DEC 2013

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

Issue link: https://digital.eyeworld.org/i/227001

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Page 13 of 74

December 2013 December 2013 May EW NEWS & OPINION 11 ASCRS update In the journal … December 2013 BBC host and innovative science writer to deliver the 2014 ASCRS Science and Medicine Lecture by Cindy Sebrell ASCRS•ASOA Director of Marketing and Communications Corneal astigmatism prediction error Douglas D. Koch, MD, Richard B. Jenkins, MD, Mitchell P. Weikert, MD, Elizabeth Yeu, MD, Li Wang, MD Investigators in this case series considered how outcomes with toric intraocular lenses are affected by posterior corneal astigmatism. Before performing cataract surgery, corneal astigmatism was first measured using five devices and this was repeated again three weeks after cataract surgery. Investigators determined that for with-the-rule astigmatism, the mean prediction errors were 0.59 D with the IOLMaster, 0.48 D with the LENSTAR, 0.51 D with the Atlas, 0.62 D with the manual keratometer, and 0.57 D with the Galilei Dual Scheimpflug Analyzer. Meanwhile, for against-the-rule astigmatism, mean prediction errors were 0.17 D with the IOLMaster, 0.23 D with the LENSTAR, 0.23 D also with the Atlas, 0.41 D with the manual keratometer, and 0.12 D with the Galilei. Investigators concluded that when it came to with-the-rule astigmatism, with the exception of the Galilei, all of the other devices overestimated this. They propose using a new toric IOL nomogram. A well-known British science writer specializing in the emerging field of evolution, genetics, and synthetic biology will deliver the annual Science and Medicine Lecture at the 2014 ASCRS•ASOA Symposium & Congress this April in Boston. Adam Rutherford, PhD, will deliver his lecture on Sunday, April 27, at 10 a.m. during the Open General Session. Dr. Rutherford, who brings a background in the genetics of eye Endothelial keratoplasty in eyes with AC IOL Vasilios S. Liarakos, MD, Lisanne Ham, PhD, Isabel Dapena, MD, C. Maya Tong, BSc, Ruth Quilendrino, MD, Ru-Yin Yeh, MD, Gerrit R.J. Melles, MD In this comparative case series, investigators set out to determine how eyes with phakic or pseudophakic bullous keratopathy fared using either thin Descemet's stripping endothelial keratoplasty (DSEK) or Descemet's membrane endothelial keratoplasty (DMEK) in conjunction with an anterior chamber intraocular lens (AC IOL). For those in group 1, an iris-claw AC IOL was used together with either DMEK or thin DSEK. Meanwhile, phakic eyes in group 2 underwent either of the two procedures, together with use of angle-supported AC IOLs. Results here indicated that it was possible to leave all AC IOLs in place for those in group 1. However, they had to be removed in 90% of cases in group 2. At the six-month mark 90% of those in group 2 had corrected distance visual acuity of 20/40 or better, as did 36% of eyes in group 1. The conclusion reached here was that use of an AC IOL was feasible in conjunction with DMEK in eyes with bullous keratopathy. However, removal of the AC IOL may be necessary in cases where complications are anticipated. For those with normal visual potential use of DMEK is recommended in eyes together with a phakic AC IOL to minimize complications. Meanwhile, thin DSEK is recommended in patients with low visual potential or who are dealing with other pathology. Review/update: Management of subluxated crystalline lens Richard S. Hoffman, MD, Michael E. Snyder, MD, Uday Devgan, MD, Quentin B. Allen, MD, Ronald Yeoh, MD, Rosa Braga-Mele, MD, for the ASCRS Cataract Clinical Committee, Challenging/Complicated Cataract Surgery Subcommittee For surgeons it can be challenging dealing with an eye with ectopia lentis in which the crystalline lens has been displaced. Investigators pointed out that these cases usually require different techniques and technology in order to attain the best possible results. The ability to successfully center and place IOLs in the bag with fewer complications has been bolstered by improvements in surgical techniques and adjunctive prosthetic devices. The investigators contend that the best possible surgical results can be attained by a thorough understanding of inherent challenges in these cases and decisive management of any intraoperative complications. Adam Rutherford, PhD development and disease to his expertise in genomics and synthetic biology, will explore ideas emerging in genomics with new theories about the simulation of the origin of life and how these issues pertain to our interpretation of modern history and the future. By all accounts, his talk is sure to raise some questions about medicine and how our changing views on genomics may affect us as patients, doctors, and members of a global community. continued on page 12

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