Eyeworld

11 EW NEWS & OPINION Headline byline goes here plus fade October 2015 J ohn S. Bell, MBA, COE, CMPE, has been named the 2015–2016 American Society of Ophthalmic Ad- ministrators (ASOA) presi- dent. This appointment follows his time as ASOA president-elect from 2014–2015 and ASOA vice president from 2013–2014. Mr. Bell has worked in ophthal- mology since 1992, and has been with North Suburban Eye Associates (NSEA) since 2008. Currently, he serves as the administrator of NSEA, which has 3 offices outside of Boston. The practice has 2 full-time In the journal . . . Simulated prototype of posterior chamber phakic intraocular lens for presbyopia correction Cari Pérez-Vives, PhD, Teresa Ferrer-Blasco, PhD, Alejandro Cerviño-Expósito, PhD, David Madrid-Costa, PhD, Robert Montés-Micó, PhD In this experimental study, the aim was to determine how the phakic intraoc- ular implantable collamer lens would be visually impacted by adding different spherical aberration values to increase the depth of focus. To simulate vision after implantation of different phakic intraocular lenses (pIOL), an adaptive optics vi- sual simulator was used and acuity and depth of focus measured in both 3.0 and 4.5 mm pupils. Investigators determined that with –3.00 D and –6.00 D pIOLs in a 3 mm pupil, nearly all pIOL prototypes attained acuity above 20/20. The only exception was with a –6.00 D pIOL that had acuity that decreased to 20/25 when examined with a positive spherical aberration of 4, at 50% corrected distance visual acuity contrast. Meanwhile, with a 4.5 mm pupil there was a significant decrease seen in corrected distance visual acuity, which with negative spherical aberration was even more pronounced. Investigators found that with the smallest pupil and the highest spherical aberration, the depth of focus increment was larger. They concluded that after implanting a pIOL, CDVA can be disrupted by negative spherical aberration. Positive spherical aberration, on the other hand, can increase depth of focus and produce excellent CDVA with a pIOL, making this a potential option for young presbyopic patients. Efficacy of axial and tangential corneal topography maps in detecting subclinical keratoconus Shyam Sunder Tummanapalli, BOptom, Haresh Potluri, BS, Optom, Pravin Krishna Vaddavalli, MS, Virender S. Sangwan, MD Investigators in this retrospective cross-sectional study wanted to determine whether subclinical keratoconus could be distinguished from normal eyes by using axial and tangential corneal topography maps from the Orbscan IIz (Bausch + Lomb, Bridgewater, N.J.). They found that in both groups the tangen- tial posterior apex curvature was significantly steeper than the axial posterior apex curvature. When it came to differentiating subclinical keratoconus cases from those of normal counterparts, from the tangential map the anterior-posteri- or apex ratio showed an area of 0.992, which was the highest under the receiver operating characteristic curve, with a sensitivity of 98.6% and a specificity of 98.7%. Next was the posterior irregularity index in the 5 mm zone with a 0.938 area under the receiver operating characteristic curve, with a sensitivity of 98.6% and specificity of 84.2% for making the differentiation. Investigators determined that for detection of subclinical keratoconus, both the anterior-posterior apex ratio on the tangential map and the 5 mm irregularity index of posterior corneal surface were specific and highly sensitive. They concluded that when screening for subclinical keratoconus, practitioners should consider tangential corneal topography maps. Intraocular pressure 3–4 and 20 hours after cataract surgery with and without ab interno trabeculectomy Yotam Weiner, BSc, Melissa L. Severson, BA, Asher Weiner, MD The aim of this retrospective, comparative investigation was to determine what happed to intraocular pressure immediately after cataract surgery, with and with- out ab interno trabeculectomy with the Trabectome (NeoMedix, Tustin, Calif.). Investigators here also considered whether the risk for IOP spikes was influenced by trabeculectomy-related hyphema. Postoperatively, IOP taken at both the 3- to 4-hour and 20-hour marks was considered. Investigators found that for the 73 eyes that underwent cataract surgery combined with ab interno trabeculectomy, there was a significant decrease in the mean IOP at both time periods, which at 3–4 hours went from a mean of 15.8 mm Hg to 12.8 and at 20 hours was at 12.7 mm Hg. Meanwhile, for the 75 eyes in the cataract only group, mean pressure significantly increased from a mean of 14.9 mm Hg preoperatively to 19.7 mm Hg at the 3- to 4-hour mark and 17.2 mm Hg at 20 hours. Investigators found the mean IOP was significantly lower for those that underwent the combined procedure rather than cataract surgery alone. They determined that when it came to IOP spikes there were significantly fewer in the combined group. Also, while 47.9% of those in the combined group experienced hyphema, IOP was similar regardless. Only 1 eye in this group with hyphema experienced an IOP spike. The conclusion reached was that both short-term postoperative IOP and the inci- dence of IOP spikes was reduced by combining ab interno trabeculectomy and cataract surgery in spite of common hyphema occurrences. October 2015 ASOA announces John S. Bell as 2015–2016 president by Abbie B. Elliott ASCRS•ASOA Manager of Communications ASCRS update John S. Bell, MBA, COE, CMPE general ophthalmologists, 2 full- time optometrists and part-time providers in retina, cornea, and oc- uloplastics. The staff of 23 includes 3 opticians who staff 2 optical shops and a finishing lab. Mr. Bell officially began his term during the 2015 ASCRS•ASOA Sym- posium & Congress in San Diego. The 2016 ASCRS•ASOA Symposium & Congress will be held in New Orleans from May 6–10. Mr. Bell is a graduate of Dartmouth College in Hanover, N.H. and Carnegie Mellon Universi- ty in Pittsburgh. The rest of the ASOA Board of Directors consists of William T. Koch, COE, COA, CPC, vice presi- dent; Sondra Hoffman, COE, COC, CMPE, OCS, immediate past presi- dent; Karen Bachman, COE, COMT, CCRC, ROUB, OCS, member-at- large; Ashlie L. Barefoot, MBA, COE, member-at-large; Janna Mullaney, COE, COA, COT, member-at-large; and Charla Ferchow, COE, NBCOE president. Daniel Chambers, MBA, COE is ASOA's president-elect and will serve as president for the 2016–2017 term. EW Contact information Elliott: aelliott@ascrs.org ASCRS members continued from page 3 surgery and was only seeking addi- tional information from stakehold- ers at this time. ASCRS has submit- ted comments—based on the above survey results—and will continue to monitor the issue should CMS de- cide to move forward with a propos- al. In its request for comments, CMS did ask for direct practice expenses that would be included in a non-fa- cility payment, but ASCRS elected not to comment on that aspect until an official proposal is made since it would require extensive survey and research, and CMS might use the information to develop a proposal in the future without the opportunity for further input from the ophthal- mic community. ASCRS has offered to work with the AMA, AAO, and RUC to develop the practice expens- es, should CMS move forward with a proposal. Should CMS develop a specific proposal, ASCRS will provide input to ensure the reimbursement reflects the cost of providing the procedure in an office-based surgical suite. EW Editors' note: For additional informa- tion, contact Nancey McCann, ASCRS director of government relations, at 703-591-2220.

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