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90 | EYEWORLD | SPRING 2025 C ORNEA Reference 1. Mimouni M, et al. Tape splint tarsorrhaphy for persistent corneal epithelial defects. Am J Ophthalmol. 2022;237:235–240. Relevant disclosures Dermarkarian: None Houser: None Kim: None Rapuano: None Dr. Dermarkarian discussed several "artistic variations" on the classic temporary suture tar- sorrhaphy. He said glue tarsorrhaphies typically last for 5–7 days, and Botox tarsorrhaphies can cause complete ptosis that can last up to around 3 months. He said he doesn't like the latter methodology because it is not as predictable, there could be hematoma formation in the eye- lid or muscle, and there isn't good control of the tarsorrhaphy timeline. For permanent tarsorrhaphies, Dr. Dermark- arian places an incision through the gray line of the upper and lower eyelid margins and sutures the back part of the upper and lower eyelid to- gether, then sutures the front part of the upper and lower eyelids together. "In simple terms, the eyelid and eyelid mar- gin are made up of two parts. There's the skin and the muscle on the front side, and there's the tarsus on the back side. The tarsus is like a form of cartilage. When you perform a permanent tarsorrhaphy, you want the upper eyelid tarsus to adhere to the lower eyelid tarsus, and you want to do the same for the skin and muscle of the upper and lower eyelid," Dr. Dermarkarian said. "So medially you could do that, laterally you could do it, or you could do the entire eyelid depending on how much the eye needs to be closed." Dr. Dermarkarian said he thinks it's import- ant for patients to hear that even "permanent" tarsorrhaphies are reversible. "I always discuss with patients that it's a great technique for heal- ing, but if they hate it or if they're miserable, we can easily take it apart in the clinic setting." continued from page 89 Nandini Venkateswaran, MD, EyeWorld Cornea Editorial Board member, shared what she is excited for at the ASCRS Annual Meeting: "The ASCRS Annual Meeting is one of my favorite meetings of the year! I always absorb so many wonderful clinical and surgical pearls and actively network with colleagues. I am very much looking forward to the meeting this year!" ASCRS ANNUAL MEETING P R E V I E W EyeWorld Daily News continued on page 3 FRIDAY, APRIL 5, 2024 A S C R S A N N U A L M E E T I N G DAILY NEWS information. ASCRS recently creat- ed the Digital Committee, she said, because we recognize that this is our future. "One of my favorite parts of this year has been getting to work more closely with Vance Thompson, MD, the incoming president," Dr. Yeu said. "The camaraderie, alignment, ide- ation, and dedication to ASCRS have led to unforgettable memories that I will cherish. What ASCRS has in Vance is the definition of true servant leadership." Vance Thompson, MD, ready to take on the role Vance Thompson, MD, will today become ASCRS President, and he said he is very much looking forward "I am proud that ASCRS mem- bers have been queried to see the dynamic approach to the education that we provide. One of my fore- most pivotal goals was that ASCRS members feel that ASCRS meets their individual needs, where they are in their professional lives, to help promote that fresh education," Dr. Yeu said. "I love that the 2024 ASCRS Live! regional dinner pro- grams around the country in nine different cities will bring relevant ed- ucation in refractive cataract surgery, OSD, refractive surgery, and MIGS to doctors." Dr. Yeu said it's likely some changes will occur in the next gener- ation or two in how cataract surgery is implemented globally. There is a real possibility to automate, stream- line, and become more efficient, she said, which could be controversial. New changes will likely include using more data and integration of this Elizabeth Yeu, MD, reflects on her year Elizabeth Yeu, MD, having served as ASCRS President for the past year, reflected on her ten- ure and the future of the Society. ASCRS has established itself as the go-to resource for all anterior segment surgeons, Dr. Yeu said. This expands beyond just cataract and refractive surgery. "We joke about how our acronym could expand to cover cornea and glaucoma because of the content that we represent and serve, in Subspecialty Day as well as broadly within our Annual Meeting and throughout other resources," she said. The Society covers all the education anterior segment surgeons need across many different subspecialties. EXPERIENCE DEXTENZA © 2024 Ocular Therapeutix, Inc. All rights reserved. DEXTENZA is a registered trademark of Ocular Therapeutix, Inc. PP-US-DX-0411-V3 LEARN MORE AT DEXTENZA.COM VISIT BOOTH 555 Experience DEXTENZA ASCRS Daily PP-US-DX-0411-V3.indd 1 Experience DEXTENZA ASCRS Daily PP-US-DX-0411-V3.indd 1 3/26/24 2:21 PM 3/26/24 2:21 PM Thoughts from the outgoing and incoming Presidents of ASCRS 08 Q&A with new Annual Meeting Program Chair 18 Eyecelerator showcases innovation 36 OPS winning photos Archives EyeWorld EVOLVING TREATMENTS AND TECHNIQUES IN OPHTHALMOLOGY IS GONIOSCOPY DEAD? CORNEAL CELL THERAPY A SHIFT TOWARD RLE WWW.EYEWORLD.ORG FOR SURGEONS. FOR YOU. WINTER 2024 VOLUME 29, NUMBER 4 Supplements NAVIGATING THE BUSINESS OF GLAUCOMA A n EyeWorld Cor- porate Education event at the 2024 American Acad- emy of Ophthal- mology (AAO) Annual Meet- ing featured presentations on "Navigating the Business of Glaucoma." The event was sponsored by AbbVie, Alcon, Bausch + Lomb, Glaukos, Nova Eye Medical, Sight Sciences, Théa, ViaLase, and Zeiss. Diagnostics and 'how doers get more done' In her presentation on diag- nostics, Lorraine Provencher, MD, first asked audience members, "What is your most valuable commodity?" She answered that for most, it's our time. "Constantly rushing to save time can feel like it's in direct opposition to the quality of care we provide," she said. Dr. Provencher noted that AAO recommends visual field testing once a year, but she said that some evidence indicates twice a year visual field testing may be the sweet spot. Unfortunately, more than 75% of patients with open angle glaucoma are getting less than one visual field a year. This is happening for a variety of reasons, including patient avoidance, clinic flow/staffing/space/time, and uncertainty with insurance/reimbursement. Dr. Provencher said that virtual reality perimetry has been a game changer for her practice to create efficiencies in visual field testing. "I have happier technicians with this; they love the improved workflow, and patients love it, too." There are better ergonomics for patients, she added. "It's often a faster test, and they're not moving around in the clinic." It also has a small footprint in the clinic, is often more affordable, and is more efficient. She called it a "slam dunk" for better care and better business. In terms of picking a virtual reality perimeter, she shared several considerations, including the battery life and weight, the validation population, background luminance, glaucoma staging accuracy, upfront vs. ongoing costs, soft- ware updates, warranty, and practice development tools. Her preference is the RadiusXR, which is a tablet-based headset. You can conveniently get an accurate visual field, interpret a familiar printout, and confidently make surgical decisions. There's a dashboard/portal to have open in the workroom to run multiple fields at once. What about OCT and optic nerve photos? Dr. Provencher likes data management systems. She noted the Zeiss Glaucoma Workplace, which integrates structure-func- tion from the CIRRUS, HFA, fundus images, and IOP. It also has at-a-glance summaries, you can add clinical events, and you can tailor it to add new baselines. It gives you a quick visual of what's been going on with the patient, she said. SLT: gateway to interventional glaucoma Manjool Shah, MD, discussed SLT. "The LiGHT Trial is the most [talked about] in my clinic on any given day," he said, adding that this showed that SLT works. 1 At 3 years, 74.2% of patients remained medication-free in the laser group; laser patients were more likely to be at IOP target at office visits (93% vs. 91.3%); disease progression was shown in 33 drop patients vs. 23 laser patients; glaucoma surgery (trabeculectomy) was required in 0 laser patients but 11 drop patients; and there was less visual field progression in the SLT group. You're capturing field progression across the spectrum, Dr. Shah said. DSLT lowers IOP in an efficient procedure that is comfortable for both patients and physicians. Improved procedure flow could help ophthalmology practices via word of mouth by increasing patient satisfaction and outcomes, Dr. Radcliffe said. Source: Nathan Radcliffe, MD Sahar Bedrood, MD, PhD Advanced Vision Care Los Angeles, California Lorraine Provencher, MD Vance Thompson Vision Omaha, Nebraska Nathan Radcliffe, MD New York Ophthalmology New York Eye Surgery Center New York, New York Manjool Shah, MD Kellogg Eye Center University of Michigan Ann Arbor, Michigan Inder Paul Singh, MD The Eye Centers of Racine and Kenosha Racine and Kenosha, Wisconsin About the physicians Experience Eyeworld's print publications online Digital.EyeWorld.org

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