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EW NEWS & OPINION 11 I n April, the Center for Medicare and Medicaid Services (CMS) released indi- vidual Medicare provider infor- mation, despite the opposition of ASCRS and the entire medical community. The data that was released includes the number and type of Medicare healthcare services that individual physicians and certain other healthcare providers delivered in 2012 as well as the amount that Medicare paid them for those services. Specifically, the searchable claims data contains information on more than 880,000 healthcare professionals in all 50 states who collectively received $77 billion in payments in 2012 for services delivered to beneficiaries under the Medicare Part B Fee-For-Service Program. Media outlets across the country have been reporting on the Medicare data, and many of those reports focused special attention on ophthalmologists. Since the release of the data, ASCRS has worked to illustrate the problems and potential misinforma- tion associated with the release. ASCRS has provided talking points to its members for use in addressing patient questions. The talking points are available on the ASCRS website. ASCRS also sent letters to the editors of the major U.S. newspapers focus- ing on key issues that impact the ophthalmology data, including the high percentage of Medicare patients treated by ophthalmologists and the fact that the data does not account for the drug and supply costs. We February 2014 C constant: New concept for ray tracing-assisted intraocular lens power calculation Thomas Olsen, MD, Peter Hoffmann, MD In this case series, investigators assessed the accuracy of the C constant for ray tracing in determining IOL power. To evaluate this, investigators compared results in which the C constant was used in conjunction with the Olsen formula to those attained with the thin-lens Haigis, Hoffer Q, Holladay 1, and SRK/T formulas. Results from optimized data sets from 2 centers involving 243 cases were studied. While the SRK/T calculation performed better than the other thin-lens formulas in eyes with an axial length greater than 27.0 mm, there were no other significant differences between these traditionally used formulas. Meanwhile, investigators determined that in the two data sets, the Olsen formula showed a 15% and a 14% improvement in the mean absolute error with a 39% and an 85% reduction in the number of large errors over the SRK/T calcula- tions. They reported that while there was a significant bias found with the thin-lens formulas regarding axial length, keratometry reading, and anterior segment length, this was not so with the Olsen formula with C constant. Investigators concluded that IOL power calculation using the C constant in conjunction with ray tracing is a promising option. Toric intraocular lens implantation versus astigmatic keratotomy to correct astigmatism during phacoemulsification Jeewan S. Titiyal, MD, Mukesh Khatik, MD, Namrata Sharma, MD, Sri Vatsa Sehra, MD, Parfulla K. Maharana, MD, Urmimala Ghatak, MD, Tushar Agarwal, MD, Sudarshan Khokhar, MD, Bhavana Chawla, MS Investigators in this prospective, randomized trial set out to determine how correction of astigmatism with astigmatic keratotomy during the phacoemulsification process compared to use of toric intraocular lenses. Included here were cataract patients with astigmatism ranging from 1.25 to 3 D. Of the 34 phacoemulsification patients, 17 were randomized to receive a toric IOL and the other 17 to undergo AK at the 7-mm optical zone. At the 3-month mark, mean residual astigmatism was 0.44 D in the toric IOL group compared with 0.77 in the AK group. Investigators concluded that for those with moderate astigmatism, use of toric lenses was comparable to that of AK for those undergoing phacoemulsifica- tion. Corneal stroma demarcation line after standard and high-intensity collagen crosslinking determined with anterior segment optical coherence tomography George D. Kymionis, MD, Konstantinos I. Tsoulnaras, MD, Michael A. Grentzelos, MD, Argyro D. Plaka, MD, Dimitrios G. Mikropoulos, MD, Dimitrios A. Liakopoulos, MD, Nikolaos G. Tsakalis, MD, Ioannis G. Pallikaris, MD Investigators in this prospective, comparative interventional case series compared how the depth of the corneal stroma demarcation line was affected by 2 different treatment protocols. Eyes in group 1 underwent the standard Dresden protocol involving 30 minutes of 3 mW/cm 2 ultraviolet-A irradiance compared with those in group 2 that received 10 minutes of 9 mW/cm 2 ultraviolet-A irradiation. Investigators found that the corneal stroma demarcation line was significantly deeper for the 9 eyes in group 1 that underwent the longer irradiation compared to the 12 eyes in group 2. Investigators concluded that with the traditional lower, longer duration irradiation, there was a significantly deeper corneal stromal demarcation line than with the shorter duration, higher intensity technique. In the journal … May 2014 May 2013 May 2014 by Cindy Sebrell ASCRS•ASOA Director of Communications ASCRS responds to CMS release of provider data ASCRS update continued on page 12 will continue our effort to get this information out to as wide an audi- ence as possible. Our issues with the data are clear. Simply put, the CMS release of provider payment information does not give the public the full picture. Dollar for dollar, there is no sur- gery performed today that impacts quality of life greater than cataract surgery. With more than 3.3 million cataract surgeries performed in the U.S. each year, there is hardly any- one who does not know someone whose life has been dramatically and positively affected by this safe and effective cure of blindness. Many studies show cataract surgery de- creases incidence of hip fractures from falls, car accidents, and even depression among elderly, and there- fore, ultimately reduces overall costs to the Medicare system. For these reasons and many more, cataract surgery is the number one Medicare surgical procedure. No other specialty, other than geriatrics, sees as high a proportion of Medicare beneficiaries. Eye dis- eases and vision problems typically develop with age. Cataract surgery in a person under the age of 65 is a rarity. Cataract surgery is the num- ber one Medicare-reimbursed surgical procedure, and Medicare beneficiaries typically comprise about 65% or higher of an ophthal- mologist's patient base. This means that many ophthalmologists rely solely on CMS payments for practice income. Other specialties repre- sented in this data receive incomes from other sources, primarily private insurance companies. Keep up on the latest in ophthalmology! 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