Eyeworld

EW NEWS & OPINION 9 D ouglas D. Koch, M.D., will present the 2012 Charles D. Kelman Innovator's Lecture, a highlight of the annual ASCRS•ASOA Symposium & Con- gress. "Corneal Optics for IOL Selec- tion: Cracking the Code" is the title of Dr. Koch's lecture. Of it, he noted, "A better understanding of the op- tics of the cornea is required to opti- mize several aspects of intraocular lens (IOL) surgery, including the ac- curacy of (IOL) calculations, visual quality, depth of focus (pseudoac- commodation), and IOL toricity. I will discuss new advances in tech- nology and formulae for addressing these issues and look ahead to future innovations." Dr. Koch is a professor of oph- thalmology and holds the Allen, Mosbacher, and Law Chair in Oph- thalmology at the Cullen Eye Insti- tute, Baylor College of Medicine, Houston, where he has been a fac- ulty member since 1982 and has been performing cataract and refrac- tive surgery since that time. Dr. Koch served as co-editor of the Journal of Cataract and Refractive Surgery for 6 years. He was president of the International Intra-Ocular Im- plant Club from 1998 to 2000, presi- dent of the American Society of Cataract and Refractive Surgery from 2000 to 2001, and one of six charter members of the executive commit- tee of the Refractive Surgery Interest Group of the American Academy of Ophthalmology. He is the author of more than 200 research articles and educational chapters. The lecture is scheduled for the Monday General Session, April 23, 10:00-11:30 a.m. ASOA Congress: Coaching attendees on the business of ophthalmology The 2012 ASCRS•ASOA Symposium & Congress will be held April 20-24 in Chicago. The American Society of Ophthalmic Administrators (ASOA) Congress focuses on the business of running the practice. All program- by John Ciccone ASCRS Director of Communications Douglas Koch, M.D., to present Kelman Innovator's Lecture Corneal endothelial cell loss and thickness with light-adjustable IOL Fritz H. Hengerer, M.D., H. Burkhard Dick, M.D., Simone Buchwald, Werner W. Hütz, M.D., Ina Conrad-Hengerer, M.D. The aim in this study involving 122 eyes was to determine the safety of using near-UV light to change the power in light-adjustable lenses. In- vestigators considered how application of a near-UV light to change the adjustable lens power affected endothelial cell loss and corneal thickness in those receiving the lens during cataract surgery. The UV light was used initially to induce a targeted refractive change and then once the desired correction was determined to lock in the lens power. With a mean cumulative UV light dosage of 61.47 J/cm 2 at the cornea, 2 weeks after surgery before UV adjustments the mean endothelial cell loss was 6.91%. At the 12-month lock-in the mean endothelial cell loss was 6.57%. When it came to corneal thickness, the mean relative change 2 weeks after surgery before UV adjustments was 6.18% and at 12 months after the lock-in was –0.64%. Investigators concluded that at the 12- month mark when changes in corneal thickness after lock-in procedures were compared to traditional reports of IOL implantation in the litera- ture, these were in agreement. They determined that no additional dam- age to the endothelium after cataract surgery resulted from UV light exposure for adjustment and lock-in procedures. Endophthalmitis after sequential bilateral cataract surgery Steve A. Arshinoff, M.D., F.R.C.S.C., Paul A. Bastianelli, B.Sc. Investigators looked at sequential bilateral cataract surgery to determine the incidence of endophthalmitis and evaluate whether prophylactic in- tracameral antibiotics were of value. After reviewing the literature and surveying members of the International Society of Bilateral Cataract Sur- geons (ISBCS), investigators found that there was no increased risk of endophthalmitis with the bilateral approach. With unilateral cataract surgery, in Europe, they found a 0.3% incidence without prophylactic intracameral antibiotics and a 0.05% occurrence with coverage. Mean- while, the rate has been as low as 0.28% in the United States for unilat- eral cases in which topical antibiotics have been prophylactically used. When it came to bilateral surgery, they found that over the past 60 years there have been just four cases involving simultaneous infection re- ported in the literature, all of which occurred after aseptic protocol had been breached. However, no bilateral simultaneous cases were reported by ISBCS members—there was in fact only one occurrence out of 5,759 procedures. The conclusion reached was that especially when proper prophylaxis is used, the ISBCS rates indicate a bilateral endophthalmitis risk that may even be lower than rates in the literature for unilateral sur- gery. Investigators also concluded that risk of post-op endophthalmitis was significantly reduced by use of intracameral antibiotics. Review/update: Anterior segment imaging in pediatrics Kamiar Mireskandari, M.B.Ch.B., F.R.C.S.Ed., F.R.C.Ophth., Ph.D., Nasrin N. Tehrani, M.B.Ch.B., M.Sc., F.R.C.S.Ed.(Ophth.), F.R.C.S.C., Cynthia VandenHoven, B.A.A., C.R.A., Asim Ali, M.D., F.R.C.S.C. In this review, investigators considered the various aspects of successful imaging in children with anterior segment disease, including familiarity with devices used, a positive outlook, and the ability to build rapid rap- port with young patients. Investigators showed how when it comes to diagnosing, documenting, and managing pediatric anterior segment dis- ease, devices such as external and slit lamp photography, Scheimpflug imaging, anterior segment optical coherence tomography, ultrasound biomicroscopy, and handheld digital fundus cameras can be invaluable. They detailed how when the disease process is documented photograph- ically, families better comprehend the situation and are often more mo- tivated to comply with the treatment process. In the journal … December 2011 continued on page 11 December 2011

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