Eyeworld

O phthalmology practices, beset by increas- ing regulatory costs and lower Medicare reimbursements, know well that efficient and visionary practice management is the key to providing quality patient care and growth. Given this business reality, the American Society of Ophthalmic Administrators (ASOA) has assumed a significant and growing importance as the sister so- ciety of ASCRS. In the past few years, the number of programs offered through ASOA at the ASCRS•ASOA EW NEWS & OPINION 11 by John Ciccone ASCRS Director of Communications ASOA provides HR assistance to members June 2011 Simultaneous bilateral cataract surgery Anna-Ulrika Sarikkola, M.D., Risto J. Uusitalo, M.D., Ph.D., Timo Hellstedt, M.D., Ph.D., Sirje-Linda Ess, M.D., Tiina Leivo, M.D., Ph.D., Tero Kivelä, M.D., Ph.D. Investigators in this consecutive study set out to see how those undergo- ing simultaneous bilateral cataract surgeries fared compared to those who underwent sequential procedures 4 to 6 weeks apart. Results indi- cated that 67.2% of eyes that underwent simultaneous bilateral cataract surgery were within 0.50 D of the target compared with 69.2% of those who underwent the sequential approach. Similarly, 91% of simultane- ous bilateral cataract surgery patients were within 1 D of the target ver- sus 90.3% of sequential patients. When it came to complications, just one eye in the simultaneous bilateral cataract group had a visual acuity- affecting complication—chronic cystoid macular edema. This same complication affected both eyes of one patient in the sequential group. Patient satisfaction ran high, with 95% of those in both groups noting that they were very satisfied with the procedure. Investigators con- cluded that whether or not a bilateral or a sequential approach was taken, outcomes, complications, and satisfaction were similar. Economic analysis of simultaneous bilateral cataract surgery Tiina Leivo, M.D., Ph.D., M.Sc.(Econ.), Anna-Ulrika Sarikkola, M.D., Risto J. Uusitalo, M.D., Ph.D., Timo Hellstedt, M.D., Ph.D., Sirje-Linda Ess, M.D., Tero Kivelä, M.D., Ph.D., F.E.B.O. The emphasis of this study of 520 patients was on the comparative eco- nomics between simultaneous and sequential bilateral cataract surgery. Satisfaction between the two procedures was comparable. However, cost favored the simultaneous approach. Patients were able to save 449 euros in healthcare cost by undergoing simultaneous surgery; when travel and paid home-care costs were factored in, this climbed to 739 euros. With lost work time factored in as well this totaled 849 euros. Investigators determined that there was substantial healthcare and non-healthcare re- lated savings with the simultaneous, bilateral approach with similar out- comes. Wavefront-guided epithelial LASIK with MMC Robert Edward T. Ang, M.D., Karen B. Reyes, M.D., Jo Anne P. Hernandez, M.D., Hungwon Tchah, M.D. In this case-controlled study of 48 eyes, investigators compared how pa- tients fared with epithelial LASIK with mitomycin-C (MMC) with flaps left on versus off. At the initial 1-week post-op mark investigators found that in cases where the flap was removed the mean pain score was lower and vision was better. Uncorrected visual acuity at the 1-year mark was −0.088 logMAR in the flap-on group and −0.036 logMAR in the flap-off group. In both groups 92% of eyes were within 0.5 D of spherical equiv- alent. One line of corrected distance visual acuity was gained in 46% of eyes where the flap was left on versus 38% of those where the flap was removed. Patients had comparable contrast sensitivity under both day and nighttime conditions, and there was no significant change in higher order aberrations in either group. Investigators concluded that this was a safe and predictable procedure for treating myopia and my- opic astigmatism. Patients encountered less pain and had faster visual recovery when flaps were removed. Otherwise, both approaches had similar results. In the journal … June 2011 continued on page 12 Trent Lutz, ASCRS•ASOA director of human resources Henry Hirschman M.D., 79, died on Tuesday, May 17 at his home in Austin, Texas after a protracted illness. Dr. Hirschman, a brilliant surgeon and edu- cator, was instrumental in the innovative eye surgery that enabled people with cataracts to have their vision restored by having the clouded lenses of their eyes replaced with new artificial lenses. Dr. Hirschman trained many ophthal- mologists in the procedure and his name is listed in the Curricula Vitae of many ophthalmologists practicing at this time. He was also one of the founding members of ASCRS and a Binkhorst Lecturer (1979). He is survived by his wife Jane and his four sons. Obituary

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