Eyeworld

JULY 2023 | EYEWORLD | 17 EYEWORLD JOURNAL CLUB by Luke (Jin Kyun) Oh, MD Columbia University Irving Medical Center ophthalmology resident survey questions using a rating scale (i.e., very confident, confident, neutral), multipliers were assigned to each response in order to determine a mean. Cross-tabulation analysis was per- formed across four categories, Practice Location, Years in Practice, Primary Surgery Location, and Average Annual Volume of Cataract Surgery, for additional segmentation and analysis of the survey responses. Results Survey response rates were stable across the study period except for a lower response rate of 13.9% seen in 2020, which was attributed to the COVID-19 pandemic and a strictly online- only survey. Most responses were from dele- gates practicing in Western Europe followed by Eastern Europe and Africa/Middle East. Cata- ract surgery trends have demonstrated fluctuat- ing but overall stable volumes with an average of 360 surgeries in 2021. The rate of presby- opia-correcting IOLs, especially trifocal/multifo- cal IOLs, increased significantly (p<0.01) over the study period, although persistent concerns remained about decrease in quality of night vision and increased costs. Similarly, the use of presbyopia-correcting and toric IOLs for astig- matism nearly doubled from 7.4% to 15.5%, with delegates suggesting use would be even higher if not for the cost. Methods for correction of astigmatism have remained consistent and dependent on cylinder, with surgeons prefer- ring on-axis incision for 0.75 D and toric IOLs for greater than 1.25 D. Greater than 75% of respondents preferred biometry for preoperative measurements; however, an increase in the use of Scheimpflug tomography (p<0.01) was seen, coinciding with a decrease in the use of man- ual keratometry (p<0.01). The use of digital image registration has also increased for axis alignment of toric IOLs (p<0.01), while manual ink marking has decreased (p=0.01). Only 61% and 45% of respondents reported evaluating the ocular surface prior to refractive and cataract surgery, respectively. Finally, the percentage of delegates performing glaucoma surgery, includ- ing MIGS or lasers, has decreased significantly over the study duration alongside a significant Review of "ESCRS Clinical Trends Survey 2016–2021: 6-year assessment of practice patterns among society delegates" S urveys of cataract and refractive sur- geons are used globally to evaluate the current practice patterns and prefer- ences of surgeons in comparison with constantly evolving evidence-based standard of care and technological advance- ments. This practice was started as early as 1975 by the American Intra-Ocular Implant Society, now known as the American Society of Cataract and Refractive Surgery, and has been adopted as an annual practice by various orga- nizations worldwide including in Europe, South Korea, Japan, Canada, and New Zealand. 1,2 These surveys typically assess surgeon prefer- ences as they pertain to IOL choice, surgical technique, use of diagnostic imaging or tools, and perioperative examination. The results of these surveys can then be used longitudinally to not only inform societies on developing trends and areas for educational emphasis, but also as a comparison for how preferences may vary across different societies around the world. In this study by Kohnen et al., a retrospective analysis of the European Society of Cataract and Refractive Surgeons (ESCRS) Clinical Trends Surveys was performed between the years of 2016–2021 to highlight practice preferences among delegates. Methods The authors conducted a longitudinal retro- spective analysis of the ESCRS Clinical Trends Surveys obtained during the annual ESCRS congresses between the years of 2016 and 2021. Surveys were available to all delegates both in person and online regardless of attendance. The number of questions varied across years; howev- er, many questions were repeated to analyze change over time. Broad categories of questions included those pertaining to cataract surgery, use of evolving IOL technology, ocular surface disease, and glaucoma. For survey questions involving a numerical range, the midpoint of the range was used for calculation of means. For EyeWorld Journal Club review continued on page 18 Luke (Jin Kyun) Oh, MD Ophthalmology Resident Columbia University Irving Medical Center New York, New York Royce Chen, MD Residency Program Director Edward S. Harkness Eye Institute Columbia University Irving Medical Center New York, New York

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