EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/276058
E W MEETING REPORTER 1 55 tioners should individualize their glaucoma surgery depending on the patient. Third, three drugs for glau- c oma patients might be enough. A fourth medication doesn't add any- thing. "We are finally seeing invest- ment in surgical glaucoma," he said. "I would gladly give up prescribing fourth medications, and I would gladly cut back on diagnostic expen- ditures to help finance innovative and improved glaucoma proce- d ures." Fourth, when implanting the iStent, don't expect blood to reflux right away, Dr. Samuelson said. "It's a nice sign, but quite often you don't see it until the eye is soft after you remove all visco from behind the implant," he said. Finally, sur- geons should know how to manage a failed EX-PRESS Glaucoma Filtra- t ion Device (Alcon). "Don't declare an EX-PRESS trab as a failure until you consider a YAG," Dr. Samuelson advised. Steven R. Sarkisian Jr., MD, Oklahoma City, offered his tips for fitting an ab interno trabecular bypass into practice. "The key here is that you're not hurting the pa- tient, even if it fails spectacularly," he said about adopting the iStent (Glaukos, Laguna Hills, Calif.). "You still have all of the options open to you." Dr. Sarkisian then showed a few of his first not-so-perfect cases to illustrate the procedure's learning curve. "It is the most delicate thing I do as an anterior segment surgeon," Dr. Lewis said. "It probably takes 10, 20, 30 procedures to get really good at this." Dr. Sarkisian said surgeons should pick simpler cases for their first few iStent procedures. "Pick someone who's controlled. Don't pick a traumatic case," he said. Pri- mary open-angle glaucoma patients are good; PG patients are better be- cause their scleral spur is easier to find. "They have those nice land- marks," Dr. Sarkisian said. "They have a runway for you to put in the iStent." Also, because iStent implan- tation is only FDA approved for use in conjunction with a cataract procedure, Dr. Sarkisian advised surgeons look for a routine phaco p rocedure. "Don't pick a patient with corneal disease or low endothe- lial cell count," he said. "If you have edema after phaco and you're trying to do the iStent, you might have an issue." Editors' note: Dr. Lewis has no financial interests related to his presentation. Dr. Samuelson has f inancial interests with Alcon and Glaukos. Dr. Sarkisian has financial interests with Glaukos. Monday, February 17 T he ASCRS•ASOA Winter Update opened its final day on Monday with a session titled "Refractive Surgery: Challenges and Improve- ments." Moderated by Eric D. Donnenfeld, MD, Rockville Centre, N.Y., it explored case presentations with interactive discussions from other faculty, including March 2014 The power of one Two types of incisions – one module The Ziemer FEMTO LDV Z Models are FDA cleared and CE marked and available for immediate delivery. The FEMTO LDV Z6 is FDA cleared and CE marked for creation of corneal incisions in patients undergoing cataract surgery. For some countries, availability may be restricted due to local regulatory requirements; please contact Ziemer for details. Exclusively available for the FEMTO LDV Z6 www.femtoldv.com V isit us at ASCRS booth #1517 CLEAR CORNEAL & ARCUATE INCISIONS • Custom-designed incisions • Topographically matched • Added precision and reproducibility • Intrastromal incisions possible ASCRS 7 51 17 15 517 #1 151 h # #15 isit u boot us at RS b t th a h th V i Custom-designed incisions • ARCUA CLEAR CORNEAL & Custom-designed incisions INCISIONS TE UA AT CLEAR CORNEAL & INCISIONS CLEAR CORNEAL & Intrastromal incisions possible • Added precision and reproducibility • opog Topographically matched • Custom-designed incisions Intrastromal incisions possible Added precision and reproducibility opographically matched Custom-designed incisions Intrastromal incisions possible Added precision and reproducibility for the FEMTO LDV Z6 for details. corneal incisions in patients undergoing cataract surgery. For some countries, availability may be restric The Ziemer FEMTO LDV Z Models are FDA cleared and CE marked and available for immediate deliver .femtoldv www corneal incisions in patients undergoing cataract surgery. For some countries, availability may be restric The Ziemer FEMTO LDV Z Models are FDA cleared and CE marked and available for immediate deliver .com .femtoldv ted due to local regulatory requirements; please contact Ziemer corneal incisions in patients undergoing cataract surgery. For some countries, availability may be restric y. The FEMTO LDV Z6 is FDA cleared and CE marked for creation of The Ziemer FEMTO LDV Z Models are FDA cleared and CE marked and available for immediate deliver ted due to local regulatory requirements; please contact Ziemer y. The FEMTO LDV Z6 is FDA cleared and CE marked for creation of ted due to local regulatory requirements; please contact Ziemer y. The FEMTO LDV Z6 is FDA cleared and CE marked for creation of continued on page 158 149-159 MR WU2014_EW March 2014-DL2_Layout 1 3/6/14 4:21 PM Page 155