EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
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E W MEETING REPORTER 98 February 2014 Sunday, Jan. 19, 2014 P hysician: Aesthetic oculoplastics enhance ophthalmology offerings B otulinum toxins and dermal fillers have unique anatomic considera- tions and injection techniques, which translate well to ophthalmol- ogists, who might consider adding these products to their practices, a physician said during Hawaiian Eye 2014 in Kauai. "As ophthalmologists, our fine m otor skill ability is second to none compared to other specialties," said Steven G. Yoelin, MD, Newport Beach, Calif. "I think those skills are transferrable to what we do in in- jectables." Dr. Yoelin started using injecta- bles in his practice in 2001, and they now constitute a large part of his ophthalmology practice, he said. He said he has saved greatly on market- ing by delivering excellent results. "If you get great results and you're really dedicated to these procedures, your patients, and the products you use, word of mouth is the only type of promotion I have used," he said. He calls the products "neuro- modulators," a term that patients often prefer to toxins. In aesthetics, the face is typically divided into three zones, but when treated it should be considered in a global, harmonious way that is complimen- tary to all zones, including those that are not being injected, he said. Skin, muscle, fat, and bone all contribute to understanding the overall aging process in a multifacto- rial way, Dr. Yoelin said. Different zones of the face respond well to different products: "In general, hyperfunctional lines of the upper face lend themselves well to being treated with toxins," he said. Dermal fillers have also been shown to com- pliment the upper part of the face. Editors' note: Dr. Yoelin has financial interests with Allergan (Irvine, Calif.) and Medicis Pharmaceutical ( Bridgewater, N.J.). Hawaiian Eye Foundation Symposium honors physicians Two physicians were honored at the Hawaiian Eye Foundation Sympo- sium for a career of excellence and a global impact on ophthalmology, respectively. I . Howard Fine, MD, Portland, received the Phillip M. Corboy, MD, Memorial Award for Distinguished Service in Ophthalmology for his many years as an ophthalmologist. Dr. Fine is clinical professor of ophthalmology at Oregon Health & Science University, cofounder of Oregon Eye Surgery Center, and in private practice at Drs. Fine, Hoff- man and Sims, LLC, Eugene, Ore. Boris Malyugin, MD, Moscow, received the International Award for Excellence. Dr. Malyugin is a profes- sor in the Department of Cataract and Implant Surgery, deputy director general (R&D, Edu), S. Fyodorov Eye Microsurgery Complex, Moscow. Editors' note: Drs. Fine and Malyugin have no related financial interests. Monday, Jan. 20, 2014 Role of macular structure in multifocal implantation Avoiding implanting multifocal lenses in patients with posterior segment comorbidities is important in these cases, said Kevin M. Miller, MD, Los Angeles. "Our patients are increasingly expecting great results from cataract surgery," said Dr. Miller. "A happy patient is one whose outcomes exceed their expectations, and conversely, the unhappy patient is one whose expectations exceed their outcomes." He said the best ways to achieve satisfied patients following multifo- cal lens implantation are to set real- i stic expectations, understand the premium IOLs on the market, and perform quality work. Identifying patients who are not candidates for premium IOLs is important, he said, and educating those patients who are candidates about what they can expect is im- portant as well. " Don't oversell or peddle lenses. Don't be a used car salesman. Never promise spectacle independence. It's nice when we get it, but never promise it," he said. He showed a list of posterior segment comorbidities that physi- cians should avoid when implanting premium lenses. It included advanced glaucoma, amblyopia, macular degeneration, macular holes, retinal vascular diseases, epiretinal membranes, and vitreomacular traction. "All of these things are like time bombs waiting for you to step on them," he said. Dr. Miller called high resolution OCT "your absolute best friend in this." Other screening tools for mac- ular pathology include fluorescein angiography, he said. He recom- mended consulting a retina special- ist for more assistance when uncertain about a case. "I get nervous recommending a multifocal IOL if the view of the fundus is too poor to perform a satisfactory examination of the macula," he said. Editors' note: Dr. Miller has no finan- cial interests related to his presentation. Reaching target refraction in first procedure key Taking an investigative tactic to determine how to obtain missed target refraction can assist in best outcomes, a clinician said. Reporting live from the 2014 Hawaiian Eye, Kauai, Hawaii Reporting live from Hawaiian Eye 2014 Sponsored by 98-105 MR Hawaii_EW February 2014-DL2_Layout 1 1/30/14 11:57 AM Page 98