Eyeworld

Reporting from the American Academy of Ophthalmology (AAO) meeting, October 15–18, Chicago EW MEETING REPORTER 84 November 2016 He also mentioned INTRACOR (Technolas Perfect Vision, Munich, Germany), which uses multiple fem- tosecond treatments for multifocali- ty in the cornea. There are a number of corneal inlays, both approved and under investigation, as well as mul- tifocal IOLs that are also potential treatments. Smart lenses are also in development to treat presbyopia. Dr. Azar concluded by stressing the success of monovision. He also said that presbyLASIK, intra-corneal apertures, and inlays hold prom- ise. Multifocal lenses are gaining acceptance, he said, but they are still plagued by visual issues like glare and halos. Editors' note: Dr. Azar has financial interests with Novartis (Basel, Swit- zerland) and Google (Mountain View, California). Spotlight on cataract A spotlight session highlighted the topic of cataract, with surgeons sharing their pearls in a number of complicated phaco scenarios. Edward Holland, MD, Cincin- nati, shared his pearls for phaco and Fuchs.' His first pearl was to develop a grading scale for the severity of Fuchs,' which includes factoring in the prognosis for phaco only and assists in discussing the expectations of the patient. His second pearl was to ad- just your preoperative workup. It's Editors' note: The presenters have no financial interests related to their comments. Case-based corneal conundrums This year's Castroviejo Lecture was given by Dimitri Azar, MD, Chicago, on the topic of surgical treatment of presbyopia. He first discussed the theories of accommo- dation. Options for the surgical correc- tion of presbyopia include corneal surgery options, scleral surgery, and intraocular lens implants. Monovision still remains the mainstay of correcting presbyopia, Dr. Azar said. It gives good near vision in one eye and good distance in the other eye. It is the surgical option chosen by most ophthalmol- ogists undergoing refractive surgery, he added. A possible corneal surgery option is presbyLASIK to create a multifocal corneal lens, Dr. Azar said, which has been popular for a long time. He said that patient selection is very important with this, and there are a number of contra- indications, including patients with thin cornea or signs of keratoconus, previous corneal surgery, ocular comorbidities like glaucoma and maculopathy, or patients over 60 years old. PresbyLASIK techniques include multifocal transitional profiles, peripheral presbyLASIK, or central presbyLASIK. on possible side effects and have ad- equate expectations for their vision. Editors' note: Dr. McDonald has financial interests with Abbott Medical Optics, Alcon, Bausch + Lomb, Calhoun Vision (Pasadena, California), and Orca Surgical (Israel). Dr. Henderson has financial interests with Alcon, Bausch + Lomb, and Clarvista (Aliso Viejo, California). Ophthalmic Premier League entertains and educates The Ophthalmic Premier League (OPL) hosted its third annual sym- posium in which four lively teams presented videos of challenging cataract cases, each hoping to win an OPL trophy. The F.B. "Eye" team, led by captain Robert Cionni, MD, Salt Lake City, donned fedoras, black sun glasses, and black suits as they pre- sented their series of cataract crimes. Following, the Black Cats with cap- tain Mohan Rajan, MD, Chennai, India, were outfitted in uniforms with specially made OPL patches and cat ears over their hats. It was the Jed-Eye Masters with captain Mitchell Weikert, MD, Houston, as Yoda and the Sumo Stars, led by Eric Donnenfeld, MD, Rockville Centre, New York—blow- up suits and all—who took home the most recognition for their en- thusiasm and surgical presentations. The audience voted the Jed-Eye Masters as the best team with the Sumo Stars as runner-up. David Chang, MD, Los Altos, California, dressed head to toe as Chewbacca, took home the audience vote in all three of the other categories: best entertainer, best video, and best pearl. Dr. Chang's video highlighted his best pseudoexfoliation teaching case. Using capsule retractors for the phaco portion, Dr. Chang then put in a capsular tension ring before placing a three-piece IOL. Before closing the case, he shook the eye. "Oh my gosh, and it is moving," Dr. Chang said in dismay. Instead of opting to glue the lens or use iris sutures for fixation, Dr. Chang moved the IOL into the sulcus. After placement, he jiggled the eye again and, to his relief, found the IOL stable. View videos from AAO 2016: EWrePlay.org Martin Dirisamer, MD, PhD, describes 4 to 7 years of clinical outcome data for Descemet's membrane endothelial keratoplasty (DMEK). continued on page 86 Sponsored by

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