EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/407647
11 EW NEWS & OPINION November 2014 T hroughout the U.S., there are many poor Americans living with treatable cata- racts whose employment status, educational opportu- nities, and general mobility are lim- ited by their vision. With this need in mind, the ASCRS Foundation established Operation Sight— a U.S.-based cataract surgery program whose mission is to eliminate treatable cataract blindness in the U.S. by providing charitable cataract surgeries. "While the ASCRS Foundation's efforts to provide ophthalmic care internationally remain extremely important, there are many people here at home who need modern eyecare but lack the access or the means to receive it," said Stephen S. Lane, MD, chair of the ASCRS Foundation Domestic Committee. The Operation Sight network consists of an ever-growing group of established charitable organizations and ASCRS-member volunteer surgeons. Through the ASCRS Foundation, Operation Sight is able to centralize patient care and pro- vide the financial support necessary to offset the cost of charitable care. "The ASCRS Foundation is offering the administrative support needed to qualify and deliver needy patients, and is actively engaging In the journal . . . Endothelial change after femtosecond pretreatment cataract surgery Robin G. Abell, MB BS, Nathan M. Kerr, MBChB, Allister R. Howie, Mohd A.A. Mustaffa Kamal, MB BS, Penelope L. Allen, PhD, Brendan J. Vote, FRANZCO Is the femtosecond laser for cataract surgery more forgiving on the corneal endothelium? Investigators in this prospective study compared the effect of the femtosecond laser approach on the endothelium to that of traditional phacoemulsification. At both the 1-day and 3- week marks, they found that postoperative corneal edema was significantly less in eyes treated with the femtosecond laser than in those that underwent traditional treatment. By the 6-month mark, however, this difference was insignificant. Meanwhile, when it came to endothelial cell density, this was significantly reduced in eyes receiving femtosecond laser-assisted treatment at the 3-week mark, but at 6 months this was not found. In cases where a laser-automated corneal incision was made, at 6 months investigators found that there was greater endothelial cell loss than eyes in either group receiving manual incisions. Investigators concluded that in the early postoperative period there was a significant reduction in corneal edema and endothelial cell loss with femtosecond laser pretreatment for cataract surgery compared with the conventional approach. With time, however, there was a reduction in this effect, they noted. They also determined that corneal endothelial cells appeared to be adversely affected by laser-automated corneal incisions. Corneal coupling of astigmatism Noel Alpins, FRANZCO, FRCOphth, FACS, James K.Y. Ong, BOptom, George Stamatelatos, BScOptom To ensure validity of most laser vision correction and incisional procedures, in this retrospective study, investigators redefined measures known as the coupling ratio and the coupling constant. To quantify the amount of spherical adjustment needed to compensate for coupling that results from astigmatism treatment, investigators developed a new measure dubbed the coupling adjustment. When these measures were applied to retrospective data, investigators found that for myopic, compound myopic, and compound hyperopic astigmatism excimer laser treatments, both the coupling ratio and the coupling adjustment were close to zero and the coupling constant close to 0.5. Meanwhile, they determined that the coupling ratio was close to 1 for incisional LRIs, with the coupling constant near zero. They found that for treatments with astigmatic components of greater than 1 D, coupling measures were consistent. However, when the astigmatism treatment component was reduced, these measures were found to be variable. The conclusion reached was that in incision and ablative surgery, revised definitions of coupling ratios and coupling constants could be used. In addition, in planning spherocylindrical treatments, use of the coupling adjustment helps to more accurately target the desired spherical equivalent by factoring in the effect of the astigmatic treatment. Review/update: Current knowledge and recommendations for ocular MRSA Francis S. Mah, MD, Richard Davidson, MD, Edward J. Holland, MD, John Hovanesian, MD, Thomas John, MD, John Kanellopoulos, MD, Neda Shamie, MD, Christopher Starr, MD, David Vroman, MD, Terry Kim, MD, for the ASCRS Cornea Clinical Committee When it comes to pathogens that cause infections after PRK, LASIK, or cataract surgery, Staphylococcus aureus is currently the most common one, investigators in this update report. In bacterial keratitis cases worldwide this was the second most common cause. Investigators stressed that increasingly reports of postoperative methicillin-resistant Staphylococcus aureus are a source of concern. The data suggests that there is growing prevalence of MRSA infections worldwide, with reports of these occurring in phacoemulsification cases, epithelial transplantation with amniotic membrane grafts, penetrating keratoplasty, and lamellar keratoplasty. Investigators highlighted recommendations for identifying, treating, and ultimately overcoming MRSA infections. November 2014 Ending treatable cataract blindness in the U.S. by Abbie B. Elliott ASCRS•ASOA Communications Manager Operation Sight patient Mary and her doctor, Operation Sight partner Kerry Solomon, MD Dr. Solomon operates on an Operation Sight patient. Source (all): ASCRS Foundation continued on page 12 ASCRS update