Eyeworld

In the journal: November 2019 Face-to-face phacoemulsification using a slit lamp in patients unable to lie flat Marc Muraine, MD, PhD, Guillaume Boutillier, MD, David Toubeau, Julie Gueudry, MD, PhD A novel patient-positioning technique, which was used on two patients (four eyes) who were unable to lie flat or even sit in a reclined position, resulted in successful cataract surgery by an experienced surgeon. The technique involves positioning the patient's chin on the chin rest of a slit lamp, as if they were receiving an exam. The surgeon sits on the opposite side and operates through a temporal corneal incision. The patients who were operated on in this manner had 20/20 vision after recovery and said they would recommend this positioning to other patients who couldn't lie flat. Billing of cataract surgery as complex versus routine in Medicare beneficiaries Sidra Zafar, MD, Peiqi Wang, MD, Divya Srikumaran, MD, Oliver Schein, MD, MPH, Jennifer E. Thorne, MD, PhD, Martin A. Makary, MD, MPH, Fasika A. Woreta, MD, MPH This retrospective analysis of Medicare fee-for-service carrier claims found significant varia- tion in the use of complex cataract surgery coding. The research included 3.5 million cataract procedures that were billed as complex or routine and looked at patient and physician characteristics that were associated with cataract surgery billed as complex. Patients who were male, older than 75 years old (compared to those 65–74 years old), or racial minorities were more likely to have surgery coded as complex. Low-volume ophthalmologists were more likely to code for complex cataract surgery, as were those who had graduated from medical school within the past 10 years (after adjusting for patient characteristics). The mean rate for complex cataract surgery coding was 11.2%; 40% of complex cataract surgeries also had a high-risk clinical diagnosis code. The investigators hypothesized some variability could be due to inaccurate coding and noted that it's not based entirely on referral pattern differences for more complex cases. 10-year clinical outcomes after implantation of a posterior chamber phakic lens for myopia Jae Hwan Choi, MD, Dong Hui Lim, MD, PhD, Seung Wan Nam, MD, Chan Min Yang, MD, Eui Sang Chung, MD, PhD, Tae-Young Chung, MD, PhD Intraocular collamer lenses (ICLs) show long-term stability and functional refractive out- comes for myopia correction, according to a retrospective review. They also appeared safe with regard to cataract formation, especially if they were implanted in younger patients. This review of medical records included 110 eyes from 60 patients. The mean preoperative age was 30.3 ± 8.3 years and preoperative spherical equivalent (SE) was –12.01 ± 3.70 diopter. At 10 years postop, SE was –0.65 ± 1.09 diopter. Vault height decreased from 562.4 ± 175.9 µm at 6-month postop to 352.9 ± 171.8 µm at 10 years. Investigators saw no significant change in endothelial cell density or IOP at 10 years postop. Lens opacity developed in 12.1% of eyes (n=21), though it didn't occur in patients who had ICLs implanted when they were 30 years old or younger. Mean vault height was lower in this group than in the clear-lens group at 4 years postop. Oscar Carlisle, MD Died Sept. 3, 2019 Snellville, Georgia Arnold Curnyn, MD Feb. 7, 1935–Sept. 26, 2019 Arlington Heights, Illinois John Elliff, MD Sept. 19, 1931–Aug. 26, 2019 Sterling, Colorado Richard Falls, MD Died Aug. 31, 2019 McLean, Virginia Steven Grossnickle, MD Sept. 18, 1946–Aug. 27, 2019 Cedar, Michigan Ronald Klein, MD Died Aug. 31, 2019 Madison, Wisconsin Leo Levieff, MD June 1, 1923–Sept. 20, 2019 Westport, Connecticut Col. Brian Nolan, MD Oct. 21, 1950–Sept. 19, 2019 Lexington, Kentucky Roger Sherman, MD Jan. 21, 1943–Aug. 27, 2019 Mount Vernon, Ohio Wilbert Washington, MD Died Aug. 29, 2019 Indianapolis EyeWorld honors the lives of ophthalmologists who have died recently with recognition in this space. To recognize an ophthalmologist here, please send the name, location, post-nominal letters, birth date, and death date to liz@eyeworld.org. In memoriam Remembering Spencer Thornton, MD Spencer Thornton, MD, a past president of ASCRS, passed away on Oct. 26, 2019. The December issue of EyeWorld will include a full obituary honoring Dr. Thornton.

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