OCT 2013

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

Issue link: https://digital.eyeworld.org/i/194331

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Page 17 of 134

October 2013 December 2011 May 2013 EW NEWS & OPINION 15 ASCRS update ASCRS: Facing forward after 40 years by Cindy Sebrell ASCRS•ASOA Director of Marketing and Communications In the journal … October 2013 Comparison of phaco-chop, divide-and-conquer, and stop-and-chop phaco techniques in microincision coaxial cataract surgery Juwan Park, MD, PhD, Hae Ri Yum, MD, Man Soo Kim, MD, PhD, Andrew R. Harrison, MD, Eun Chul Kim, MD, PhD Investigators in this prospective, randomized clinical trial compared how cataract density during microincision cataract surgery affected outcomes. Included here were eyes with grades 2 to 4 cataracts, which were randomized to undergo cataract surgery using phaco-chop, divide-andconquer, or stop-and-chop techniques. Investigators found that in grade 4 cataracts when the phaco-chop technique was used this took significantly less ultrasound time and reduced mean cumulative dissipated energy and balanced salt solution use compared with either of the other two techniques. In addition, at the two-month mark, eyes in this group with grade 4 cataracts showed significantly lower endothelial cell loss. Investigators concluded that while for mild to moderate cataracts all three techniques may be effective using coaxial microincision cataract surgery, the phaco-chop technique can be more effective for harder cataracts. Using this technique in such cases can result in more effective lens removal, with a decrease in endothelial damage when compared to the other two methods. Shape of the anterior cornea: Comparison of height data from four corneal topographers Tim de Jong, MSc, Matthew T. Sheehan, MSc, PhD, Michiel Dubbelman, MSc, PhD, Steven A. Koopmans, MD, PhD, Nomdo M. Jansonius, MD, PhD For an accurate description of optical properties, knowledge of the anterior shape is crucial, contributing about 70% of the power of the eye. With this in mind, investigators considered how the shape of the anterior cornea compared when using four different topographers. With the aid of the Atlas Placido disk (Carl Zeiss Meditec, Jena, Germany), Galilei dual Scheimpflug (Ziemer Ophthalmic Systems, Port, Switzerland), Orbscan scanning slit (Bausch + Lomb, Rochester, N.Y.), and Pentacam single Scheimpflug (Oculus, Arlington, Wash.) topographers, investigators assessed anterior corneal shape in healthy eyes. At 5.5 mm, investigators determined that it was the single Scheimpflug topographer that showed the smallest coefficient of repeatability here. Such coefficients of repeatability were found to be up to 10 times larger for the other topographers. They also found that the topographic data of the Placido disk topographer and single Scheimpflug topographer corresponded the best. At 8.0 mm investigators had similar findings. However, when it came to determining detailed descriptions of the anterior corneal shape for individuals, test-retest variability hampered their ability. Likewise, the ability to exchange the devices was compromised by inter-device variability. Evaluating the benefits of second-eye cataract surgery among the elderly Takuro Ishikawa, BA, Ediriweera Desapriya, PhD, Maneesh Puri, MB BS, John M. Kerr, BSc, D. Sesath Hewapathirane, PhD, Ian Pike, PhD In this systematic review investigators set out to determine how vision, patient-reported quality of life, driving ability, and likelihood of falls were all affected by undergoing cataract removal in the second eye. After searching MEDLINE, investigators culled 10 studies that met quality and inclusion criteria. In considering these, they determined that there was an improvement in visual acuity, contrast sensitivity and visual functioning as reported by patients, over and above first-eye results, terming the evidence here "moderate." Investigators stressed, however, that there was no definitive evidence from the studies provided that factors such as visual fields, quality of life, driving ability, or fall prevention were affected by second-eye surgery. Investigators concluded that for both clinicians and healthcare policymakers outcomes had implications and stressed, given how widely performed the procedure is, that there is a need for additional trials on this. F orty years ago, a group of innovative ophthalmologists frustrated with the slow acceptance of intraocular lenses gathered together in Dallas for the first meeting of the American Intra-Ocular Implant Society. Later changing its name to the American Society of Cataract & Refractive Surgery, the organization was founded on the conviction that it would serve as a catalyst for the field of ophthalmology by providing opportunities where innovative ideas could be developed, tested, questioned, shared, and eventually, if appropriate, adopted. That innovative spirit has continued to thrive at ASCRS. Marking its 40th anniversary in Boston in April 2014, ASCRS is expecting record attendance with more than 14,000 physicians, practice administrators, technicians and nurses, exhibitors and others related to the field of anterior segment surgery. ASCRS Program Chair Edward Holland, MD, and the ASCRS Clinical Committees are already at work selecting more than 1,300 papers, courses, posters, films, and symposia dedicated to forward-leaning topics, innovations in surgical treatment of glaucoma, complicated surgical cases, and advances in cornea and cataract surgeries. Registration for the event opened October 16, 2013. Throughout its 40-year history, ASCRS has kept a keen focus on innovation and has served as a guidepost for the practice of ophthalmology as it has been forced to evolve in the face of advances in technology and sea changes in delivery of medicine in the United States and beyond. Although it is helpful to reflect on how far ophthalmology has come in 40 years, ASCRS President Eric Donnenfeld, MD, is at the helm of an organization working to help its 9,100 member physicians face the future through rigorous scholarship, valuable educational programming, strong legislative and regulatory advocacy, and adaptation to shifting demographics. "Substantial changes in healthcare delivery, access to patients, and monitoring are impacting the daily lives of every ophthalmologist and, most importantly, the patients we care for," Dr. Donnenfeld said in his speech at the 2013 ASCRS•ASOA Symposium & Congress in San Francisco. "These are complex and confusing times in medicine. As practicing ophthalmologists, we must require our national societies step forward, represent our needs, voice our opinions, and demonstrate leadership based on what is in the best interest of our patients. We need our societies to educate the ophthalmologists of today and tocontinued on page 16

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