Eyeworld

EW NEWS & OPINION 9 by John Ciccone ASCRS Director of Communications ACTIONED offers online education to eyecare professionals July 2011 Femtosecond laser capsulotomy Neil J. Friedman, M.D., Daniel V. Palanker, Ph.D., Georg Schuele, Ph.D., Dan Andersen, M.S., George Marcellino, Ph.D., Barry S. Seibel, M.D., Juan Batlle, M.D., Rafael Feliz, M.D., Jonathan H. Talamo, M.D., Mark S. Blumenkranz, M.D., William W. Culbertson, M.D. Investigators here set out to evaluate how successfully a femtosecond laser capsulotomy can be performed compared to the manual approach. Results showed that size and shape of femtosecond created capsu- lorhexis was significantly more precise than those that were manually created. While the deviation from the intended diameter using the laser was just 29 microns, for the manual technique this was 337 microns. Likewise, mean deviation from circularity was just 6% for the femtosec- ond versus 20% for the manual approach. While the strength of the manual capsulorhexis was just 65 mN for the laser group, this ranged from 113-152 mN, with this strength declining with increasing pulse energy. The conclusion reached here was that the laser created stronger, more precise, accurate, and reproducible capsulotomies than the manual approach. Pseudophakic negative dysphotopsia Samuel Masket, M.D., Nicole Fram, M.D. The aim in this interventional case series was to evaluate four surgical methods for treating negative dysphotopsia. These included piggyback- ing a secondary IOL in the eye, performing reverse optic capture, ex- changing the IOL in the bag, or using iris suture fixation. By the 3-month mark, there was partial or complete resolution of symptoms in all of those in which a piggyback IOL was used or reverse optic capture was performed. Meanwhile, although lenses with different materials or edge designs were used in IOL exchange cases, none of these patients improved. Likewise, no improvement was seen in the iris suture fixation case in which a posterior chamber collapse was confirmed. Investigators concluded that no particular IOL material or design was to blame for negative dysphotopsia here. Rather results substantiated the idea that when it comes to resolving negative dysphotopsia it is IOL coverage of the anterior capsule edge that matters. Special report: Microbial keratitis after refractive surgery Renée Solomon, M.D., Eric D. Donnenfeld, M.D., Edward J. Holland, M.D., Sonia H. Yoo, M.D., Sheraz Daya, M.D., José L. Güell, M.D., Francis S. Mah, M.D., Stephen V. Scoper, M.D., Terry Kim, M.D. In this survey of 9,121 ASCRS national and international members, in- vestigators considered the incidence of infectious keratitis following ker- atorefractive procedures, culture results, current trends, treatment and outcomes and how all of this was changing worldwide. Of infections re- ported during this 2008 period, there was an incidence of one infection in every 1102 procedures done by those who experienced this complica- tion. In 16 cases, which was the overwhelming majority, the infections were detected in the first post-op week and were diagnosed at the initial presentation. However, in three cases presentation was delayed. In one case this occurred during the first post-op week, in another between the second and the fourth weeks, and in the third at the 1-month or later mark. Methicillin-resistant Staphylococcus aureus was found to be the most common cause. Investigators determined that following refractive surgery practitioners are increasingly recognizing microbial keratitis as a sight-threatening complication. In the journal … July 2011 O phthalmology practices, beset by increasing regula- tory costs and lower Medicare reimburse- ments, know well that ef- ficient and visionary practice management is the key to providing quality patient care and growth. Given this business reality, the American Society of Ophthalmic Ad- ministrators (ASOA) has assumed a significant and growing importance as the sister society of ASCRS. In the past few years, the number of pro- grams offered through ASOA at the ASCRS•ASOA Symposium & Con- gress has dramatically expanded. Tracks providing programming for beginning as well as senior level ad- ministrators have been developed. Additionally, more offerings have been made for physicians. In the service area, ASOA has ex- panded partnerships with valuable product and service providers; among them is ACTIONED. Online education offers a solu- tion to some of the most basic yet continued on page 10

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