Eyeworld

11 EW NEWS & OPINION November 2015 Operation Sight restores sight and hope for patients by Abbie B. Elliott ASCRS•ASOA Manager of Communications ASCRS update I raq war veteran Chris Hadsall is seeing clearer these days without the use of his contact lenses. He recently became one of the first treated through the ASCRS Foundation Operation Sight program, which provides free LASIK treatment to wounded American veterans as part of its domestic humanitarian eyecare efforts. "It has meant a night-and-day difference for me," Mr. Hadsall said. "Before I had constant worry about losing a contact during exercise and races, or having to touch my eyes to take out my contacts while camping, or spending hundreds of dollars a year on eye products and contacts." A Marine Corps captain who deployed to Al Anbar Province in Iraq as a scout/sniper platoon com- mander, Mr. Hadsall was hit by a suicide car bomb and eventually had to medically retire after 10 years in the Corps. He is currently a strategic accounts manager for Zimmer Biom- et in Denver. "It was an absolutely smooth process," Mr. Hadsall said. "Once I was selected, the doctor's staff stayed in contact with me the entire time from the pre-procedure consults to all the subsequent follow-up exams. For the procedure itself, I was in the doctor's office for maybe 4–5 hours, but the LASIK procedure only took about 20 minutes. With drops to help deal with minor irritation, the discomfort was almost completely gone the next day." The procedure was performed by Gary Foster, MD, in Fort Collins, Colo. Dr. Foster is among a growing list of ASCRS members across the country who have volunteered their time and talents to the Operation Sight program. Considering his improved quality of life, Mr. Hadsall regrets not having LASIK sooner. "I'm 100% satisfied with the results, and my only regret is that I waited 8 years to have the procedure done." "It was an absolutely amazing experience, and I can't thank the ASCRS Foundation and Dr. Foster enough. I think I would have just dealt with the hassle of contacts for the next 20 years had it not been for the Operation Sight program." Tamra Broach can see balance sheets clearly again thanks to the Operation Sight program. An ac- countant from Florence, S.C., Ms. Broach lost her job 2 years ago when her employer downsized. Scheduled to have cataract surgery only 2 months after her layoff, the timing couldn't have been worse. "My eyesight was getting so bad that I was unable to Chris Hadsall Tamra Broach Source: ASCRS In the journal . . . Risk factors for endophthalmitis after cataract surgery: Predictors for causative organisms and visual outcomes Mats Lundström, MD, PhD, Emma Friling, MD, Per Montan MD, PhD The aim of this retrospective review of cases found in the Swedish National Cataract Register, reported from 2002 to 2010, was to identify groups at risk for endophthalmi- tis following cataract surgery. Of 692,786 cataract surgeries performed during this peri- od, 244 resulted in postoperative endophthalmitis. Investigators here determined that of these cases, 22 were in a group that did not receive any intracameral antibiotics; in 18 cases there was communication with the vitreous; and in 56 cases the patients were age 85 or older. There were another 148 patients who didn't have related risk factors. In 99% of those that received intracameral antibiotics, cefuroxime was administered. The worst prognosis was seen in cases involving communication with vitreous, with most of these caused by gram-positive bacteria. Patients over age 85 tended to be affected by staphylococci and gram negative-bacteria. Investigators concluded that giving prophylactic intracameral antibiotics to everyone could lower the risk of endophthalmitis, as could removing cataracts earlier. In some risk groups they also recommend adjusting the intracameral regimen. Visual outcomes after femtosecond-assisted laser in situ keratomileusis flap complications Dip S. Jadav, MD, Niraj Desai, MD, Kenneth R. Taylor, MD, Matthew C. Caldwell MD, Vasudha A. Panday, MD, Charles D. Reilly, MD In this retrospective chart review, investigators set out to determine how vision compared in complicated and uncomplicated LASIK cases, with flaps created with the femtosecond laser. Of the 586 eyes, 91.8% of patients had normal flaps with a mean uncorrected distance visual acuity of 20/19 and corrected distance visual acuity of 20/16.8 at 1 month. There was an incomplete side cut or intraoperative flap tear in an- other 51% of patients, with a mean uncorrected distance visual acuity of 20/17.5 and a corrected distance visual acuity of 20/16.9. In 4.9% of patients, micro-stria was found, resulting in 20/21.7 uncorrected distance vision at 1 month and 20/17.4 corrected distance visual acuity. They found that in 0.68% of patients, diffuse lamellar keratitis developed, resulting in a mean 1-month uncorrected visual acuity of 20/21.7 and a corrected distance visual acuity of 20/15.6. In the 1.5% of cases where the epithelial ingrowth developed at 1 month, there was a mean uncorrected visual acuity of 20/18.7 and corrected distance visual acuity of 20/16.9. Investigators concluded that for com- plicated and normal flap cases, visual outcomes were equivalent. Cataract surgery outcomes in corneal refractive surgery eyes Sonia Manning, MRCOphth, MD, Peter Barry, FRCS, FRCOphth, Ype Henry, MD, FEBO, Paul Rosen, FRCS, FRCOphth, Ulf Stenevi, MD, PhD, Mats Lundström, MD, PhD How do those who have undergone previous refractive surgery fare with cataract surgery? That's what investigators here wanted to find out. To do so, they examined the database of the European Registry of Quality Outcomes for Cataract and Refrac- tive Surgery over a 5-year period. They determined that 15% of the 807,220 cataracts removed involved post-refractive cases. Patients in such cases tended to be younger, at 62.9 years versus 74.0 for typical cataract patients. Visual acuity, both corrected and uncorrected, had a similar mean. However, in 4% of prior refractive cases, postopera- tive corrected distance visual acuity was worse than preoperative, which was true for only 1.5% of non-refractive cases. This was especially true for the 54.3% of refractive patients who had preoperative distance visual acuity of 6/6 or better. Investigators concluded that prior corneal refractive patients tended to be younger but had similar preoperative corrected distance visual acuity. Prior refractive patients, especially those with preoperative acuity of 6/6 or better, were at increased risk for worse postoperative corrected distance visual acuity after cataract surgery. November 2015 continued on page 12

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