EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/407647
EW MEETING REPORTER 72 Reporting from the American Academy of Ophthalmology (AAO) 2014 annual meeting, Chicago and whether micropulse longitudi- nal phaco is superior to continuous phaco in efficiency. Dr. Olson presented several objective research studies that have addressed these surgical issues. The research showed that Kelman tips are not superior to straight tips in longitudinal phaco, and in fact double the time it takes to remove a controlled fragment and double the chatter. When it comes to phaco efficiency, research showed that pulsing modalities are more efficient than continuous, and specifically that micropulse phaco is better than long pulse phaco. When performing research to resolve these kinds of issues, the researcher needs to know the opti- mized parameters before legitimately comparing modalities, Dr. Olson said, and the research needs to be able to control for all but the study variable. Editors' note: Dr. Olson has no finan- cial interests related to his comments. Castroviejo Lecture: Points of Light in the History of Cornea The session concluded with the Castroviejo Lecture by Mark Mannis, MD, Davis, Calif., on "Points of Light in the History of Cornea." Dr. Mannis discussed important discoveries in the subspecialty of cornea and how they were conceived. "Innovation begins with a new idea or insight," he said. It then moves to enhancement or refine- ment by others to develop an idea, drug, or technique. There is eventual improvement and/or replacement. Types of clinical discovery include novel surgical technique/new instrumentation, new bio-anatom- ical insights, recognition of a new clinical phenomenon, pharmacolog- ic discoveries, or new infrastructure development. Dr. Mannis specifically high- lighted points of light in the history of cornea, including penetrating keratoplasty (PK), the discovery of endothelial function, contemporary corneal microsurgery, understanding of graft rejection, corticosteroids, the discovery of corneal stem cells, eye banking, and selective keratoplasty. He discussed the history and devel- opment of these techniques. PK can be traced back to 1906 with the first reported case by Eduard Zirm, MD. However, it would be his successors who would carry out clinical trials, Dr. Mannis said. Anton Elschnig, MD, Vladimir Filatov, MD, and Ramon Castroviejo, MD, helped to advance PK. Under the topic of new infra- structure development, Dr. Mannis highlighted the genesis of the eye bank. Not every clinical advance is surgical, bio-anatomical, or clinical, he said. The 1950s saw the prolifera- tion of eye banks, with the Eye Bank Association of America later established in 1961 and national medical standards established in 1980. In the last 2 decades, American eye banking has become increasingly efficient and comprehensive, Dr. Mannis said. Based on current criteria, it is not clear which endothelial proce- dure is truly superior to the others, he said. The ultimate goal is endo- thelial restoration or replacement without complex surgical proce- dures. He called for consistent data, not just marketing, when deter- mining which procedure is better, Descemet's membrane endothelial keratoplasty (DMEK) or ultra-thin Descemet's stripping automated endothelial keratoplasty (DSAEK). Editors' note: Dr. Mannis has no finan- cial interests related to his comments. Ophthalmic Premier League highlights the best cataract complications videos The Ophthalmic Premier League (OPL) video competition featured 4 teams with 4 members each vying for the AAO-OPL trophy. Each team member presented a 4-minute surgical video on manag- ing cataract complications. Roger F. Steinert, MD, Irvine, Calif., led team 1, the Chicago Choppers; Kevin Miller, MD, Los Angeles, led team 2, the LA Accommodators; David Chang, MD, Palo Alto, Calif., led team 3, the Frisco Flomaxinators; and Robert Osher, MD, Cincinnati, led team 4, the Vegas Multifocals. The Vegas Multifocals swept the competition, winning the AAO-OPL trophy. Dr. Osher was voted best entertainer in the OPL, and won best overall video for the depiction of his quest to determine the etiology of a patient's polychromasia capsulare. EW Editors' note: The physicians have no financial interests related to their comments. November 2014 VideoEd.EyeWorld.org Watch John Kanellopoulos, MD, discuss the role of next generation combination pharmaceuticals and MIGS in the physician's armamentarium on VideoEd.EyeWorld.org. Supported by