Eyeworld

EW NEWS & OPINION 9 by John Ciccone ASCRS Director of Communications Books, training CD-ROMS, and ASOA products August 2011 Toric IOL in cataract and refractive surgery Nienke Visser, M.D., Tos T.J.M. Berendschot, Ph.D., Noël J.C. Bauer, M.D., Ph.D., Jessica Jurich, Oliver Kersting, Ph.D., Rudy M.M.A. Nuijts, M.D., Ph.D. In this clinical case series, investigators set out to determine just how ef- fective a commonly used three-step ink marker procedure can be for im- planting toric pseudophakic and phakic IOLs. Investigators determined that for reference axis marking the mean error was 2.4 degrees. For the alignment axis marking, this climbed to 3.3 degrees and for toric IOL alignment this was 2.6 degrees. The total mean error was determined to be 4.9 degrees for toric IOL alignment. Investigators concluded that placement of toric IOLs was off by approximately 5 degrees in instances where the thee-step procedure was used. In cases involving higher cylin- der power IOLs, they surmise that this may be particularly important. To achieve optimal cylinder correction investigators stress the importance of orienting the toric IOL with greater accuracy. Meta-analysis of wavefront-guided LASIK Usama Fares, M.D., Hanif Suleman, M.R.C.Ophth., Mouhamed Ali Al-Aqaba, M.B.B.Ch., Ahamd Muneer Otri, M.D., Dalia G. Said, F.R.C.S., Harminder S. Dua, M.D., Ph.D. The aim of this meta-analysis of eight trials was to consider how wave- front-guided and non-wavefront-guided ablations stacked up in terms of efficacy, predictability, safety, and induced higher-order aberrations. When it came to attaining 20/20 uncorrected distance acuity, the weighted mean difference between wavefront-guided and non-wave- front-guided ablations was 1.10. The difference for higher-order aberra- tions was determined to be -0.09. In none of the studies was there a loss of two or more lines for either method. While investigators could find no significant benefit for wavefront-guided over non-wavefront-guided ablations, investigators pointed out that any advantage for wavefront- guided ablations might be masked by the fact that there's no standard- ized way of reporting uncorrected distance visual acuity of greater than 20/20. Investigators concluded that wavefront-guided procedures might be advantageous in those cases where patients pre-op had higher levels of higher-order aberrations. Review/update: Swedish National Cataract Register 1992-2009 Anders Behndig, M.D., Ph.D., Per Montan, M.D., Ph.D., Ulf Stenevi, M.D., Ph.D., Maria Kugelberg, M.D., Ph.D., Mats Lundström, M.D., Ph.D. When investigators considered data collected from 1992 to 2009 in the Swedish National Cataract Register, they found that the rate of cataract surgery climbed from 4.47 to 9 out of every 1,000 individuals. The regis- ter included 96.6% of all cataract procedures performed during that pe- riod. Investigators found that pre-op while until the year 2000 the distribution between the sexes had been stable, the proportion of women undergoing cataract surgery slowly subsequently declined. Pa- tient pre-op acuity at the time of cataract surgery has steadily increased. Also, with use of an improved questionnaire, Catquest 9-SF, which has been offered since 2008, new insight has been gained regarding indica- tions for surgery and patient expectations. Post-op, investigators deter- mined that endophthalmitis rates have declined from 10% to less than 0.04%, and patient results logged have generally been good. In the journal … August 2011 T imes are tough. Economic recovery is only crawling for- ward. New healthcare regula- tions are on the way as Obama Care is implemented. You're finding your- self with an increased need to im- prove the efficiency of your practice. Now more than ever is the time you can benefit from the resources af- forded by the American Society of Ophthalmic Administrators (ASOA), the practice management division of ASCRS. ASOA's extensive bookstore is a valuable resource that provides you with access to the latest offerings on ophthalmology business manage- ment. ASCRS members receive a 50% discount on the entire inven- tory in the ASOA bookstore. The ASOA bookstore also in- cludes exclusive ASOA-only prod- ucts, such as the COE Flash Cards to assist your administrator in becom- ing certified as an Ophthalmic Exec- utive. You can also purchase the entire John Pinto collection for 50% off. The collection includes: Cash Flow, The Efficient Ophthalmologist, Turnaround, Legal Issues in Ophthal- mology, and the bestselling Little Green Book of Ophthalmology. The 4th edition of Little Green Book of Ophthalmology includes chapters on 2011 benchmarking, scorecards, metrics, and statistics, financial and economic pearls, and 500+ pages of increased ophthalmic knowledge, specialty practice appen- dices, and encyclopedic treatment of new ophthalmic topics. "Over the past 5 years, the general economy has changed," Mr. Pinto said. "Healthcare econom- ics have changed. Your job has changed. The benefit of Little Green Book of Ophthalmology is that it af- fords you the confidence that you are doing your job well and running your practice to its full potential." The ASOA bookstore offers a wide collection of materials, which includes a plethora of resources on ophthalmology business manage- ment topics: ASC, COE, reimburse- ment, finance, administration, IT, leadership, marketing, manage- ment, operations, business develop- ment, optical shop, human resources, and legal. Go to http://shop.asoa.org. ABOUT THE AUTHOR John Ciccone is director of communications for the American Society of Cataract and Refractive Surgery. Contact him at 703-591-2220.

• Cover