Eyeworld

43 EW RETINA January 2017 Contact information Adelman: mehran.afshari@yale.edu Brown: david.brown2@bcm.edu Charles: scharles@att.net Other drugs to note include prostaglandins, alpha-1 adrenergic antagonists, niacin, and ginkgo. Dr. Brown said there have been reports of prostaglandin inhibitors increas- ing CME, but in his practice this has been rare. Dr. Adelman reported a similar experience. "I've seen about two or four in the last 10 years," he said, adding that after patients changed medica- tions, their condition improved. Postop considerations The webinar presentation noted that cataract surgery doesn't increase the rate of adverse macular events, intraoperative or perioperative com- plications, recurrence of leakage, or increased frequency of intravitreal injections. While cataract surgery can cer- tainly improve vision, persistent ret- inal issues can reduce vision postop. The presentation noted that until OCT, epiretinal membranes and vitreoretinal traction were underdi- agnosed. Now it's seen as a common cause of blurred vision postopera- tively. Epiretinal membranes can develop before or after cataract sur- gery but are not caused by cataract surgery. Educating the patient prior to surgery will reduce the likelihood of the patient blaming the cataract surgery for decreased vision. OCT is the only way to rule out epireti- nal membranes and vitreomacular traction. Dr. Charles said if the cataract is 1+ or 2+ nuclear sclerosis, he would remove the epiretinal membrane prior to cataract surgery, but would recommend cataract surgery first if the epiretinal membrane is 3+ or 4+ nuclear sclerosis or a 1+ posterior subcapsular cataract. Combined phaco-vit does not produce the refractive outcomes patients demand today. EW Editors' note: Dr. Brown has finan- cial interests with Regeneron, Bayer (Leverkusen, Germany), Novartis (Basel, Switzerland), ThromboGenics (Brussels, Belgium), Adverum Bio- technologies (Menlo Park, California), Optos (Dunfermline, U.K.), Clearside Biomedical (Alpharetta, Georgia), Alcon (Fort Worth, Texas), Alimera Sciences (Alpharetta, Georgia), Allergan (Dub- lin, Ireland), Heidelberg Engineering (Heidelberg, Germany), Carl Zeiss Med- itec (Jena, Germany), and Genentech. Dr. Charles has financial interests with Alcon. Dr. Adelman has no financial interests related to his comments. 840 Walnut Street Philadelphia, PA 19107 www.willseye.org 1-877-AT-WILLS EMBRACING CHANGE Photography/Jack Scully Dr. Mark Blecher is an innovator. This summer, he performed one of the first implants of Symfony IOL, a new class of intra-ocular lenses that help provide continuous high-quality vision by helping patients focus on objects at near distances. At Wills Eye, we are dedicated to preparing the way for what comes next.

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