Eyeworld

Archives EyeWorld ASCRS S AT U R DAY, M AY 16 , 2 0 2 0 | AS C R S V I R T U A L A N N U A L M E E T I N G DAILY NEWS HIGHLIGHTS ASCRS FOUNDATION UPDATE P. 6 FILM FESTIVAL PREVIEW P. 12 OPS WINNING IMAGES P. 28 way to help our members with the recovery process," he said. The meeting will feature more than 30 CME credits and more than 400 hours of content, and special sessions will highlight COVID-19-related content. Dr. Kim started by congrat- ulating and thanking Edward Holland, MD, chair of the ASCRS Program Committee, Steve Speares, ASCRS execu- tive director, ASCRS staff and leadership, industry sponsors, and participating faculty for by Ellen Stodola Editorial Co-Director T hough the ASCRS An- nual Meeting looks a bit different this year in its new, virtual for- mat, Terry Kim, MD, incoming president of ASCRS, said that it's a major step forward to ad- dress the current crisis, and he emphasized all the efforts that ASCRS is making to guide its members through these chal- lenging times. The Virtual Annual Meet- ing is an enormous initiative in terms of time and resources that ASCRS decided to under- take to address the COVID-19 crisis, Dr. Kim said. "We took this important step because we thought it would be the best their collaboration to make the very first Virtual Annual Meeting a reality. "We've never done a virtual meeting before, and due to having to cancel our Annual Meeting in Bos- ton fairly late, we didn't have much time to put this together. But thanks to the hard work and long hours put in by our Program Committee and ASCRS staff, we were able to produce a high-quality virtual Shifting gears to reflect on his year as president of ASCRS, Dr. Mamalis took a moment to pause and preface. "This terri- ble crisis in the whole country and what the entire profession is going through makes it diffi- cult to sit down and talk about what accomplishments have been done over the past year," Dr. Mamalis said. That said, he mentioned the rebranding of ASCRS that launched a year ago, making it clear what ASCRS does for its members and for surgeons. It's slogan—For surgeons. For you.—Dr. Mamalis said shows the commitment the society has for surgeons. "This is truly by Liz Hillman Editorial Co-Director N ick Mamalis, MD, outgoing president of ASCRS, shared his thoughts on the ASCRS Virtual Annual Meeting and his presidency as a whole. First, he gave "huge kudos" to the ASCRS staff and the Program Committee who took the full ASCRS Annual Meeting and distilled it into a 2-day virtual meeting in an extremely short period of time. "I'm very grateful that we were able to put togeth- er this meeting virtually," Dr. Mamalis said. "I am incredibly impressed at the amount of work everyone has been doing putting this together." Features he is excited for include the two-part "Turning the Lights Back On" session, which he said will be extremely timely for attendees. "The sessions on getting the practice going again, what are the steps to doing this … I think these are going to give invaluable information for people who are going through the process of restarting their practices," he said, adding later that these sessions come at a time when many states are be- ginning to loosen restrictions. He also noted the discus- sion with Scott Gottlieb, MD, former head of the FDA, who Dr. Mamalis said will likely offer valuable insights into this process. "The virtual meeting will also have the usual tremendous education that goes on at the ASCRS Annual Meeting," Dr. Mamalis said, mentioning that it even has a virtual exhibit hall for attendees to interact with industry representatives. continued on page 4 continued on page 3 Thoughts from outgoing ASCRS President Nick Mamalis, MD Incoming ASCRS President Terry Kim, MD, speaks about current situation and what ASCRS is doing to address this F R I DAY, J U LY 2 3 , 2 0 2 1 | A S C R S A N N UA L M E E T I N G DAILY NEWS EyeWorld: What was it like com- ing on as ASCRS president at the beginning of the pandemic? Dr. Kim: As I was taking on my role as president, I never imag- ined I'd face the immediate challenges that our organization had to face, but I was prepared to take on that challenge. I was thankful to have a strong and supportive organization in terms of the ASCRS staff, executive director, Executive Committee, and Governing Board to help nav- igate through the difficulties. For anyone dealing with this crisis, it was a dynamic, ever-evolving situ- ation; it was never just one thing. There were adjustments that were constantly being made in terms of our clinical care protocols, edu- cational offerings, governmental relief initiatives, and communica- tion with members. continued on page 4 continued on page 3 FOR MORE INFORMATION, VISIT US AT BOOTH #5201 SO YOUR PATIENTS DON'T HAVE TO © 2021 Ocular Therapeutix, Inc. All rights reserved. DEXTENZA is a registered trademark of Ocular Therapeutix, Inc. PP-US-DX-0323 OT_ASCRS_Daily_News_Banner_MECH_07Jul2021.indd 4 OT_ASCRS_Daily_News_Banner_MECH_07Jul2021.indd 4 7/14/21 11:28 AM 7/14/21 11:28 AM Visit Booth 5208 to Hear What's New at BVI BVI and all other trademarks (unless noted otherwise) are property of BVI. BVI ©2021 Outgoing ASCRS president reflects on unprecedented year A Q&A with ASCRS president Richard Hoffman, MD R ichard Hoffman, MD, the current ASCRS president, has been involved with ASCRS, EyeWorld, and the Journal of Cataract & Refractive Surgery for years. He shared his thoughts on his presidency and his vision for the society. T erry Kim, MD, served as ASCRS president during a year full of unprecedent- ed challenges brought on by the COVID-19 pan- demic. He reflected on his year as president, the challenges and how ASCRS addressed them, import- ant initiatives, and more. EyeWorld: How and when did you first become involved with ASCRS? Dr. Hoffman: I became involved with ASCRS in the mid-1990s, in part due to the work my part- ner, Howard Fine, MD, had been doing with ASCRS. Howard was teaching at meetings and in- volved in the Governing Board and Executive Committee and Daily News In 2019, ASCRS again conducted its Clinical Survey, which identifies education gaps by compiling data from respondents about their experiences across specialties. The survey in- cluded questions on cataract, refractive, cor- nea, glaucoma, and retina surgery. Information collected is used by ASCRS to guide educational initiatives and activities. The 2019 survey had 1,204 total ASCRS member respondents, with 54.9% practicing in the U.S. and 45.1% practicing elsewhere. Of the respondents, 73.3% were male and 26.7% were female. The survey respondents had a wide range of experience, from those cur- rently in residency or fellowship (11.2%) to those who have been in practice more than 30 years (17.3%). The largest percentage of respondents was those who have been in practice 21–30 years (25.3%), and 64.1% of respondents have been in practice for more than 10 years. Respondents also varied in where they perform surgery, with the largest percentage (32%) performing surgery in a surgeon-owned ASC. CLINICAL SURVEY 2019 HIGHLIGHTS OF THE 2019 ASCRS CLINICAL SURVEY HOW MANY YEARS HAVE YOU BEEN IN PRACTICE? WHERE IS YOUR PRIMARY SURGERY LOCATION? (Select all that apply.) WHERE PRACTICE IS LOCATED MALE VS. FEMALE RESPONDENTS SUPPLEMENT TO EYEWORLD JUNE 2022 Supported by CONNECTING THE DOTS: Advancements in cataract surgery P haco Fundamentals has been a long-standing symposium at the ASCRS Annual Meeting, giving attendees the latest information that they can incorporate in their surgical cataract practice for safe and effective outcomes. The 2026 symposium, sponsored by Alcon and Bausch + Lomb, moderated by Richard Tipperman, MD, and Yousuf Khalifa, MD, FACS, was broken into three main categories with several presentations in each section. Part 1a: Essential Phacodynamic Principles Lisa Park, MD, discussed when adjustments should be made to the vacuum or flow settings. "Essentially, it's all about anterior chamber stability," she said. "What goes into the eye should equal what comes out of the eye." This balance is important because, as Dr. Park pre- sented, an underpressurized eye can cause shallowing and chamber collapse, which can result in endothelial cell loss, iris damage, and posterior capsule rupture. An overpres- surized eye does the opposite, causing anterior chamber deepening, which can lead to zonular stress or misdirection of aqueous fluid. Modern phaco systems incorporate sophisticated fluidics technologies to help maintain chamber stability by balanc- ing inflow and outflow during surgery. Flow rate (the flow of fluid through the tubing) influences how quickly frag- ments flow to the phaco tip, while vacuum refers to how tightly the materials are held at the tip (occurring when the tip is occluded). Peristaltic pumps are flow based, creating vacuum upon occlusion with flow being constant until oc- clusion occurs. This pump type, Dr. Park said, is slower but considered safer. Venturi pumps are vacuum based, with the vacuum being created by the pump and flow varying based on the level of vacuum. Dr. Park said venturi pumps are fast- er, but they come with an increased risk of post-occlusion surge. This difference may be mitigated by advanced sensors in current phaco machines. PHACO FUNDAMENTALS 2026 Dr. Khandelwal spoke about how to recognize and handle post-occlusion surge. Source: Sumitra Khandelwal, MD "We should understand that when you adjust the settings on your machine, you are setting the maximum vacuum versus actual vacuum," Dr. Park said. "On a linear setting, the actual vacuum will depend on how much you are pressing down on the foot pedal. One should understand that achiev- ing maximum vacuum also requires tip occlusion." Dr. Park said there are different phaco tip angles, and physical adjustments may need to be made when touch- ing the tip to the nucleus to achieve full occlusion. She also discussed how fluidic imbalance can be caused, either through incorrect wound construction or oblique positioning of the handpiece in the wound. Conditions that may require adjustments in fluidic settings include floppy iris syndrome, zonulopathy or extreme myopia, floppy posterior capsule, and posterior capsule rupture, Dr. Park said. Sumitra Khandelwal, MD, dove deeper into the topic of post-occlusion surge, specifically recognizing and managing it. She shared a case of one of her fellows (the first time she had them sit superiorly) and before even pushing play, she noted a few pitfalls. "What you see here is we're pushing the eye down. We're going to have a lot of egress from the paracentesis there on the left, and it was well dilated when we started this case … but it's getting smaller, so we already have a stressor here because we're losing some of that visu- alization," she said. Dr. Khandelwal described surge as the sudden with- drawal of fluid after an occlusion break, resulting in shallowing or collapse of the anterior chamber. There are various ways to prevent surge, including decreasing vacuum or flow rate, using a short and stiffer tubing, constructing tighter wounds, raising the bottle height or IOP, and use of an aspiration bypass system. Dr. Khandelwal also discussed "pseudo-surge," which can occur due to leaking tubing, "It's all about anterior chamber stability. What goes into the eye should equal what comes out of the eye." —Lisa Park, MD Supplements Growing your practice with new techniques and technologies FOR SURGEONS. FOR YOU. WWW.EYEWORLD.ORG JUNE 2022 VOLUME 27, NUMBER 2 2022 ASCRS ANNUAL MEETING RECAP P. 38 WWW.EYEWORLD.ORG FOR SURGEONS. FOR YOU. FALL 2026 VOLUME 31, NUMBER 3 how ophthalmology is refining, combining, and reimagining modern care REWIND. REFRESH. REFINE. NEW PRESBYOPIA- CORRECTING IOLS U.S. PHYSICIANS EMBRACE EPI-ON CROSSLINKING DROPLESS CATARACT SURGERY IN 2026 EyeWorld.org ASCRS ASCRS News resources EyeWorldOnsite.org

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