Eyeworld

Reporting from the 2015 Combined Ophthalmic Symposium, August 21–23, Austin, Texas EW MEETING REPORTER 126 October 2015 Descemet's stripping endothelial keratoplasty (DSEK) is a good proce- dure? DSEK revolutionized the treat- ment of corneal endothelial disease; only transplanting the diseased layers of the cornea allows patients to have a faster visual recovery with fewer complications. In many ways, DMEK is more trouble, Dr. Hamill said—you have to stain the tissue to see it, you can't directly manipulate the graft, and there's a very steep learning curve. In addition, DMEK grafts have a higher rate of graft de- tachment—so why bother with it? The reality is that DMEK does offer some advantages over DSEK; DMEK grafts have a 10-fold lower to traditional ads for these patients. Meanwhile, in the age bracket of 45–65 years, patients are usually Internet friendly and will respond to both Internet and traditional ads. Editors' note: Ms. Musgrave has no financial interests related to her comments. Endothelial keratoplasty: Which procedure should you choose? During the "Cornea Challenges and Controversies" session, M. Bowes Hamill, MD, Houston, posed this question to attendees: Why bother with Descemet's membrane endo- thelial keratoplasty (DMEK) when The HOLOS IntraOp has streaming video of intraoperative wavefront data to assess continuous real-time refraction changes during cataract surgery, he said. It offers "sequential scanning wavefront." It delivers qualitative and quantitative refractions overlaid on video of the patient's eye. The other option for intra- operative aberrometry is the ORA with VerifEye, which has real-time streaming refractive data coupled with a dynamic reticle, which tracks the pupil during surgery. It takes 40 wavefront readings in 4 seconds. ORA with VerifEye has been tested in clinical studies and is proven to improve toric IOL outcomes by reducing the number of patients that fall outside of the intended astigmatic target (by more than half a diopter) by more than 50%. Intraoperative aberrometry is another way surgeons can refine their postoperative results to try to achieve the best outcomes possible for their patients, Dr. Tipperman said. Having several companies developing competitive technologies will benefit both surgeons and their patients, he concluded. Editors' note: Dr. Tipperman has no financial interests related to his comments. Assessing the cataract patient mindset The practice management program featured a number of valuable pre- sentations for attendees. The final session of the day gave attendees a look at what cataract patients are thinking as Brandi Musgrave, Fast Track Marketing, assessed the patient mindset. When doing this, it's important to consider 3 main things. These include analyzing the cataract industry, understanding your audience, and taking a targeted approach to market, educate, and see. When marketing to the cata- ract population, age becomes a big factor. She divided these patients into 2 segments. The first segment is those who fall in the 65–80 age range. These patients will have a small digital base, Ms. Musgrave said, but there will be a larger appeal View videos from Monday at COS 2015: EWrePlay.org Zaina Al-Mohtaseb, MD, describes patient selection for intrastromal femto AK. View videos from Monday at COS 2015: EWrePlay.org Douglas Rhee, MD, describes the point at which he advocates laser trabeculoplasty.

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