Eyeworld

44 | EYEWORLD | JUNE 2022 ASCRS NEWS continued from page 43 Looking at each of these endophthalmitis cases in detail, five of them seriously breached proto- cols of how to do simultaneous surgery safely. Some used the same instruments in both eyes, some didn't autoclave for the second eye. You must treat each eye as a separate surgery. The other four cases seemed to do reasonably well, Dr. Arshinoff said, but also still had some slight differentiations in principles of doing immediate sequential surgery. The risk of bilateral endoph- thalmitis is not very high. Using an intracameral antibiotic increases safety, accuracy, and efficacy and is the most effective way to prevent en- dophthalmitis currently, Dr. Arshinoff said. During his presentation, Dr. Arshinoff also highlighted some of the benefits of ISBCS, and these included decreased cost for the patient, family, and surgical center; patient and family preference; better for remote patients, disabled patients, and patients requiring difficult po- sitioning; faster recovery of excellent normal binocular vision; no anisometropia, no loss of stereo, reduced risk of falls, amblyopic eyes; quicker adaptation to MFIOLs; and reduced medical visits. In his presentation, Dr. Cummings ad- dressed the concern of needing to have refrac- tive outcomes from the first eye in order to effectively complete the second eye surgery. But he said that modern optical biometry measure- ments offer excellent results, and other im- provements to surgical techniques have helped improve outcomes, as have formulas incorporat- ing artificial intelligence (AI). Optical biometers increase the success rate of axial length measurements, Dr. Cummings said. He also highlighted other revolutions in IOL power calculations, specifically in AI, which he said can help improve accuracy in formulas. Dr. Cummings shared information on several specific formulas: the RBF formula, Hoffer QST, Kane formula, Pearl DGS, and Ladas Super Formula. Biometry today using AI allows for optimi- zation, which can ultimately lead to a self-cali- brating biometer with your surgical technique. He also mentioned the Light Adjustable Lens (RxSight) and other tunable/adjustable options that could be available in the future. Dr. Cummings concluded by saying that IOL power prediction need not be one of the barri- ers to same-day, bilateral cataract surgery. Dr. Arshinoff discusses the evolution and benefits of same-day, bilateral cataract surgery. Source: ASCRS Dr. Arshinoff highlighted some of the benefits of ISBCS, including decreased cost for the patient, family, and surgical center; better for remote patients, disabled patients, and patients requiring difficult positioning; faster recovery of excellent normal binocular vision; reduced medical visits; and more.

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