Eyeworld

17 EW NEWS & OPINION April 2016 full power immediately—without spinning." He has driven a Tesla on the steep hills of San Francisco and the snow- and ice-covered roads of Scandinavia. In addition to the trac- tion, Dr. Kratholm is impressed with battery performance in temperatures as low as –30 C (–22 F). Dr. Kratholm has driven his all-wheel-drive Model S extensive- ly. In fact, on the Tesla website, he blogged about his 1,500-mile road trip from Narvik to Aarhus, Den- mark to visit family. Long-distance travel is entirely possible thanks to the worldwide network of Tesla Superchargers, which are free and offer a much faster rate of charge than other methods. Dr. Kratholm bought his first Tesla, a Roadster (no longer in production), in 2010—sight un- seen. The nearest Tesla dealer was 1,300 miles away in Copenhagen, Denmark, and Dr. Kratholm didn't have time for the trek south for a test drive. "I was never really a car guy," he said, "but I read a lot about the Tesla. I ordered it, and it was delivered to me." His wife, Ellen, who was "very keen on cars, espe- cially Mercedes," wasn't convinced that electric was the way to go. That changed when she drove it for the first time. "The point with Tesla is to get people in the car to try it. When you drive it, you know that it's a totally different car," said Dr. Kratholm, who added that his 2010 "insane green" Roadster remains the favorite among his fleet. It's not surprising that Dr. Kratholm is so enthusiastic about Tesla and its advanced technology. After all, technology played a role in his decision to become an ophthal- mologist. Growing up in a small town in Denmark, Dr. Kratholm's father was the only anesthesiologist covering 2 hospitals. "He worked day and night," said Dr. Kratholm, who couldn't help noticing that another doctor in town, an ophthal- mologist, had more free time and worked with interesting cameras and other smart instruments. "I thought, 'I'll be an ophthalmologist.'" Today, Dr. Kratholm's Narvik practice is quite busy because, just like his father, he's the only game in town. However, he does find the time to attend the annual ASCRS•ASOA Symposium & Congress. "I learn a lot from those guys in America," Dr. Kratholm said. His favorite aspect of the annual meet- ing is discovering new techniques and advancements in cataract sur- gery. He often travels after the meet- ing—in a Tesla, of course—to meet and observe his American colleagues in their clinical settings. This year, Dr. Kratholm hopes to bring some of his children. He has 6 altogether, 3 of whom are training to be ophthal- mologists. All of them enjoy driving the family Teslas around Narvik when they're in town. If you ever find yourself in northern Norway, treat yourself to a test drive in Narvik. According to Dr. Kratholm, who wants to spread the word about the personal and environmental benefits of owning a Tesla, "I always tell people that where we live, the key is in the door and the key is in the car—so if we are not at home, they can just go in, or they can take a drive in the car." For more information about the 2016 ASCRS•ASOA Symposium & Congress and the Tesla drawing, visit annualmeeting.ascrs.org. EW Contact information O'Brien: tobrien@ascrs.org In the journal . . . Preoperative OCT in patients receiving advanced technology IOL Betty Klein, MD, Emma Brown, Richard Casden, MD In this prospective case study, investigators set out to use spectral- domain optical coherence tomography (SD-OCT) to identify occult macular disease in patients slated to receive either a ReSTOR multifocal (Alcon, Fort Worth, Texas) or a toric IOL during cataract surgery. Macu- lar pathology was found in 13.2% of the 265 consecutive scans. Age-re- lated macular degeneration, which was identified in 5.66% of eyes, was the most common condition identified. In addition, 4.1% were found to have idiopathic epiretinal membranes, 1.89% had ischemic atrophy from previously undiagnosed retinal vascular pathology, and 1.13% had edema. When investigators conducted a subgroup analysis they found that in those with a history of heart disease (39.6%), in men (23.9%), and in those who smoked (20.2%) there was a higher incidence of mac- ular pathology. Investigators concluded that for identifying patients at risk for compromised visual outcomes after implantation of a premium IOL, preoperative macular SD-OCT scanning was effective. Improved refractive outcomes of postgraduate year-4 cataract surgery after implementation of a stepwise biometry lecture series reinforced by self-assessment at a teaching program Kevin Kaplowitz, MD, Bennett Hong, BA, Timothy Chou, MD, Azin Abazari, MD, Robert Honkanen, MD Can refractive outcomes of resident-performed phacoemulsification be improved with the aid of a structured biometry course? In this retrospec- tive case study, investigators compared outcomes of resident-performed phacoemulsification surgery before and after a biometry curriculum was implemented. They considered the phacoemulsification results attained by 4 residents prior to the biometry curriculum and 2 after. Investigators found that before residents had taken the biometry course, 10% attained results that had less than a mean absolute difference of 0.25 D, while after, 35% attained these results. Likewise, with a mean absolute differ- ence of 0.5 D just 40% reached this mark before the biometry curricu- lum, with 70% attaining this mark after. When the difference was 1.0 D, 75% reach this mark prior to the institution of the curriculum versus 94% once this was taken. Investigators concluded that once residents have taken a formal biometry curriculum, it is possible to improve phacoemulsification outcomes. Accuracy of a 3-D computer-guided system Ildamaris Montes de Oca, MD, Eric Kim, BS, Li Wang, MD, Mitchell Weikert, MD, Sumitra Khandelwal, MD, Zaina Al-Mohtaseb, MD, Douglas Koch, MD Investigators in this retrospective case series considered how using a 3-dimensional computer-guided visualization system compared to traditional manual marking in terms of toric intraocular lens alignment with femtosecond laser-assisted cataract surgery. Anterior keratometry values were used to create the toric IOL alignment plan. Surgery was guided by either intrastromal marks at the intended toric meridian made by the femtosecond laser or manual marks placed at the limbus at the 3 and 9 o'clock positions, while the patient was in a seated position. Investigators determined that when the 3-D system was used, at the 3-week postoperative point there was a mean 3-D imaging error of –0.58 degrees versus a mean error of –0.27 with the manual method. Likewise, there was a mean absolute error of 2.96 degrees with the 3-D method as opposed to 2.88 for manual. The conclusion reached was that when it came to accuracy of toric alignment, results were similar with the 3-D computer-guided system and manual marking. April 2016 Meet continued from page 14 A large crowd gathered for the Tesla drawing at the 2015 annual meeting in San Diego. Source: ASCRS

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