Eyeworld

UPDATE by Natalie Zundel ASCRS Foundation Development Director Amar Atwal, MD, Ephraim Atwal, MD, and Kenneth Anthone, MD, Cheektowaga, New York, also participated in National Sight Week, addressing a substantial need in the Buffalo, New York area. Atwal Eye Care Center delivered 31 procedures for 26 patients with the help of ophthalmology residents from the University at Buffalo's Jacobs School of Medicine and Biomedical Sciences. When interviewed by The Buffalo News, Dr. Anthone had this to say about the Operation Sight experience: "Of all the senses, losing your eyesight is probably the worst. The patients who get the surgery are so appreciative, and it's fun for us and makes us feel good." Consider joining more than 200 other surgeons and becom- ing an Operation Sight volunteer. If volunteering is not an option, you can still help with a gift to the ASCRS Foundation. A gift of $250 before the end of the year is all that is needed to provide an Operation Sight surgery in 2017 to one of the many patients on the waiting list. Visit www.ascrsfoundation.org for more information. EW Contact information Anthone: kanthone@aol.com Atwal: debbied@atwalec.com Lane: sslane@associatedeyecare.com Nesti: heathernesti@gmail.com Scott: mariascott@yahoo.com Zundel: nzundel@ascrs.org W hen you think about humanitarian eyecare, you may think of outreach to a faraway, developing nation. But there are patients everywhere, even in countries like the U.S., who face the challenge of affording cata- ract surgery. Operation Sight was launched by the ASCRS Foundation just over 2 years ago to meet the needs of U.S. patients living and working right in physicians' own communities. The program serves uninsured patients who could otherwise not afford cataract surgery. Through Operation Sight, the ASCRS Foundation has created a national network of volun- teer ASCRS members who give their time and expertise to treat those who have no other option. Stephen Lane, MD, Stillwater, Minnesota, co-chair of the ASCRS Foundation and director of the Op- eration Sight initiative, said, "We've all seen the heartbreaking photos of cataract-blinded patients in the developing world, but many forget that there is a similar need right here at home. Although they often go unnoticed, many poor Americans still fall outside the traditional safety nets. The future is especially bleak for cataract patients who lack private insurance and are not eligible for government care." The ASCRS Foundation pro- vides the administrative support needed to identify and pre-qualify eligible patients, and then matches them with local volunteer surgeons. A small financial stipend helps partially offset the cost of providing care. Since beginning work in 2014, Operation Sight volunteers have de- livered more than 700 free surgeries. While the Operation Sight program runs year-round, the ASCRS Foundation began a National Sight Week (October 24–28, 2016) initia- tive to raise awareness and encour- age surgeons to join the growing volunteer network. ASCRS members answered the call. Practices across the U.S. provided nearly 200 free surgeries to patients in need in cele- bration of National Sight Week. Maria Scott, MD, and Heather Nesti, MD, Chesapeake Eye Care and Laser Center, Annapolis, Maryland, were among the participants in the inaugural National Sight Week. They saw the need firsthand in their com- munity, and through their practice and Operation Sight offered as many charitable surgeries as they could in their community. Working closely with the ASCRS Foundation, Drs. Scott and Nesti were able to perform 14 surgeries. They were also awarded an Official Citation from Maryland State Senator Edward Reilly for their charitable surgeries. Hundreds receive the gift of sight during National Sight Week Back row, from left: Senator Reilly and patient James Chilcoate. Front row, from left: Tonya Hartman, clinic coordinator of Anne Arundel Medical Center (AAMC) Community Clinics, Dr. Nesti, Dr. Scott, and Sharon Cameron, manager of AAMC Community Clinics Source: Chesapeake Eye Care and Laser Center Insightful news from the ASCRS Foundation has incorrectly deemed the unap- proved implant and procedure as simply "controversial." Management of cosmetic color changing iris implants Patients will occasionally present to ophthalmology practices in the U.S. and Europe for "clearance" before traveling abroad for surgery. It is incumbent on any eyecare provider who sees these patients to educate them on the dangers associated with these unapproved implants and strongly discourage surgery. Regarding patients who come for consultation after cosmetic iris implantation, close periodic monitor- ing for early signs of complications is warranted. Prompt explantation of implants is recommended at the earliest sign of corneal endothelial cell loss, corneal edema, prolonged iritis, ocular hypertension, cataract, or pupil ovalization, which may be difficult to detect behind an implant. Following primary explantation, these eyes should be treated for ele- vated IOP and inflammation. Second- ary interventions can be planned, as indicated. Because of the time and money these patients invest, and because of their desire for a new cosmetic appearance, some are hes- itant to have the implants removed despite being educated on the risks. The rate of complications with cosmetic iris implants is unknown, but as with historical closed-loop angle-supported implants, complica- tions are expected to increase with time. Conclusion Cosmetic anterior chamber iris implants represent a health hazard for unsuspecting patients. ASCRS, ESCRS, APACRS, and ALACCSA-R/ LASCRS strongly advise against this surgical procedure until appropriate clinical trials have been performed that yield long-term safety data and regulatory approvals have been obtained. EW References 1. Mansour AM, et al. Iritis, glaucoma and corneal decompensation associated with BrightOcular cosmetic iris implant. Br J Oph- thalmol. 2016;100:1098–101. 2. Hoguet A, et al. Serious ocular complica- tions of cosmetic iris implants in 14 eyes. J Cataract Refract Surg. 2012;38:387–393. 3. Arjmand P, et al. Surgical technique for explantation of cosmetic anterior cham- ber iris implants. J Cataract Refract Surg. 2015;41:18–22. 4. Shweikh Y, et al. Complications secondary to cosmetic artificial iris anterior chamber implants: a case report. BMC Ophthalmol. 2015;15:97. 5. Sikder S, et al. Complications and manage- ment of NewColorIris implantation in phakic eyes. J Refract Surg. 2011;27:239–40. 6 www.youtube.com/watch?v=ZCloJN5iCu- w&feature=youtu.be&a. Accessed 9/12/16. Contact information Denise Monasterio: dmonasterio@ascrs.org Clinical continued from page 3 9

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