Eyeworld

JUL 2012

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

Issue link: https://digital.eyeworld.org/i/76185

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July 2012 EW NEWS & OPINION In the journal … July 2012 Laboratory science: Negative dysphotopsia Jack T. Holladay, M.D., M.S.E.E., Huawei Zhao, Ph.D., Carina R. Reisin, Ph.D. In this study, investigators aimed to hone in on the origins of negative dysphotopsia in pseudophakic eyes. Investigators determined that the inner annulus shadow had a width of 14 degrees and the outer annulus a width of 17.4 degrees. The shadow of this inner annulus was apparent temporally when this was superimposed on the visual field in an area where this was able to be perceived by the patient. From the patient's perspective, a temporal dark crescent-shaped shadow would appear. Investigators reached the conclusion that a myriad of factors such as a distance of 0.06 mm or more behind a small pupil, a sharp-edged lens design, and a functional nasal retina that extends in front of the shadow are at the heart of this phenomenon. A high index of refractive optic material was one of the secondary factors named here. Posterior corneal response to myopic LASIK David Smadja, M.D., Marcony R. Santhiago, M.D., Glauco R. Mello, M.D., Cynthia J. Roberts, Ph.D., William J. Dupps Jr., M.D., Ph.D., Ronald R. Krueger, M.D., M.S.E. The aim in this cohort study of 80 eyes was to see how performing myopic LASIK at different ablation depths affected the posterior corneal surface in the early post-op period. An ablation depth of 100 microns was attained for those in group 1, a depth between 50 and 99 microns was targeted for those in group 2, and for those in group 3, a depth of 50 microns was used. Following myopic ablation, the posterior surface was steepened and appeared more prolate in the very early post-ablation stages. At its peak, the central posterior cornea reached –0.106 D, a statistically significant change that occurred at the 1-day mark for those in group 1. For those in group 2, the mean posterior cornea reached the –0.042 D level, and for those in group 3 this was –0.026 D. By the 3-month mark this change was no longer significant. Review/update: Endophthalmitis outbreaks following cataract surgery Avinash Pathengay, F.R.C.S., Harry W. Flynn Jr., M.D., Ryan F. Isom, M.D., Darlene Miller, D.H.Sc. The two most common causes found when investigators reviewed 27 reports of endophthalmitis post-cataract surgery between 1985 and 2011 were contaminated solutions and tainted phacoemulsification machines. The solutions accounted for 37% of cases and the machines for 22%. Also implicated were ventilation systems, which accounted for 11.1% of cases, defective sterilization in 11.1% of cases, and miscella- neous causes in another 11.1%. In 18.5% of cases, investigators were unable to identify the case. In 85.2% of cases it was determined that bacteria were at the heart of the outbreak, and in 14.8% of cases it was found to be fungus. Gram-negative bacteria were implicated in 65.2% of cases, gram-positive in 21.7%, and a combination in 13.1%. Investigators further determined that in 51.8% of cases of the gram- negative, pseudomonas aeruginosa was the causative agent. Even after treatment, visual outcomes may not be promising. Out of 229 cases, just 55.5% had acuity of 20/400 or better after treatment. Investigators concluded that perioperative irrigation solutions are the most common source of infection here, with gram-negative agents usually the causative agent. Visit the MediaCenter for materials from the ASCRS•ASOA Annual Meeting 1,300 scientific papers and presentations from the ASCRS Annual Meeting now available online by Cindy Sebrell ASCRS Director of Communications The ASCRS MediaCenter also includes valuable material from the ASOA Annual Congress T hose who attended the ASCRS•ASOA Symposium & Congress in Chicago this year joined more than 7,500 eye surgeons, admin- istrators, nurses, and technical staff for 4 days of educational sessions. As the largest educational event dedicated exclusively to anterior segment surgery and ophthalmic practice management, the ASCRS•ASOA Symposium & Con- gress is the most important meeting each year for ophthalmologists to gather, learn, connect, and engage. Now you can access this valu- able meeting material online, even if you did not attend the event. For the first time, ASCRS•ASOA is offer- ing online access to more than 1,300 educational sessions from the 2012 Symposium & Congress through its new MediaCenter project. The MediaCenter includes all paper sessions, symposia, films, and posters, along with the entire Glaucoma and Cornea Day pro- grams, which were held in conjunc- tion with the Annual Meeting. Also available are select clinical courses and practice management sessions focused on marketing, coding, per- sonnel, electronic medical records, regulatory issues, and a wide range of other relevant medical-business topics, including PROBE (Practice Revenue Optimization and Business Efficiency), a core selection of CME- designated courses that provide a comprehensive analysis of your practice to maximize revenue. MediaCenter access is free to all 2012 meeting attendees and avail- able for purchase at discounted rates for members who did not attend. Non-members may also purchase access to the MediaCenter. The ASCRS•ASOA Symposium & Congress, and now the ASCRS MediaCenter, are unmatched in offering of the latest techniques and technologies in ophthalmic surgery and practices and the most impor- tant educational programs for the anterior segment surgeon. This is a convenient and affordable way to review important material or access new, valuable information, accord- ing to Roger Steinert, M.D., continued on page 12 11

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