Eyeworld

13 EW NEWS & OPINION Headline byline goes here plus fade March 2016 T he ASCRS•ASOA Sympo- sium & Congress never fails to deliver education and networking opportunities of the highest quality, and 2016 will be no different. For Young Eye Surgeons (YES)—residents, fellows, and surgeons in their first 5 years of practice—this year's annual meeting promises to be better than ever. The YES All Access Pass (free for U.S. residents and fellows) is the ticket to content developed with the young surgeon in mind. "The program for the young eye surgeon is quite remarkably organized to provide both didactic and hands-on learning experiences, particularly for the weekend of the annual meeting," said Elizabeth Yeu, MD, chair, ASCRS YES Clinical Committee. "This starts with the Friday subspecialty day; continues with a robust Saturday featuring the Skills Transfer Session for Residents and Fellows, Roundtable with the Experts, Challenging Video Cases symposium, and the Derby Party social event; and wraps up on Sunday with the EyeWorld Phaco Fundamentals symposium followed by the Top 10 Residents and Fellows Poster Presentations." Friday Kick off your annual meeting at the YES Connect Lounge, which opens Friday and features a Mardi Gras theme. "The YES Connect Lounge is a new initiative by the YES Clinical Committee to create a space where we can bring members together, In the journal . . . Indications and outcomes in resident-performed cataract surgery requiring return to the operating room Caroline Schmidt, MD, Miel Sundararajan, BS, Kristin Biggerstaff, MD, Silvia Orengo-Nania, MD, Robert Coffee, MS, MD, Sumitra Khandelwal, MD Residents have to start their surgical careers somewhere. In this retrospective study of 6,644 resident-performed cataract surgeries, investigators honed in on factors that were likely to predict the need for reoperations, which occurred within just 30 days of the original procedure. They determined that in the 54 eyes in which such a reoperation was necessary, this was more likely to occur in the first half of the academic year, at a rate of 1.18% versus 0.55% of reopera- tions needed during the latter half. At the 1-year mark, the average visual acuity was 20/40. Four eyes lost lines of visual acuity. On average, residents took 59.23 minutes for the cataract procedure, with cases that took longer more likely to have worse outcomes. Investigators concluded that in most resident-performed cataract surgeries, visual acuity for patients improved. But when there was a need for reoperation in cases where surgery took longer, this was predictive of poorer visual outcomes. Subluxated cataract lens surgery using sutured segments or rings and implantation of toric intraocular lenses Anna Do, MD, Huck Holz, MD, Robert Cionni, MD Investigators in this retrospective case review set out to see how adult patients with subluxated lenses fared with toric intraocular lens implantation with a sutured ring or segment. Included here were 21 eyes of 15 subluxated cataract patients who underwent toric IOL implantation with a segment or sutured ring. Investigators found that the mean corrected distance visual acuity at the final follow-up was 0.10 logMAR, which was a significant improvement over the preoperative mean corrected distance visual acuity of 0.73 logMAR. Meanwhile, in all patients, cylindrical power was significantly improved postoperatively with a mean reduction in astigmatism of 2.37 D. Postoperative enhancements were required in 6 eyes, with 2 that had anterior laser capsulotomy for bilateral capsular phimosis, 1 that underwent photorefractive keratectomy, 1 that needed a pupilloplasty, and 2 that needed posterior laser capsulotomy. The conclusion reached here was that implantation of a toric IOL combined with a sutured ring or segment capsule stabilizing device was a safe and effective alternative for those with corneal astigmatism as well as subluxated cataract lenses. Near-term analysis of corneal epithelial thickness after cataract surgery and its correlation with epithelial cellular changes and visual acuity Tianyu Zheng, PhD, Jin Yang, MD, Jianjiang Xu, MD, PhD, Wenwen He, PhD, Yi Lu, MD, PhD As part of this prospective observational study, investigators sought to identify cellular changes 2 weeks after cataract surgery and to quantify changes in corneal central epithelial thickness. They considered how both affected corrected dis- tance visual acuity. Investigators determined that beginning on postoperative day 1, the central epithelial thickness significantly increased. Over the next 2 weeks it gradually decreased, returning to near baseline on day 3, and continuing to decrease until it was back to baseline on day 14. Also after surgery, investigators found that corneal basal epithelial cell density significantly increased. On days 3 and 5, there was significant Langerhans cell infiltration. Investigators found a correlation between central epithelial thickness and central corneal thickness and corrected distance visual acuity. They found that patients with the most central corneal thickening and central epithelial thickness attained the lowest corrected distance visual acuity after surgery. Those who on day 1 had significant edema on day 14 ended up with worse corrected distance acuity. The conclusion reached was that during the early postoperative period, epithelial remodeling occurs. This begins with some initial thickening that may be the result of edema and is followed by thinning, possibly from inflammation. Ultimately, this returned to baseline levels. The amount of visual recovery after cataract surgery was tied to edema of the corneal epithelium. March 2016 YES All Access Pass key to exclusive programming for young eye surgeons by Tami O'Brien ASCRS•ASOA Copywriter ASCRS update continued on page 14

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