Eyeworld

127 September 2015 EW MEETING REPORTER Reporting from the Date AAAA City, Country centration of the IOL, and the cir- cumference, among other factors. He added that there are "4 Cs" of being proactive, which include chair time and counseling, choosing patients well, paying attention to the cornea surface, and conducting your "best surgery." The chair time and counseling both have a lot to do with the direct relationship to the patient, he said. It's important to discuss a number of different topics with the patient pri- or to surgery, particularly the neural adaptability that will need to occur when the patients adjust to their multifocal lens. Dr. Cabrera said that he has noticed that the younger the patient, the more easily they can adapt. To explain this change to older patients, he will describe it as going back to vision similar to what they had in their early 40s. Examinations with the many technologies available will give the patient actual proof of what he or she does have or doesn't have. Those diagnostics are the same ones that will help you postoperatively, Dr. Cabrera said, because if you have an unhappy patient, you can use the diagnostics to show them the actual results. Dr. Cabrera again stressed the importance of counseling the patient prior to surgery and explain- ing all possible results. If you don't mention something that the patient experiences later, it becomes a com- plication, he said. But if you have discussed it with them beforehand then it's an expectation. Don't discard! Toward 'bespoke' medicine Modern society has often been criticized for its wastefulness, yet it isn't likely to have occurred to the average ophthalmologist just how wasteful their respective practices can be, and they probably haven't given a thought to the potential riches hidden within all that waste. Imagine, for instance, all the tears collected during a simple Schirmer's test, disclosing no more information to the diagnostician than volume or rate of production. Moreover, imagine all the epithelial tissue excised, aqueous and vitreous humor aspirated, simply discarded during numerous types of surgery. The number of cataracts removed following cataract surgery, the amount of crystalline lens material extracted during lens exchange, par- ticularly in high-volume ophthalmic surgery practices. Have you ever wondered: What are we missing by discarding all this material? One ophthalmologist has. His idea, presented at the final cataract surgery symposium on the last day of the 28th APACRS annual meeting, View videos from Saturday at APACRS: EWrePlay.org Clara Chan, MD, Toronto, Canada, reports results of her survey on risk factors for wound burns. continued on page 130

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