Eyeworld

HIGHLIGHTS FROM THE 2026 ASCRS CLINICAL SURVEY Cataract More than half of respondents do not perform imme- diate sequential bilateral cataract surgery (ISBCS). Cataract surgery has gotten better and better, and the recovery has gotten faster and faster. People have become more interested in the potential to do ISBCS. The reality is that one of the big drawbacks to it is that reimbursement is unfair for both the facility and the doctor. ASCRS has proposed a tremendous initiative for an option that would work for ISBCS for both payers and doctors, and the Society has met with Medicare and CMS but has been unable to get traction to move it forward. I think most doctors, myself included, will do it for select cases. But most people won't do it frequently because it is not something that is realistically feasible to do for every patient at the current time. When the center and the doctor are going to get reimbursed 50% for doing the second surgery, it's not something that's feasible. Looking at the clinical benefit of laser cataract surgery vs. conventional cataract surgery, respondents pointed to arcuate relaxing incisions, capsulorhexis creation, and reduced phaco energy by laser pretreat- ment as the biggest benefits (more than a third for each). Some also noted improved refractive outcomes, less risk of surgical complications, and improved ELP. I think that the newer laser platforms are very different from the older platforms, and they have some benefits that the older platforms didn't have. When lasers first came out, there was a learning curve associated with them. I think as surgeons have learned the technology and the technology has gotten better, there's been more widespread acceptance of it. Considering use of intracameral antibiotics, the peer-reviewed literature is clear that there are signif- icant benefits. As a cataract surgeon, I think a patient with endophthalmitis is one of the worst things you can deal with. There's little downside to using intra- cameral antibiotics, and they seem to have a positive effect in reducing the potential for endophthalmitis. —Richard Tipperman, MD ASCRS Cataract Clinical Committee Chair n=669 How often do you perform simultaneous bilateral/ same-day cataract surgery? (Select one) 9% Often 8% Sometimes in routine cases without extenuating circumstances Only for extenuating circumstances (general anesthetic/mentally challenged patients, etc.) 27% I do not perform bilateral cataract surgery 56% n=817 In which of the following areas do you believe laser cataract surgery may provide a significant clinical benefit versus conventional cataract surgery? (Select all that apply) 17% Less risk of surgical complications 17% Improved effective lens position (ELP) 17% I do not believe FLACS offers a significant clinical benefit in any of these areas Arcuate relaxing incisions 38% 36% Capsulorhexis creation 21% Improved refractive outcomes 34% Reduced phaco energy by laser pretreatment n=669 Do you use intracameral antibiotics during cataract surgery? (Select one) Practice location All Respondents U.S. International Early (0–5 years) Mid (6–10 years) Late (11+ years) Office Male Female Hospital outpatient department Perform majority of surgeries Gender Years in practice 75% 25% 74% 26% 76% 24% 79% 22% 67% 33% 77% 23% 72% 28% 80% 20% 76% 24% 69% 31% Yes No

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