Eyeworld

11 EW NEWS & OPINION Headline byline goes here plus fade July 2016 O ne of the best reasons to join an association like ASCRS is the sharing of information and ideas. The collective knowledge and experience of more than 9,000 ophthalmologists across the globe is a valuable resource. Peer-to-peer communication offers the chance to draw upon that experience and learn from each other—and it's the idea behind eyeCONNECTIONS, the popular virtual communities that allow members from around the world to connect with each other 24/7 using any computer or personal device. Discussions facilitate knowl- edge exchange, content curation, idea incubation, and professional networking. "eyeCONNECTIONS is 1 of the best sources of ongoing learning and sharing of knowledge that I know of in our profession. It's like a daily grand rounds," said Steve Safran, MD, Lawrenceville, New Jersey, an active eyeCONNECTIONS member. "When I left my fellowship and went into solo private practice, I missed the opportunity to discuss cases with colleagues on a daily basis," he said, adding that eyeCONNECTIONS is the "water cooler" of ophthalmology. "It's where we can hang out and shoot the breeze, share ideas, and get help fast from others. The responses are often immediate, usually unfiltered, and often provocative, leading to great discussions and opportunities to share knowledge." Richard Schulze Jr., MD, Savannah, Georgia, agreed: "I have participated in the ASCRS discus- sion lists online since 1997. These discussions are, without question, the most valuable educational venue that I have found for keeping me up to date with new technologies," he said. "There is an incredible wealth of experience on these lists, so if I have a complication or an unusual case, I can count on getting opin- ions from respected surgeons from all over the world within hours of posting a message. The eyeCONNECTIONS discussions are by far the most valuable part of my ASCRS membership." As of May 2016, there were 14 eyeCONNECTIONS peer discussion groups, or communities, which range in nature from broad top- ic (comprehensive, business) and subspecialty (cornea, glaucoma, cataract/refractive, retina) to specific demographic (young physicians) and geographic location (India, Brazil, Philippines). Communities range in size from single digits to more than a thousand members. Among the 5 most active commu- nities so far this year, there has been an average of 95 new conver- sation threads each month, with an average of 904 messages in each thread. In addition to starting new In the journal ... Through-focus acuity with corneal shape-changing inlay Jeffrey Whitman, MD, John Hovanesian, MD, Roger Steinert, MD, Douglas Koch, MD, Richard Potvin, OD In this prospective non-randomized clinical study conducted at 2 U.S. clinical practices, investigators set out to determine how a corneal inlay, which changed the anterior central cornea surface shape, affected visual function and acuity. The 30 patients included required a reading add from +1.50 to 2 D. Each had the Raindrop Near Vision Inlay (ReVision Optics, Lake Forest, California) implant- ed in the non-dominant eye with the aim of improving near and intermediate vision. At the 1-year postoperative mark, investigators found that there was a more than 3-line improvement on average in near acuity, with distance-corrected vision of 20/40 or better. They determined that 97% of patients attained binoc- ular uncorrected visual acuity of 20/32 or better at distance, intermediate, and near. There was a 1.60 D mean reading add reduction, with high patient satis- faction and no change in binocular contrast sensitivity. Investigators concluded that for emmetropic patients, range of functional vision at intermediate and near increased significantly without loss of binocular distance acuity when a corneal inlay was implanted in the non-dominant eye. Cataract surgery modifies ocular surface temperature Giuseppe Giannaccare, MD, Michela Fresina, MD, Luca Agnifili, MD, Piera Versura, BSD For those who have undergone age-related cataract surgery, ocular surface tem- perature may reveal certain conditions. Investigators in a recent prospective case series involving 26 patients considered the correlation between ocular surface temperature and microincision cataract surgery. Investigators used infrared ther- mography to determine temperature soon after eye opening at the central cornea, nasal limbus and temporal limbus and took the temperature again after sustained eye opening of 10 seconds. They then calculated the difference between the 2 in each of the areas. Investigators found that the central cornea showed a significant cooling soon after eye opening while the nasal and temporal limbus both showed heating. Meanwhile, after undergoing cataract surgery, all regions showed an in- crease in temperature after 10 seconds of sustained eye opening when compared to that soon after eye opening. For the Ocular Surface Disease Index, they found that in the central cornea there was an inverse relationship between the tempera- ture difference at the 10-second sustained mark and that attained soon after the eye was opened. They likewise found that tear break-up time was directly related to this. Also, inflammatory indices were directly related to the temperature measured soon after eye opening, which increased in the temporal limbus. They concluded that after cataract surgery, depending on the region, selected ocular surface temperature changes. In the central cornea, cooling may be linked to in- creased tear film instability while postoperative inflammation could be connected to heating in the temporal limbus. Influence of OVDs on intraoperative biometry Samuel Masket, MD, Nicole Fram, MD, Jack Holladay, MD Can the OVD you choose impact intraoperative aberrometry and ultimately the IOL power suggested? In this prospective study of 120 eyes undergoing routine phacoemulsification, investigators considered whether the OVD might indeed influence the IOL power selected. Patients were divided into groups of 20 with each receiving 1 of 6 OVDs: DisCoVisc (Alcon, Fort Worth, Texas), Amvisc Plus (Bausch + Lomb, Bridgewater, New Jersey), Amvisc (Bausch + Lomb), Healon (Ab- bott Medical Optics, Abbott Park, Illinois), Healon GV (Abbott Medical Optics), or ProVisc (Alcon). Following cataract removal, balanced salt solution was placed in the anterior chamber and aberrometry performed. After this, aberrometry was re- peated with an OVD in place instead. However, it was the balanced salt solution reading that was used to make the IOL power selection. While all the IOL powers were lower with OVDs, investigators found that when DisCoVisc or Amvisc Plus was used, the mean absolute error difference was statistically significant with a resulting IOL power about 0.5 D less than with the balanced salt solution. Inves- tigators urged practitioners to keep in mind that OVDs can influence intraopera- tive aberrometry outcomes and ultimately affect the recommended IOL power in some cases. July 2016 Valuable peer-to-peer learning opportunities through eyeCONNECTIONS by Tami O'Brien ASCRS•ASOA Copywriter ASCRS update continued on page 12 " There is an incredible wealth of experience on these lists, so if I have a complication or an unusual case, I can count on getting opinions from respected surgeons from all over the world within hours of posting a message. " –Richard Schulze Jr., MD

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