Eyeworld

13 EW NEWS & OPINION September 2016 P hysicians have to meet various requirements every day as they prac- tice medicine. One such requirement is maintaining their medical license by obtain- ing continuing medical education (CME) credits. As CME requirements vary by state, locating and completing appropriate courses for CME credits can be challenging, especially given physicians' busy schedules. With the new ASCRS CME 365, that process has become a little easier. Launched earlier this year, CME 365 is an on-the-go continuing medical education platform with online courses curated by ASCRS. The content is available to ASCRS mem- bers free of charge, and nonmember pricing varies based on individual course listings. With compelling and cutting-edge anterior segment activities varying in credit length and format, CME 365 is a one-stop shop that allows users to receive AMA PRA Category 1 Credits™ in an accessible, convenient location. "CME 365 allows physicians to shape their own education by choosing courses 'on demand' that meet their specific interests, needs, and time constraints," said Manjool Shah, MD, Ann Arbor, Michigan. Dr. Shah is a member of the ASCRS On- line Learning Subcommittee. "The convenience of an online portal for course completion opens a world of possibilities in terms of resources and access." CME 365 is designed to provide engaging and relevant education- al content. The platform will be refreshed with new activities every month to ensure that users are In the journal . . . Endophthalmitis after cataract surgery despite intracameral antibiotic prophylaxis with licensed cefuroxime Charles Mesnard, MD, Laurence Beral, MD, Rabih Hage, MD, Harold Merle, MD, Selim Farès, MD, Thierry David, MD Investigators in this retrospective study of post-phacoemulsification endophthalmitis reported on cases that developed despite prophylactic intracameral use of cefuroxime. Those included received the cefurox- ime prophylaxis during no-stitch sutureless cataract surgery between March 1, 2013 and July 31, 2015. Within 15 days after surgery, five patients developed endophthalmitis despite the prophylaxis. While one patient had a posterior capsule rupture, all of the others were unevent- ful. Investigators determined that in two cases the bacteria involved was alpha-hemolytic streptococcus, in another it was Staphylococcus epidermidis, and in one it was Serratia marcescens. Poor visual outcomes of worse than 20/200 were seen in four out of five cases. Investigators concluded that the potentially devastating complication of endoph- thalmitis persisted even with licensed cefuroxime usage, which despite reducing the risk of this condition did not eliminate it. Visual outcomes tend to be poor in such cases due either to the infection itself or result- ing complications. Outcomes after combined phacoemulsification and trabecular mi- crobypass stent implantation in controlled open-angle glaucoma Leonard Seibold, MD, Kevin Gamett, MD, Jeffrey Kennedy, MD, Matthew Mulvahill, MS, Miranda Kroehl, PhD, Jeffrey SooHoo, MD, Mina Pantcheva, MD, Malik Kahook, MD What effect does iStent (Glaukos, Laguna Hills, California) implantation have on cataract surgery patients' IOP and medication use in open-angle glaucoma cases involving low mean preoperative IOP? In this retro- spective case series, investigators set out to determine this. Included here were 64 eyes of 45 patients. Investigators found that at the 1-year mark, mean IOP decreased significantly from 1.81 mm Hg to 1.41 after combined cataract surgery and iStent implantation. They estimated that there was a 3.5% IOP reduction at 1 month, 7.9% at 3 months, 9.7% at 6 months, and 12.2% at 1 year. They found that 76.1% of patients attained treatment success at the 1-year mark and that 41% no longer needed medications. At 1 year, corrected visual acuity improved from a baseline of 0.4 logMAR to 0.17. They concluded that when cataract surgery was combined with implantation of a trabecular microbypass stent, this was not only effective in significantly reducing IOP but also in the amount of medication needed in open-angle glaucoma cases with low preoperative IOP. Effect of cataract surgery training on operating room productivity: How long trainees take Dong Young Park, BSc, Andrew Walkden, BSc, Timothy De Klerk, MBChB Investigators in this study reviewed 1,904 cases to determine whether specialty training affected operating room efficiency. In this retro- spective consecutive cases series, they considered how case times for consultants with specialized training compared to those of trainees. They determined that those with specialized training took significantly shorter time at a mean of just 19.59 minutes compared to 24.25 minutes for trainees. Also, the newest trainees, with 1 to 3 years of experience, had mean case times of 27.63 minutes, while those with 4 to 7 years of experience took significantly shorter time at 22.55 minutes. When faced with complications such as posterior capsule rupture, the consultant groups' surgical time increased to a mean of 49.81 minutes, while for those in the trainee group, this jumped to 67 minutes. When using iris hooks, consultants took a mean of just 26.41 minutes while for trainees this was a mean of 34.11 minutes. The conclusion reached was that it took trainees longer for the procedures than consultants. However, with experience trainees' cases got shorter. Once the 3-year training mark was reached, when it came to operating room efficiency, there was no longer a significant effect. September 2016 New Center for Learning CME 365 provides online courses by Denise Monasterio ASCRS Communications Manager ASCRS update continued on page 14

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