EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/511377
EW MEETING REPORTER 84 May 2015 Reporting from the 2015 ASCRS•ASOA Symposium & Congress, April 17–21, 2015 San Diego drug delivery represents a huge unmet need in ophthalmology. Compliance with drop regi- mens is an issue for several reasons, but the bottom line is that patients really don't like taking drops, he said. Ocular surface toxicity, cost, and penetration into the eye are also issues that can be directly addressed with a dropless drug delivery regi- men. In addition to intracameral or intravitreal drug injection, sus- tained-release drops, punctal plugs, and external inserts show promise as dropless therapies. Reimbursement remains a challenge, however, and Dr. Donnenfeld called on physicians to lobby for adequate reimburse- ment for these therapies. Rosa M. Braga-Mele, MD, FRCSC, Toronto, shifted the topic to immediately sequential bilater- al cataract surgery. Dr. Braga-Mele doesn't believe it's the right time for this yet, but believes surgery is slowly moving in that direction. For patients that must undergo general anesthesia, it should definitely be considered, she said, and possibly for patients who are travelling long distances to the clinic. If individual surgeons do choose to offer immediately sequential surgery, patient choice and informed consent are essential, she said. The second eye must always be option- al, there must be separate consent forms for bilateral surgery, and the surgeon must have complete aseptic separation of the right and left eyes, she said. Femtosecond laser-assisted cat- aract surgery complicates the issue, Dr. Braga-Mele added. Should both eyes be docked and lasered before going to the OR? What happens if there are complications during pha- co in the first eye? These issues will need to be addressed before moving forward, she said. Douglas D. Koch, MD, Hous- ton, presented "IOL Design—Is This the Best We Can Do?" The IOL features available now are high quality optics, toric IOLs that meet our needs, improving pseudoaccom- modative designs, and square edges that retard posterior capsular opaci- fication (PCO), but some features are still missing, he said. His "wish list" of IOL design includes elimination of PCO, elimination of dysphotop- sias, a more precise definition of IOL power, true accommodative designs, and drug delivery. While we are making strides in these areas, it may be time for an en- tirely new approach, Dr. Koch said. "Why are we still either prescribing drops or injecting drugs through the zonules?" he asked. Having the lens elute drugs would reduce the need for both of these therapies. When it comes to a truly accommodative IOL, the ultimate solution is a long way down the road, he concluded. Editors' note: Dr. Donnenfeld has financial interests with Abbott Med - cal Optics, AcuFocus, Alcon, Allergan, AqueSys, Bausch + Lomb, Elenza, Glaukos, Icon Biosciences, Kala Pharmaceuticals, Katena, Mati Ther- apeutics, Merck, Mimetogen Pharma- ceuticals, NovaBay Pharmaceuticals, Odyssey Medical, Omeros, Pfize , PRN, RPS, Shire Pharmaceuticals, Strathspey Crown, and TearLab. Dr. Koch has financial interests with Abbott Med - cal Optics, Alcon, i-Optics, ReVision Optics, TrueVision, and Ziemer. Dr. Braga-Mele has financial interests with Abbott Medical Optics, Alcon, and Allergan. Leveraging technology to drive the future of health and medicine When it comes to technology, phy- sicians are still practicing old school medicine, but it is time to change their way of thinking, said Daniel Kraft, MD, San Francisco, this year's speaker at the ASCRS Lecture on Science and Medicine. A renowned physician-scientist, Dr. Kraft has 20 years of experience in clinical practice, biomedical research, and healthcare innovation. He holds numerous medical device, immunology, and stem cell-related patents and has founded several in- formation technology and biotech- nology companies. Rather than reacting to rapidly advancing technologies, physicians should take a proactive role, leverag- ing technology to provide the best care for their patients, Dr. Kraft said. This is what will bring healthcare into the modern era. "We need to think differently if we're going to reinvent health- care and address some of the grand challenges we have in whatever field we're in," he said. "Technology can be disruptive, but we should be the disrupters, not the disruptees." Some of the biggest challenges in delivering healthcare are cost, access to care, and variations in clinical practice, Dr. Kraft said. In addition, physicians are unable to View videos from Sunday at 2015 ASCRS•ASOA: EWrePlay.org Donald Tan, MD, Singapore, talks about the evolution and current state of affairs in lamellar corneal surgery. Supported by