EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/1171786
O NSITE Highlights from the 2019 ASCRS ASOA Combined Ophthalmic Symposium continued on page 30 Steve Charles, MD Manjool Shah, MD Naveen Rao, MD Terry Kim, MD Validating your biometry by ensuring that your data makes sense and ensuring your staff is trained in validation can help reduce re- fractive surprise, said Manjool Shah, MD, Ann Arbor, Michigan. Tools that can give you more information include ultrasound bio- microscopy, which is helpful for suspected or known zonulopathy cases; A-scan/B-scan for cases of poor optical view or optical bi- ometry; specular microscopy for eyes with shallow anterior cham- ber depth, previous angle closure, or known endothelial disease; and macular OCT for patients seeking advanced technology IOLs. Naveen Rao, MD, Peabody, Massachusetts, recommended phy- sicians record themselves as they practice their informed consent speech. Try to get it under 1 minute without talking too fast. He also recommended splitting the cataract evaluation into two visits: a dilated visit for macular OCT and to introduce concepts, expec- tations, and provide informed consent documents, and a second undilated visit for topography, biometry, IOL options, and to sign informed consent. In many cases, Terry Kim, MD, Durham, North Carolina, thinks LASIK/PRK are more accurate, safer, simpler, more accessible, and more sensitive options for addressing residual refractive error compared to IOL exchange. However, if you have more than 1.5 D of error, he recommended exchange. "There is a tremendous amount of invisible pathology" that can be identified when looking at all gray-scale OCT B-scan slices, said Steve Charles, MD, Memphis, Tennessee, speaking on the im- portance of taking OCT on every cataract surgery patient to avoid visual surprises. 28 | EYEWORLD | OCTOBER 2019