JUN 2013

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

Issue link: https://digital.eyeworld.org/i/137624

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Page 63 of 74

September 2011 Immediately following the ASOA Opening General Session, attendees participated in roundtables on a range of more than 30 topics. Source: EyeWorld in IOLs, he said. Cornelius Binkhorst, MD, designed variations on iris-fixated IOLs. The evolution of modern cataract surgery, with a small incision phacoemulsification procedure with foldable IOLs, also assisted in the improvement in lenses and efficacy, Dr. Mamalis said. He discussed different IOL materials, designs, and technologies on the market, and the pros and cons of multifocal and accommodative lenses. Achieving excellent vision at all distances is the major goal in current and future IOL design, he said. ASCRS/OPS Symposium examines imaging and the eye Showcasing incredible images of the eye and helpful tips on using imaging devices, the joint ASCRS/OPS symposium, "Imaging the Anterior Segment With the Ophthalmic Photographers' Society," covered multiple topics in ocular imaging. Joshua C. Teichman, MD, Ontario, presented "Imaging with iPhone." He recommended either using little light or flooding with light when using an iPhone for imaging. The iPhone also is useful for video, he said. Timothy Bennett, CRA, FOPS, OCT-C, Hershey, Pa., presented "Anterior Segment Imaging with Retinal Instruments"; Beth Ann Benetz, CRA, Cleveland, presented "Endothelial Analyses: Best Practices and Common Errors"; Kenneth L. Cohen, MD, and Sarah Moyer, CRAOCT-C, both of Chapel Hill, N.C., presented "Anterior Segment OCT" together; Elizabeth L. Affel, MS, Philadelphia, presented "Ultrasound Biomicroscopy"; and James P. Gilman, CRA, Salt Lake City, presented "Exposure Challenges With Digital Slitlamp Imaging." In addition, Ditte J. Hess, CRA, Miami, presented "Gonio photography with RetCam [Clarity Medical Systems, Pleasanton, Calif.]," and George O.D. Rosenwasser, MD, Hershey, Pa., presented "Imaging the Eye, Front to Back: A Day in the Life of a Corneal Specialist." Incorporating premium IOLs takes change in mindset Incorporating premium IOLs into your practice takes a change in mindset and a commitment to educating patients on their choices, said John Vukich, MD, Madison, Wis., at an EyeWorld Education session, "Maximizing Outcomes with Premium IOLs Through Ideal Toric Alignment and Corneal Astigmatism Management." The event was supported by a grant from Abbott Medical Optics (Santa Ana, Calif.). Program co-chairs were Dwayne K. Logan, MD, Huntington Beach, Calif., and Farrell C. Tyson, MD, Cape Coral, Fla. The setup for successful toric IOL surgery is fairly minimal, said Dr. Vukich. Diagnostics are critical, including axial length, keratometry, and topography, he said. He also recommended marking the eye before surgery to eliminate the decrease in power associated with cyclorotational movement. Surgeons use toric IOLs in 810% of U.S. cataract procedures, Dr. Vukich reported. However, soft and gas permeable toric contact lenses are about 25% of the U.S. contact lens market. The gap in percentages indicates that there's a potential for toric IOL market growth, he added. If you are looking to expand your practice to offer a variety of refractive IOL options, then you are already on the right track if you offer toric IOLs, said Elizabeth A. Davis, MD, Minneapolis. "If you offer monofocal spherical and toric IOLs in your practice, your practice is already refractive," she said. Dr. Davis recommended setting appropriate expectations for patients, explaining that results with refractive IOLs are quite good but that no IOL is perfect. She also stressed the utility of evaluating ocular anatomy to rule out poor candidates in advance. In a presentation on key elements of a toric IOL workup, Cynthia Matossian, MD, Mercer County, N.J., said that you can have a flawless surgery but if you don't select the right implant, you might have less-than-perfect outcomes. For better results, Dr. Matossian recommended separate goals for the cataract consult and the surgical testing appointment. Beginning with the cataract consult, Dr. Matossian maximizes the patient's ocular surface, including the use of artificial tears four times a day for all patients. Inaugural IOMED symposium discusses synergies needed The first symposium in the Integrated Ophthalmic-Managed Eyecare Delivery (IOMED) track covered EW MEETING REPORTER 61 new technologies that can help improve practice efficiencies, business strategies necessary to improve patient outcomes, and how to manage challenging cases in integrated eyecare settings. Richard C. Edlow, OD, Baltimore, said the demographics of the country are changing, and "we're coming up on a 20-year plateau in the 65+ year old population," he said. "That will change dramatically in this decade—we'll see a 360% increase in demand for our services." The Affordable Care Act will add 40 million previously uninsured people who need care, age-related care will grow with the aging population, and there will be an increase in treatment modalities. In 2020, "there will be a 10.8% increase in eyecare visits," he said. And the types of diseases commonly seen in eyecare practices are likely to change as well, he added. MarketScope data predicts there will be about 3.8 million cataract procedures in 2015, increasing to 4.5 million in 2020, and to 4.8 million in 2030. In 2020 there will be 36,700 full time employee ODs and 14,820 full time employee MDs. "The Bureau of Labor Statistics predicts that we'll need 45,500 ODs and 15,000 MDs in 2020 to keep up with demand. We are woefully short," he said. Derek A. Preece, MBA, Incline Village, Nev., said ophthalmic techs need about 17 minutes to conduct an exam, reducing the MD's time to 8 minutes. "At that rate, though, a practice needs to have three techs and five open lanes so no one is standing around waiting to see a patient," he said. "Ophthalmologists need to learn to delegate more routine tasks to their staff in order to improve efficiency." Some other time-saving techniques: using kiosks or tablets to have patients self-check in, and using time tracking software to evaluate the lulls and resolve bottlenecks. "The less time patients spend in the exam area, the more time they will spend in the optical area," he said.

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