increasing your staff's efficiency. Wall panel and pager Call, email, or visit our web site today to see how easy it is to benefit from the efficiency of Varitronics' Call System. Call Systems are available for both new and existing construction. CS 2000 Wireless System Leading the way in Interoffice Communications 800.345.1244 email:varimed@varitronics.com www.varitronics.com