Eyeworld

87 June 2016 EW MEETING REPORTER at the prevalence of glaucoma in cataract patients. This shows the op- portunity for MIGS procedures, Dr. Brown said, and it's so important to be thinking about glaucoma at the time of cataract surgery. The other 2 papers that Dr. Tipperman presented looked at the comparison of toric IOL outcomes and calculator recommendations for manual and femtosecond laser-as- sisted cataract surgery, and the intraocular lens transection and explantation assisted by a femtosec- ond laser. Presenting the cornea papers was Dr. Lee. One of the papers he chose looked at refractive outcomes of manual vs. femtosecond laser- assisted cataract surgery (FLACS). Dr. Chan said that she sees FLACS as a safer option for the corneal endothelium. Dr. Chang added that because results are good with manual, there need to be huge numbers to try to show a difference between the 2. Dr. Noecker highlighted the best glaucoma papers. The first was an evaluation of a trabecular micro bypass stent with phaco in patients audience so much was on topog- raphy-based ablations (WaveLight Allegretto Wave Eye-Q Laser, Alcon). "I don't think we treat astig- matism correctly," Dr. Slade said. "For all these devices, for all that we have, we treat based on 1 number, and that's the magnitude." Using a topographically based ablation system, Dr. Slade said you are treating the actual pattern on the cornea, effectively "normalizing" the cornea. He alluded to this improving the odds for better outcomes for lat- er cataract surgeries because you've created a "normal cornea." "A normal cornea will fit better with whatever complex, trifocal, aspheric toric lenses come up," he said. Finally, Dr. Chang was the only panelist in the last category of "Complication Management—Best Save of the Year" to present. His discussion focused on using capsule retractors, like the MST Capsule Re- tractor, in cases of very dense lenses with pseudoexfoliation. Editors' note: Dr. Slade has financial interests with Calhoun Vision, Alcon, Novartis (Hunenberg, Switzerland), Carl Zeiss Meditec, Bausch + Lomb, Glaukos, and ReVision Optics (Lake Forest, California). The other physi- cians have no financial interests related to their comments. The Best of ASCRS 2016 To conclude the 2016 meeting, the last general session was "The Best of ASCRS 2016." This session fea- tured a wrap-up of some of the most important and interesting papers from the meeting as a whole. Eric Donnenfeld, MD, Rockville Centre, New York, moderated the session with panelists Reay Brown, MD, Atlanta, Clara Chan, MD, Toron- to, David Chang, MD, Los Altos, California, and Boris Malyugin, MD, Moscow. Speakers during the session included Neel Desai, MD, Clearwater, Florida, W. Barry Lee, MD, Atlanta, Dr. Malyugin, Robert Noecker, MD, Fairfield, Connecti- cut, and Richard Tipperman, MD, Bala Cynwyd, Pennsylvania. Dr. Tipperman presented 3 top cataract papers. The first looked with open angle glaucoma and cataract. This was a study using the iStent (Glaukos). iStent is certainly within the skill set of a cataract surgeon, Dr. Chang said, and 1 key skill to have is intraoperative gonioscopy. The second paper was 1 that Dr. Brown had worked on about su- praciliary microstenting concurrent with cataract surgery, specifically looking at the CyPass micro-stent (Transcend Medical, Menlo Park, California). "This is the data that is going before the FDA right now," Dr. Brown said, adding that the ex- pectation is that it will gain FDA approval. This would mean there would be more than 1 MIGS device in the market, he said, since current- ly the iStent is the only available MIGS device in the U.S. This targets a completely different outflow space and was very effective in the trial, Dr. Brown added. Dr. Desai presented the refrac- tive papers at the session, with 1 of his choices overlapping with Dr. Lee's choices. He also presented on results with the FluidVision IOL (PowerVision, Belmont, California) and a paper on Bowman Roughness Index in relation to small incision lenticule extraction (SMILE). Dr. Desai offered his opinion on the best tests for diagnosis of keratoconus, indicating that he thinks topography/tomography are the "gold standard." Other valuable tools include using slit lamp exam or tear film analysis. Dr. Malyugin concluded the ses- sion by presenting on more cataract papers. He chose 1 paper on evalua- tion of a trifocal toric IOL. Dr. Malyugin said there are cur- rently 3 different trifocals approved in Europe, and he knows a number of ophthalmologists who have had these implanted in their own eyes and are happy with the outcomes. The other 2 papers he presented were on a bioanalogic polyfocal IOL and a comparison of different types of corneal incisions (both femtosec- ond and manual). EW Editors' note: The physicians have no financial interests related to their comments.

• Cover