Eyeworld

MAR 2014

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

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E W NEWS & OPINION 1 3 R ichard A. Lewis, MD, a nationally known glau- coma specialist and eye surgeon, will assume his role as the new president of the American Society of Cataract & Refractive Surgery (ASCRS) in April 2014. He will deliver the incoming president's address on Saturday, April 26, during the Opening General Session of the ASCRS•ASOA Symposium & Congress in Boston. Dr. Lewis says he is looking for- ward to the challenge of leading the organization. "This is a unique time for ophthalmology," he said. "Tech- nology has broadened our diagnos- tic and surgical options in ways not envisioned only a few years ago. At the same time, government regula- tory changes including the ACA, ICD-10, and the SGR effects on reimbursement threaten our care of patients. I want to see ASCRS con- tinue to guide its members through these and other, yet unforeseen, challenges going forward." Dr. Lewis, who currently serves as the association's vice president, replaces outgoing president Eric D. Donnenfeld, MD, becoming the 29th leader of the association. 2014 also marks the 40th anniversary of the ASCRS•ASOA Symposium & Congress. February 2014 Laser vision correction in physicians Theodore A. Pasquali, MD, David Smadja, MD, Michael J. Savetsky, MD, Glauco R. Mello, MD, Fadiah Alkhawaldeh, Ronald R. Krueger, MD Practitioners themselves may be a procedure's toughest critics. Investigators honed in solely on practitioners to consider what their quality of life was like after laser vision correction and determine how satisfied they were with the procedure. In this study, there was an overall satisfaction rate of 95.3% reported by the 132 physicians who responded to the survey. Of those included, 43.2% were physicians who perform procedures but not surgery, 28% who perform surgery, and 28.8% who perform neither procedures nor surgery. Postoperative improvement in quality of vision after undergoing laser surgery was reported by 84.8% of physicians. Of those who perform procedures, 39% reported that their ability to do so had improved, against just 1.6% who said that this ability had diminished. When asked if they would have the procedure again, 96% said that they would. Investigators concluded that physicians have good visual outcomes with laser vision correction and that despite intense visual demands, a substantial percentage report improvement in quality of life and high satisfaction. Reproducibility of manifest refraction Dan Z. Reinstein, MD, Timothy E. Yap, BMedSci (Hons), Glenn I. Carp, MB BCh, Timothy J. Archer, MA(Oxon), Marine Gobbe, PhD, and the London Vision Clinic Optometric Group Investigators in this retrospective case series set out to determine just how repro- ducible manifest refraction is with different observers determining this. Manifest refraction on the 1,922 consecutive eyes included here was first performed by one of seven optometrists, and a second test was conducted by one of two surgeons experienced in the technique. When they compared the two findings, investiga- tors determined that there was a mean difference of just 0.21 D between the measurements. Investigators found that intra-observer reproducibility was not affected by the severity of myopia or hyperopia. They concluded that with the use of a standard manifest refraction protocol there was less than a 0.25 D difference between results attained by surgeons and optometrists. These results meshed well with those of other published studies. Investigators believe the tight reproducibility found here may be the result of the use of a standard manifest refraction protocol and that this signifies the value of training when patients are co-managed by surgeons and optometrists in practices. Artificial iris devices Konrad R. Koch, MD, Ludwig M. Heindl, MD, Claus Cursiefen, MD, Hans-Reinhard Koch, MD Some patients with acquired iris defects may opt for implantation of a custom- made foldable artificial iris to manage this. Investigators honed in on the limita- tions and benefits in such cases. Included in the case series were three eyes of two patients. Investigators found that after anterior chamber artificial iris implanta- tion in a case of post-uveitic mydriasis, one patient developed a cataract and corneal decompensation in the eye. The artificial iris was subsequently removed, followed by cataract surgery, iridoplasty and Descemet's membrane endothelial keratoplasty (DMEK) to treat this. Investigators found that visual acuity had increased from 20/50 to 20/25 by the six-month follow-up mark. Meanwhile, the second patient, who had undergone implantation of NewIris devices for cosmetic reasons, had developed bilateral secondary glaucoma, cataract, corneal edema, and iris atrophy. After bilateral explantation of the devices, the patient under- went cataract removal, artificial iris implantation, and DMEK in both eyes. In the right eye, he also had the Ahmed valve implanted. At the six-month follow-up mark, investigators found that visual acuity had improved to 20/32 in the right eye and 20/20 in the left. Also, the patient's photophobia was gone and his intraocular pressure was sufficiently reduced in both eyes. Investigators concluded that the artificial iris should be placed in the posterior chamber to prevent secondary complications and should only be implanted in aphakic or pseudophakic eyes. In the journal … March 2014 May 2013 March 2014 by Cindy Sebrell ASCRS•ASOA Director of Communications Richard A. Lewis, MD, named 2014 ASCRS incoming president ASCRS update Richard A. Lewis, MD Dr. Lewis is a practicing physi- c ian and partner at Grutzmacher, Lewis & Sierra Surgical Eye Special- ists, in Sacramento, Calif. The former director of glaucoma at the University of California, Davis, Dr. Lewis has lectured extensively on glaucoma and cataract surgery and is actively involved in clinical research in glaucoma therapy. He is past p resident of the American Glaucoma Society. Dr. Lewis is on the editorial board of the Journal of Cataract & Refractive Surgery, the Journal of Glaucoma, and Glaucoma Today. He has published more than 80 articles and book chapters focusing on glaucoma, ophthalmic surgery, and ophthalmic pharmacology in the Archives of Ophthalmology, Ophthal- mology, and the American Journal of Ophthalmology. He is co-author of the book Curbside Consultation in Glaucoma. He has received the American Academy of Ophthalmol- ogy Honor and Senior Honor Awards for his contributions in teaching and leadership and for initiating the American Academy of Ophthalmol- ogy Subspecialty Day meeting. Dr. Lewis attended the Univer- sity of California, Berkley, as an undergraduate and received his doctorate in medicine from North- western University Medical School in Chicago. His professional training included an internship in internal medicine at Northwestern Univer- sity Evanston Hospital; a residency at the Department of Ophthalmol- ogy at the University of California, Davis; and a fellowship in glaucoma at the University of Iowa Depart- ment of Ophthalmology. He is a diplomat of the American Board of Ophthalmology and the National Board of Medical Examiners. EW Contact information Sebrell: csebrell@ASCRS.org

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