APR 2013

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

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April 2013 EW NEWS & OPINION 11 ASCRS update In the journal … April 2013 Femtosecond laser-assisted cataract surgery Jonathan H. Talamo, MD, Philip Gooding, MS, David Angeley, MS, William W. Culbertson, MD, Georg Schuele, PhD, Daniel Andersen, BS, George Marcellino, PhD, Emma Essock-Burns, PhD, Juan Batlle, MD, Rafael Feliz, MD, Neil J. Friedman, MD, Daniel Palanker, PhD When it comes to femtosecond laser-assisted cataract surgery, different platforms have different patient interface designs. Investigators set out to see how a curved contact lens interface compared to a liquid optical immersion interface when performing laser capsulotomy during cataract surgery. Results indicated that 70% of those treated using the curved contact lens interface had corneal folds. Investigators noted that beneath the corneal folds there were incomplete capsulotomies found in 63% of these cases. Meanwhile, with the liquid interface there were no incomplete capsulotomies or corneal folds found. With the curved contact lens interface during capsulotomy creation investigators observed mean eye movement of 50 microns, compared to just 20 microns for those in the liquid optical immersion interface cohort. Those in the curved contact lens interface group also tended to experience a greater IOP rise during suction than those in the other group, with a mean rise of 32.4 mm Hg compared with 17.7 mm Hg using a liquid interface. Also, there was 36% less subconjunctival hemorrhage found with this liquid interface than with the curved contact lens approach. The conclusion reached here was that corneal folds leading to incomplete capsulotomy during laser cataract surgery could be created by the curved contact lens interface. Meanwhile, corneal folds were not found using the liquid interface, an approach that also decreased IOP rise and rate of subconjunctival hemorrhage and increased globe stability. Review/update: Toric IOL Nienke Visser, MD, Noël J.C. Bauer, MD, Rudy M.M.A. Nuijts, MD In this review, investigators offered a look at those traditional toric and multifocal toric IOLs currently on the market. They discussed a variety of related issues including proper patient selection, toric lens calculation concerns, and proper surgical technique. Investigators also drilled down on how patients fared visually, considering acuity outcomes, spectacle independence, and issues involving residual refractive astigmatism. Investigators highlighted what is thought to be the most important complication with toric IOLs, the issue of misalignment, and determined the incidence of this. In addition, with an eye toward new developments, they considered the future of toric IOLs. Incision integrity and outcomes of microcoaxial phacoemulsification Vaishali Vasavada, MS, Abhay R. Vasavada, FRCS, Viraj A. Vasavada, MS, Samaresh Srivastava, DNB, Devarshi U. Gajjar, PhD, Siddharth Mehta, DO The aim of this prospective, randomized study of microcoaxial phacoemulsification was to consider how incision integrity compared as well as to look at resulting outcomes with the two systems. For the study, patients underwent phacoemulsification either with the Stellaris system (Bausch + Lomb, Rochester, N.Y.), using a 1.8 mm clear corneal incision, dubbed group one, or with the Intrepid Infiniti system (Alcon, Fort Worth, Texas), with a 2.2 mm incision, group two. After surgery the investigators examined the incisions and used trypan blue to help evaluate ingress into the anterior chamber. They found that with the Stellaris system at the day one and week one marks, there was significantly greater incision enlargement and trypan blue ingress into the anterior chamber than with the Intrepid Infiniti. For those in group one, investigators also more frequently noted wound gaping and endothelial misalignment at these same marks. When it came to surgically induced astigmatism, endothelial cell loss, changes in central corneal thickness, or anterior segment inflammation, they did not, however, see any significant differences between the two groups. They concluded that clear corneal incision integrity is determined not only by initial incision size but also by any subsequent distortion. ASCRS launching new membership survey to help drive future education efforts by Cindy Sebrell ASCRS•ASOA Director of Public Affairs D octors are regularly asked to participate in surveys. While many surveys provide important data for the profession, most are not used to drive specific educational efforts aimed at improving the practice of medicine and patient outcomes. This is the objective behind the launch of the ASCRS Annual Clinical Trends Survey. The survey will ask ASCRS members key questions relating to current issues they face on a regular basis. The goal is to obtain opinion from a significant percentage of the membership and to have the results reviewed and interpreted by the ASCRS Clinical Committees. If the committees determine there exists a gap between current programming and membership viewpoints, understanding or practice patterns, the information will be used to address future education efforts, both in the main program and through ASCRS' CME educational grants. Data collected from the annual survey will provide a solid basis for tracking ASCRS' progress in resolving these education gaps. Brad Fundingsland will support the development of this survey, the analysis of the results, and will assist in establishing future educational programs designed to address the identified gaps. Mr. Fundingsland has been in the ophthalmic industry for more than 20 years; is a published clinical researcher; a former editor of EyeWorld magazine; and has developed educational programs for several leading ophthalmic industry partners. ASCRS: ASCRS has been working hard to reach out to its membership in an effort to better understand the issues, trends, and challenges that ophthalmologists face each day. The Annual Clinical Trends Survey is part of that effort. What is it all about? Fundingsland: ASCRS is initiating an annual membership survey with a goal of addressing some of the most compelling clinical issues facing the ASCRS membership, and assessing the prevailing clinical opinions, understanding, and praccontinued on page 12 PLAN AHEAD FOR NEXT YEAR YEAR HOUSI NG NOW OPE N HOUSING IS NOW OPEN www.WinterUpdate.org www.WinterUpdate.org 2014 2014 APRIL 25–29 APRIL 25–29 BOSTON www.AS C R S.org www.ASCRS.org

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