EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/307281
EW NEWS & OPINION 13 September 2011 by John Ciccone ASCRS Director of Communications ASCRS appoints public trustee/medical ethicist to governing board Subconjunctival steroid depot after cataract surgery Myrthe Dieleman, M.D., René J. Wubbels, Ph.D., Marina van Kooten- Noordzij, M.D., Peter W.T. de Waard, M.D. Investigators in this prospective, randomized trial compared the efficacy of dexamethasone 0.1% eye drops after phacoemulsification to that of a single perioperative subconjunctival injection of betamethasone acetate. They wanted to see which was better for preventing anterior segment inflammation and development of macular edema after cataract surgery. Patients in group one were randomized to receive a perioperative sub- conjunctival injection of 5.7 mg per mL betamethasone acetate, while those in group two received dexamethasone 0.1% eye drops. Investiga- tors found mean flare values were significantly higher at the 4-week post-op mark for those in group one. When it came to macular edema, however, the incidence was not significantly different in either group. Investigators concluded that instead of prolonged use of dexamethasone following cataract surgery, use of a single subconjunctival betametha- sone acetate injection was a viable alternative. Visual quality after LASIK monovision correction Aixa Alarcón, M.Sc., Rosario G. Anera, Ph.D., César Villa, Ph.D., Luis Jiménez del Barco, Ph.D., Ramón Gutierrez, Ph.D. In this clinical case series involving 50 eyes of 25 presbyopic patients, the aim was to determine how visual quality fared when LASIK patients underwent monovision correction. Patients had their dominant eye fully corrected for distance vision, while the non-dominant eye was cor- rected for –1.25 D of myopia. Investigators found that although contrast sensitivity declined somewhat, binocular vision in greater than 90% of cases was Plano or better. There was, however, a tradeoff. In particular, contrast sensitivity was diminished in the non-dominant eye. In addi- tion, for all patients, stereoacuity declined significantly. Investigators also saw a decline in visual discrimination capacity in the non-domi- nant eye. The conclusion reached was that functional near vision can be restored with monovision, but contrast sensitivity and stereoacuity is significantly diminished by the process. Special report: Prevention and diagnosis of post-operative bacterial endophthalmitis Mark Packer, M.D., David F. Chang, M.D., Steven H. Dewey, M.D., Brian C. Little, M.D., Sonia Yoo, M.D., for the ASCRS Cataract Clinical Committee This investigation took a closer look at the peer-reviewed literature on cataract surgery-related infection in order to offer the latest on epidemi- ology, etiology, and pathogenesis related to bacterial endophthalmitis. Investigators looked at suspected endophthalmitis cases and considered the parts that antibiotic prophylaxis and surgical technique play. They also delved into current use of diagnostic and therapeutic intervention in such cases, offering a comprehensive picture. In the journal … September 2011 J ohn Banja, Ph.D., has been appointed to the newly cre- ated position of public trustee to the Governing Board of the American So- ciety of Cataract and Refractive Sur- gery. "The advance of medical tech- nologies and fundamental changes in the nation's healthcare system are posing complex new challenges to doctors as they strive to provide bet- ter care to patients," said Edward Holland, M.D., ASCRS president. "As a public trustee to the Govern- ing Board, and someone who is not a surgeon, [Dr. Banja] can view pa- tients' interests from a perspective different from that of a physician. In addition, his expertise is in the field of medical ethics, which offers an invaluable resource when develop- ing policy on clinical questions and in forming our positions on legisla- tive and regulatory affairs." "I am extremely honored and proud to be invited to serve as the public trustee of the ASCRS Govern- ing Board. As a medical ethicist and educator, the significance I attach to board membership stems not only from the enormous value our society places on vision, but also from the technological and economic dimen- sions that continue to propel as well as concern ophthalmologic prac- tice," said Dr. Banja. "Ethicists and public policy ana- continued on page 14 lysts have been commenting on the 'marketplace' evolution of American healthcare for three decades, and ophthalmology, especially as prac- ticed by cataract and refractive sur- geons, is a remarkable example of marketplace medicine. With that, of course, come all sorts of challenges that I look forward to learning more about and assisting the Board in its deliberations and planning. Also, ophthalmology, like so many other medical disciplines, is in the midst of extraordinary technological ad- vances whose benefits might appear obvious to some but will almost cer- tainly concern us with regard to their costs, overall effectiveness, and determining which patient popula- tions (and ophthalmologic practices) will have access to them. Conse- quently, I'm eager to join the Board, explore these issues in greater depth, and make a positive contribution to ASCRS," said Dr. Banja. John Banja, Ph.D. Dr. Banja is a professor in the Department of Rehabilitation Medicine and a medical ethicist at the Center for Ethics at Emory Uni- versity, Atlanta. He also directs the Section on Ethics for the Atlanta Clinical and Translational Science Institute at Emory. Dr. Banja received a doctorate degree in philosophy from Fordham University in New York and has taught and lectured on topics in medical ethics throughout the United States. He has authored or coauthored over 150 publications and has delivered more than 800 invited presentations at regional, national, and international confer- ences. He currently serves as the as- sociate editor of AJOB-Neuroscience, the leading scholarly journal in the field of neuroethics. Dr. Banja has conducted re- search or educational projects with numerous federal and private organ- izations including the National Institutes of Health, the American College of Surgeons, the Agency for Healthcare Research and Quality, the National Institute for Disability and Rehabilitation Research, the Ameri- can Society for Healthcare Risk Man-