Eyeworld

Heading Name title by Sumit "Sam" Garg, MD Chief Medical Editor APRIL 2023 | EYEWORLD | 3 T he ASCRS Annual Meet- ing, this year in beautiful San Diego, California, is upon us. In my humble opinion, the ASCRS Annual Meeting is the best meeting for anterior segment surgeons. Our meeting brings together unsurpassed education, innovation, advocacy, partnership with industry, mentorship, friendship, and more—all in 4 days. A relatively new addition to the meeting is Eyecelerator, which occurs on the Thursday before the Annual Meeting. This year's Eyecelerator pro- gram is chaired by John Berdahl, MD, Julie Schallhorn, MD, and Gil Kliman, MD. Eyecelerator is a joint venture with ASCRS and the American Academy of Ophthalmology and provides a plat- form for entrepreneurs and startups to showcase their ideas and innovations in front of a panel of experts and potential investors. The program is well rounded and allows for doctors and industry to gather with a focus on advancement in ophthalmology. Another highlight of the ASCRS An- nual Meeting is Subspecialty Day, which occurs on Friday. Whether you attend Cornea Day, Refractive Day, Glaucoma Day, or the new Digital Day, you will be immersed in these respective areas with interactive programs including case studies, videos, and panel discussions. Now in its second year, Party for a Purpose will be held on May 5 at NOVA SD. ASCRS, ASOA, industry attendees, as well as their guests, are welcome to attend for a night of fun, live music, dancing, and philanthropy with dona- tions benefiting the ASCRS Foundation. This event is a must-attend! This year marks a huge transition for the ASCRS Annual Meeting, as Edward Holland, MD, who has held the post of Program Chair for the meeting since 2012, has stepped down. Having some insight into what it takes to put the Annual Meeting together, I can hon- estly say that Program Chair is one of the toughest roles we have in our orga- nization. Ed has led the evolution of our meeting, and his profound leadership and input will be missed. Thank you, Ed, for all of your dedication to making the Annual Meeting what it is today. Just like the education you will receive at the Annual Meeting, this issue of EyeWorld covers topics that impact our daily lives as ophthalmol- ogists. Our new section editors and Editorial Board members are working hard to deliver content that is useful and pertinent to daily practice. Cataract surgery is the center of our universe. With that context, we explore issues that can occur after cataract surgery, ad- vanced-technology IOLs, insights on IOL formulas, and patient perceptions after second eye cataract surgery. Outside this universe are other smaller univers- es—refractive surgery, corneal disease, glaucoma, etc. We also cover breaking into refractive surgery, the role of pre- operative IQ (image quality), corneal ulcer management, updates in amniotic membrane, and MIGS, among others. Finally, I would like to congratulate Douglas Rhee, MD, on a great job as president of ASCRS for this last year. Doug has led our organization with professionalism, strategic vision, and integrity—all with a healthy sense of humor. Thank you, Doug! Also, I would like to welcome our incoming president, Elizabeth Yeu, MD. Liz is an amazing ophthalmologist and an even more amazing person. I am looking forward to serving under her leadership and am excited to see what she will (continue) to bring to our organization. I look for- ward to seeing you all in San Diego. As always, if you have any sugges- tions for topics, improvements, etc., please feel free to reach out to me at gargs@uci.edu. Bringing together unsurpassed education, innovation, and more © 2023 Alcon Inc. 02/23 US-CLI-2300057 IMPORTANT PRODUCT INFORMATION: CLAREON ® FAMILY OF IOLS CAUTION: Federal law restricts these devices to sale by or on the order of a physician. INDICATION: The family of Clareon ® intraocular lenses (IOLs) includes the Clareon ® Aspheric Hydrophobic Acrylic and Clareon ® Aspheric Toric IOLs, the Clareon ® PanOptix ® Trifocal Hydrophobic IOL, Clareon ® PanOptix ® Toric, Clareon ® Vivity ® Extended Vision Hydrophobic Posterior Chamber IOL and Clareon ® Vivity ® Toric IOLs. Each of these IOLs is indicated for visual correction of aphakia in adult patients following cataract surgery. In addition, the Clareon ® Toric IOLs are indicated to correct pre-existing corneal astigmatism at the time of cataract surgery. The Clareon ® PanOptix ® lens mitigates the effects of presbyopia by providing improved intermediate and near visual acuity, while maintaining comparable distance visual acuity with a reduced need for eyeglasses, compared to a monofocal IOL. The Clareon ® Vivity ® lens mitigates the effects of presbyopia by providing an extended depth of focus. Compared to an aspheric monofocal IOL, the lens provides improved intermediate and near visual acuity, while maintaining comparable distance visual acuity. All of these IOLs are intended for placement in the capsular bag. WARNINGS/PRECAUTIONS: General cautions for all Clareon ® IOLs: Careful preoperative evaluation and sound clinical judgment should be used by the surgeon to decide the risk/benefit ratio before implanting any IOL in a patient with any of the conditions described in the Directions for Use that accompany each IOL. Physicians should target emmetropia, and ensure that IOL centration is achieved. For the Clareon ® Aspheric Toric, PanOptix ® Toric and Vivity ® Toric IOLs, the lens should not be implanted if the posterior capsule is ruptured, if the zonules are damaged, or if a primary posterior capsulotomy is planned. Rotation can reduce astigmatic correction; if necessary lens repositioning should occur as early as possible prior to lens encapsulation. For the Clareon ® PanOptix ® IOL, some visual effects may be expected due to the superposition of focused and unfocused multiple images. These may include some perceptions of halos or starbursts, as well as other visual symptoms. As with other multifocal IOLs, there is a possibility that visual symptoms may be significant enough that the patient will request explant of the multifocal IOL. A reduction in contrast sensitivity as compared to a monofocal IOL may be experienced by some patients and may be more prevalent in low lighting conditions. Therefore, patients implanted with multifocal IOLs should exercise caution when driving at night or in poor visibility conditions. Patients should be advised that unexpected outcomes could lead to continued spectacle dependence or the need for secondary surgical intervention (e.g., intraocular lens replacement or repositioning). As with other multifocal IOLs, patients may need glasses when reading small print or looking at small objects. Posterior capsule opacification (PCO), may significantly affect the vision of patients with multifocal IOLs sooner in its progression than patients with monofocal IOLs. For the Clareon ® Vivity ® IOL, most patients implanted with the Vivity ® IOL are likely to experience significant loss of contrast sensitivity as compared to a monofocal IOL. Therefore, it is essential that prospective patients be fully informed of this risk before giving their consent for implantation of the Clareon ® Vivity ® IOL. In addition, patients should be warned that they will need to exercise caution when engaging in activities that require good vision in dimly lit environments, such as driving at night or in poor visibility conditions, especially in the presence of oncoming traffic. It is possible to experience very bothersome visual disturbances, significant enough that the patient could request explant of the IOL. In the parent AcrySof ® IQ Vivity ® IOL clinical study, 1% to 2% of AcrySof ® IQ Vivity ® IOL patients reported very bothersome starbursts, halos, blurred vision, or dark area visual disturbances; however, no explants were reported. Prior to surgery, physicians should provide prospective patients with a copy of the Patient Information Brochure available from Alcon informing them of possible risks and benefits associated with these IOLs. ATTENTION: Reference the Directions for Use labeling for each IOL for a complete listing of indications, warnings and precautions. REFERENCES: 1. Oshika T, Fujita Y, Inamura M, Miyata K. Mid-term and long-term clinical assessments of a new 1-piece hydrophobic acrylic IOL with hydroxyethyl methacrylate. J Cataract Refract Surg. 2020 May;46(5):682-687. 2. Maxwell A, Suryakumar R. Long-term effectiveness and safety of a three-piece acrylic hydrophobic intraocular lens modified with hydroxyethyl-methacrylate: an open-label, 3-year follow-up study. Clin Ophthalmol. 2018;12:2031-2037. 3. Clareon ® Vivity ® Extended Vision Hydrophobic IOL (CNWET0) Directions for Use – US. 4. Clareon ® PanOptix ® Trifocal Hydrophobic Acrylic IOL Model: CNWTT0 DFU. 5. Lehmann R, Maxwell A, Lubeck DM, Fong R, Walters TR, Fakadej A. Effectiveness and Safety of the Clareon ® Monofocal Intraocular Lens: Outcomes from a 12-Month Single-Arm Clinical Study in a Large Sample. Clin Ophthalmol. 2021;15:1647- 1657. Published 2021 Apr 20.

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