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46 | EYEWORLD | JUNE 2022 2022 ASCRS ANNUAL MEETING RECAP ASCRS NEWS Innovators General Session recap F rancis Price Jr., MD, delivered the Charles D. Kelman, MD, Innovator's Lecture during the Innovators Gener- al Session at the 2022 ASCRS Annual Meeting. There were also several other presentations on innovative ideas, techniques, and technologies. Charles D. Kelman, MD, Innovator's Lecture Dr. Price spoke about improving patient care through innovation and tracking outcomes. He said that ASCRS is an association of innovators, founded to promote ideas and technologies that, while commonplace now, were initially contro- versial, such as phacoemulsification, IOLs, and refractive surgery. Innovators are not necessarily inventors, like Dr. Kelman, Dr. Price said, adding that not all innovations work. As innovators, he continued, we should share our ideas with others and strive to improve care and outcomes for our patients. There needs to be a balance between inno- vation and regulation, Dr. Price said. Regulation can serve to protect patients, but it also can increase costs, be a barrier to entry, and delay development. Innovation can improve treat- ment outcomes, tailor treatments to patients, and disrupt the status quo. But unregulated or untracked innovations can lead to the "wild west." The wild west can be controlled, if we're responsible and we track our results, Dr. Price said, adding that when we're not responsible, the result can be more regulation. He went on to describe some of his early work, including the creation of the Cornea Re- search Foundation of America (CRFA) in 1988. The goal was to have a database for corneal transplants (prior to this, there was no tracking of grafts in the U.S.) with full-time researchers and the ability to conduct studies. At the time CRFA was founded, Dr. Price said non-profit reg- ulations were different. Study regulations were also looser; retrospective studies didn't require IRB approval, "off-label use" was not an issue, and there were little to no regulations for devic- es that were small volume and not marketed. The work of CRFA allowed tracking and analyzing of corneal transplants, offering the ability to see the advantages of DSEK in 2003 and DMEK in 2008. The databases also enabled them to demonstrate the differences to PK for both patients, physicians, and at times, insur- ance companies, Dr. Price said. Dr. Price also described a multicenter study that compared LASIK and contact lens wearers (the first study to track LASIK for 3 years and to compare LASIK to a control group). It found that LASIK outperformed contacts in terms of night driving, patient satisfaction, dry eye, and infections/abrasions. Research and techniques from the CRFA helped change corneal transplants, providing the first prospective, randomized studies on topical steroid dosing after corneal transplants, a prospective study on stopping steroids after 1 year for DMEK, and it identified glaucoma tubes as the most significant risk factor for EK failure, Dr. Price said. He questioned whether large databases, which are commonplace now, will replace single-center databases. He thinks not because while large databases have the advan- tage of seeing what's going on all over, single centers have more consistent data entry, highly skilled and experienced surgeons, potentially better follow-up, and may be better at determin- ing cause and effect. Dr. Price said the next data challenge is healthcare reform. He spoke about how the by Liz Hillman Editorial Co-Director About the physicians John Berdahl, MD Vance Thompson Vision Sioux Falls, South Dakota Joseph Ciolino, MD Mass Eye and Ear Boston, Massachusetts Kenneth Mandell, MD, PhD Founder and CEO LayerBio Boston, Massachusetts Francis Price Jr., MD Price Vision Group Indianapolis, Indiana Roger Zaldivar, MD Instituto Zaldivar Mendoza, Argentina Parisa Zamiri, MD, PhD Chief Medical Officer Graybug Vision Brookline, Massachusetts Dr. Price spoke about improving patient care through innovation and tracking outcomes, with specific examples from his own research, in the Charles D. Kelman, MD, Innovator's Lecture. Source: ASCRS continued on page 49

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