EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
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March 2013 EW NEWS & OPINION 13 ASCRS update Incoming ASCRS president to take the helm at annual meeting in San Francisco In the journal … by Cindy Sebrell ASCRS•ASOA Director of Public Affairs March 2013 IOP during femtosecond pretreatment of cataract Nathan M. Kerr, M.B. Ch.B., Robin G. Abell, M.B. B.S., Brendan J. Vote, F.R.A.N.Z.C.O., Tze 'Yo Toh, F.R.A.N.Z.C.O. What happens to intraocular pressure when the femtosecond laser is used for pretreatment of the lens for cataract surgery? Investigators here evaluated IOP over the course of femtosecond surgery in 25 eyes. Prior to surgery they found that the mean IOP was 17.5 mm Hg. The mean IOP rise was 11.4 mm Hg while vacuum was applied. They determined that laser capsulotomy and lens fragmentation both immediately proceeded peak IOP, which rose to a mean of 36.0 mm Hg. IOP remained elevated after the procedure, at a mean of 26.6 mm Hg, for two minutes. No connection was found between spiking IOP and central corneal thickness, docking attempts, or vacuum or treatment time. Investigators concluded that pretreatment with a femtosecond laser appeared to be well-tolerated and safe for patients. Safety of concomitant cataract surgery and micro-stent implantation for glaucoma Helmut Hoeh, M.D., Iqbal K. Ahmed, M.D., Swaantje Grisanti, M.D., Salvatore Grisanti, M.D., Günther Grabner, M.D., Quang H. Nguyen, M.D., Magda Rau, M.D., Sonia Yoo, M.D., Tsontcho Ianchulev, M.D. In this interim report of an ongoing multicenter study, investigators set out to determine if implantation of the CyPass Micro-Stent (Transcend Medical, Menlo Park, Calif.) could be done at the time of cataract surgery in open angle glaucoma patients. At baseline they determined that mean medicated IOP was 21.1 mm Hg. Then all patients underwent removal of their cataract with standard phacoemulsification followed by implantation of the new suprachoroidal device. Investigators found that early hypotony, which occurred at a rate of 13.8%, was the most common complication, followed by transient IOP increase at a rate of 10.5%. None of the major complications such as retinal or choroidal detachment or endophthalmitis occurred here. At the six-month postop mark, investigators noted that there was a 37% drop in IOP for hypertensive patients, along with more than a 50% reduction in medications for glaucoma. Meanwhile, the reduction in glaucoma medications was 71.4% for those in which intraocular pressure was already controlled. Investigators concluded that in this population, there was a low rate of surgical complications resulting from implantation of the CyPass Micro-Stent, allowing for a decrease in patients' IOP as well the need for glaucoma medications in many cases. Late opacification of hydrophilic acrylic IOL Priscilla de Almeida Jorge, M.D., Delano Jorge, M.D., Camila Vieira Ventura, M.D., Bruna Vieira Ventura, M.D., Wagner Lira, M.D., Marcelo Carvalho Ventura, M.D., Liliana Werner, M.D., Newton Kara-Junior, M.D. Four years after patients in rural areas of Pernambuco, Brazil, were implanted with the Ioflex IOL (Mediphacos, Minas Gerais, Brazil) as part of a community effort to aid the underprivileged, investigators set out to determine the incidence of late post-op opacification with the lens. As detailed in the patients' charts, the phacoemulsification itself and postop period were uneventful in these cases. A diagnosis of late IOL opacification was given in 7% of the 87 eyes. Investigators found that early postop corrected distance visual acuity, which had ranged from 20/20 to 20/40, dropped to hand motions and 20/80 in two eyes with late IOL opacification. The two patients' corrected distance acuity returned to 20/60 and 20/20, respectively, after undergoing IOL replacement. Macular disease precluded IOL replacement in a third case involving late opacification. In two other eyes findings of asteroid hyalosis and high myopia were an issue. Investigators could not find an association with any risk factors for the development of late opacification. E ric D. Donnenfeld, M.D., a well-respected refractive cataract surgery pioneer and LASIK eye surgeon, will deliver his first address as president of the American Society of Cataract & Refractive Surgery in San Francisco this April. Dr. Donnenfeld, who currently serves as the Society's vice president, will assume his new role at the ASCRS•ASOA Symposium & Congress, April 19-23. He will replace outgoing president David F. Chang, M.D., becoming the 28th leader of the Society. Dr. Donnenfeld's address will take place during the Opening General Session on Saturday, April 20. Dr. Donnenfeld is a founding partner of Ophthalmic Consultants of Long Island and Ophthalmic Consultants of Connecticut, national medical director of TLC Laser Eye Centers, and surgical director of the Lions Eye Bank of Long Island. He is a clinical professor of ophthal- mology at New York University Medical Center. During his nearly 30-year career, Dr. Donnenfeld has garnered extensive experience in the field of ophthalmology, performing thousands of refractive and laser eye surgeries and corneal transplant procedures. He has made significant advancements in the field; he was the first surgeon in the northeast U.S. to perform laser cataract surgery, participated in the studies that led to FDA approval of the excimer laser technology, and has been selected as an investigator for numerous other FDA clinical studies. Dr. Donnenfeld is a graduate of Dartmouth College and Dartmouth Medical School. He served as chief resident at Manhattan Eye Ear and Throat Hospital in New York, and completed his cornea and refractive fellowship at Will Eye Hospital in Philadelphia. He has been on the Dartmouth Medical School Board of Overseers since 2003 and a member of the Dean's Council for the Future of Dartmouth Medical School since its inception in 2001. An internationally recognized leader and pioneer in refractive, cornea, and cataract surgery, Dr. Donnenfeld has served as an expert resource to fellow eye surgeons. He has written hundreds of papers, scientific articles, and books on vision care. He is also on the editorial board of nine medical journals and serves as editor-in-chief of Cataract & Refractive Surgery Today. Among his many accomplishments, Dr. Donnenfeld has received EyeWorld @EWNews continued on page 14 Follow EyeWorld on Twitter at twitter.com/EWNews Find us on social media Are you a fan of EyeWorld? Like us on Facebook at: facebook.com/EyeWorldMagazine