Eyeworld

11 EW NEWS & OPINION Headline byline goes here plus fade August 2016 E arlier this year ASCRS held the Young Eye Surgeons (YES) Advanced Cataract Training (ACT) program in New York. The program is a weekend of training designed specif- ically for ophthalmology residents, fellows, and surgeons in their first five years of practice. YES ACT was conceived by ASCRS leadership in the summer of 2015. While residents and fellows have dedicated program tracks avail- able during the annual ASCRS•ASOA Symposium & Congress and the annual Combined Ophthalmic Sym- posium, leadership thought there was a need—and an opportunity—to provide the younger members of ASCRS with more hands-on, one-on- one training. YES ACT program is comprised of several components. Over the course of one-and-a-half days, young surgeons from around the country gather together to take part in this unique training. Each day various topics—including Surgical Management of Astigmatism and Enhancements Following Cataract Surgery—are presented by faculty in a general education session. But what is most unique about YES ACT is the hands-on wet lab and round- table discussions. "The panel discussions are wonderful," said Will Griffeth, MD, Gainesville, Florida, an attendee at the New York event. "It's good to see how five different experts in the field will solve the problem in differ- ent ways." The hands-on wet lab allows young surgeons the opportunity to apply the skills they've learned during residency and fellowship. In the wet lab, attendees have access to different types of equipment and instrumentation that allow them to gain a more well-rounded experi- ence. "The wet lab was fantastic," said Narae Ko, MD, Seattle, a YES ACT attendee. "It is helpful as a young surgeon to be able to try the LRIs and astigmatic surgical procedures." While developing YES ACT, leadership understood the need for an affordable program for young surgeons, which is why a stipend is available to eligible attendees. Residents and fellows traveling to the program location from 100 miles away or more are eligible for a $500 stipend that can be used toward travel costs associated with attend- ing the meeting, including hotel stay, coach or train fare, ground In the journal . . . Intraoperative complications in intumescent cataract surgery using a phaco capsulotomy technique Selim Genç, MD, Emre Güler, MD, Hanefi Çakır, MD, Yusuf Özertürk, MD When it comes to eyes with white cataracts, can a modified phaco cap- sulotomy technique impact resulting complications? In this comparative randomized study of 80 eyes, investigators considered how those with intumescent white cataracts fared with 2 different approaches. Patients in group 1 were treated with a modified phaco capsulotomy technique, while a high-viscosity OVD-assisted capsulorhexis approach was used for those in group 2. Investigators found that for those in group 1, in 11 cases the capsulorhexis diameter was oversized and in 4 it was under- sized. Meanwhile, for those in group 2 there were 16 oversized capsulor- hexis and 6 undersized cases. When they considered capsule tears they found that this occurred in just 2 cases for those in group 1, with 1 of these cases changed to extracapsular cataract extraction. Meanwhile, they determined that there were 22 eyes that experienced capsule tears in group 2, with extracapsular cataract extraction used to manage 20 of these. Investigators concluded that for those with intumescent cataracts, the risk of capsule tears during capsulorhexis may be decreased with use of the modified phaco capsulotomy technique. Bromfenac ophthalmic solution 0.09% as an adjunctive therapy to topical steroids after cataract surgery in pseudoexfoliation syndrome Marco Coassin, MD, PhD, Alfonso Iovieno, MD, PhD, Anna Soldani, Silvio Cavuto, MS, Luca Cimino, MD, Antonio Sartori, MD, Debora Formisano, MS, Luigi Fontana, MD, PhD The aim of this randomized clinical trial of 62 pseudoexfoliation patients was to consider whether bromfenac heightened the anti-inflammatory effect of topical steroids after cataract removal in these individuals. Those in group 1 were randomized to receive dexamethasone 0.1% and tobra- mycin 0.3%. Those in group 2 were also given bromfenac ophthalmic solution 0.09%. Investigators found that at the 3-day postoperative mark, mean flare with laser flare photometry in the anterior chamber was 31% lower in group 2 than in group 1. Meanwhile, ocular pain, symptoms, and postoperative visual acuity showed no significant differences. At the 1-month mark, mean macular thickness was increased in group 1. How- ever, this did not occur in group 2. In addition, investigators found that group 1 had a higher incidence of intraretinal cysts, with 4 occurring versus 0 in group 2. Investigators concluded that after cataract surgery in eyes with pseudoexfoliation syndrome, the addition of bromfenac to a steroid regimen reduced inflammation more than steroid use alone. Night vision after small incision lenticule extraction Marcus Ang, FRCS, Mohd Farook, BSC, Hla Htoon, PhD, Donald Tan, FRCOphth, Jodhbir Mehta, FRCOphth In this prospective case series, investigators considered how those under- going small incision lenticule extraction with the VisuMax 500 kHz fem- tosecond laser system (Carl Zeiss Meditec, Jena, Germany) fared in terms of night vision symptoms and refractive outcomes. Included here were 50 eyes that underwent the procedure. Investigators determined that at the 12-month mark, overall simulated night vision was not affected, with mean mesopic corrected distance acuity at 0.08 logMAR. Preoperatively, in low myopia, this was at a mean of 0.099, while at 12 months postop- eratively this was at 0.006 in this group. At the 3-month postoperative mark, patients had either mild night vision symptoms or none at all. With patient acuity at 20/40 or better in 100% of eyes and 86% at 20/20 or better, investigators put the overall efficacy index at 0.98. They also determined that the overall safety index was 1.17, with 94% of eyes within 1 D of attempted correction. August 2016 YES ACT provides intensive hands-on training by Denise Monasterio ASCRS Communications Manager ASCRS update continued on page 12 A YES ACT attendee works in the wet lab at the phaco station. Source: ASCRS

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