Eyeworld

4 September 2016 EW NEWS & OPINION Crossing the crosslinking bridge 78 Incorporating this newly approved procedure into a practice by Maxine Lipner Epi-off vs. epi-on debate continues 80 Deciding when to deviate from standard crosslinking protocol, if at all, comes down to careful patient selection by Liz Hillman Corneal crosslinking's refractive possibilities 84 How this versatile approach fares in combination with certain refractive procedures by Vanessa Caceres Deciding when to use crosslinking 86 Surgeons discuss when to offer crosslinking as well as the conversation to have with patients about the procedure by Ellen Stodola Pushing the limits of corneal collagen crosslinking 88 Surgeons outline the promise and known limits of crosslinking in new therapeutic areas by Rich Daly NEWS & OPINION Setting the record straight: There is no "fourth option" for treating Medicare patients 3 A fourth option does not exist and creates liability risk for non-enrolled physicians who provide and bill for Medicare covered services without opting out by Robert Portman, JD, MPP, and Rebecca Burke, JD Clara Chan, MD, FRCSC, FACS World VieW 12 Considering corneal crosslinking Feature September 2016 Corneal collagen crosslinking 78–90 16 21 38 46 Reflections on the 2016 ASCRS•ASOA/Alliance of Specialty Medicine Legislative Fly-In 21 Physicians and administrators share their experiences at this year's Fly-In eyeCONNECTIONS excerpts Discussion on HORV association with intraocular vancomycin 26 ASCRS and ASRS members answer questions from the eyeCONNECTIONS Cataract/Refractive listserv Chief medical editor's corner of the world New IOL provides high quality vision over extended range 30 Dr. Donnenfeld shares highlights of the Tecnis Symfony clinical trial results by Eric Donnenfeld, MD Insights In life's bingo, B-9 is a winner 32 A radiologist's oversight forces an ophthalmologist to face down a patient's greatest fear by J.C. Noreika, MD, MBA To the point: Simple practice tune-ups for complex times Delegation: The key to effective management 36 Most ophthalmologists are less effective delegators than they need to be, which leads to professional inefficiency, under-used staff resources, and provider burnout by John B. Pinto and Corinne Wohl, MHSA, COE CATARACT Anterior segment grand rounds Delicate and dangling 40 How to fix lens dangling backward by a few zonules in young male golfer with toric IOL that has dislocated into vitreous cavity after retina surgery by Steven Safran, MD YES Connect Expecting the unexpected: Settings and technique for complicated cataract cases 46 What to do in cases of weak zonules, anterior capsule tear by Liz Hillman Webinar reporter Webinar focuses on rock hard cataracts 50 "Phacodynamics of the Rock Hard Cataract" featured tips on a number of issues associated with these challenging cases by Ellen Stodola World's only Flying Eye Hospital makes cross-country tour 16 On board the new, third generation Orbis Flying Eye Hospital by Liz Hillman Dermatology drugs, ocular side effects 38 Part two of a closer look at dermatology drugs that can affect the eyes by Vanessa Caceres Cover image: Karl Brasse, MD, EyeLand Design 50

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