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UPDATE 13 O n December 12, 2016, Dennis Shepard, MD, Santa Maria, California, a founding member of ASCRS, died peacefully at 84 years old. He was described by his colleagues as a "force to be reckoned with." "He's definitely a presence that is going to be missed," said Rami Zarnegar, MD, Shepard Eye Center, Santa Maria, California. "He was great with patients, and he was a fantastic surgeon who was always looking to improve his outcomes, always looking to come up with new ideas and new instruments. … He was never satisfied with the status quo, always looking to adapt the field and advance the care he was giving to his patients." Dr. Shepard was among the early adopters of IOL implantation and strove to educate his colleagues on the use of these implants. In 1974, Dr. Shepard, with John Gilmore, MD, Don Dickerson, MD, and Kenneth Hoffer, MD, created an IOL course at Santa Monica Hospital to introduce IOLs and their surgical technique to thousands of ophthal- mologists. Dr. Shepard traveled the world to teach surgeons in other countries about phaco, IOL implan- tation, and new techniques at the time. He held nine patents. According to his obituary pub- lished in Oregon's Statesman Journal, Dr. Shepard served as a Hospital Corpsman in the U.S. Marines Corps in Asia. After military service, Dr. Shepard remained in Asia to perform humanitarian work with Thomas Dooley, MD, in Laos. After return- ing to the U.S., Dr. Shepard met and married his wife, attended George Washington University Medical School, and served his residency at the University of California, Los Angeles. Dr. Shepard started his practice in Santa Maria in 1967 and built the renowned Shepard Eye Center in the early 1980s, which included one of the first independent surgery centers in California. Kenneth Kendall, OD, Shepard Eye Center, said he had the privilege of joining the team as managing partner in the early 2000s. What was especially noticeable to him were Dr. Shepard's efforts to improve efficiency, Dr. Kendall said. For example, Dr. Shepard invented a light system in the 1980s that could identify which technician or doctor was in a room, or send an alert if something or someone was needed in a certain room. Dr. Kendall said this was so use- ful that when the practice moved to a new location in 2015, they worked with a commercial vendor to recre- ate the unique system. "Dr. Shepard extended this drive for efficiency to all processes in the office, and we still use many of the same processes and protocols to this day," Dr. Kendall said. Dr. Shepard's colleagues also recalled his manner with patients. "As a young ophthalmologist who joined the practice about the time Dennis retired, I still remember the personal connection he made with each patient," said Randall Goodman, MD, Shepard Eye Center. "He'd enter the exam room and reach to shake the patient's hand, and at the same time he would gently touch their forearm or elbow with his left hand. This extra touch gave the patient an added impres- sion of how much Dennis cared." The Shepard name is well- known in the coastal communi- ty between Los Angeles and San Francisco, not just because so many experienced Dr. Shepard's medical care, but because he and his wife were so active in the area. "He and his family were very involved in the community. There are many chari- ties that have benefited from their generosity," Dr. Zarnegar said. According to the Statesman Journal, Dr. Shepard provided free ophthalmic services to those in need on Valentine's Day, an event he called "Doctors with a Heart." Local news reports recount how he and his wife used to provide weekly meals for the homeless and supported the local community college, the public library, and local law enforcement. Dr. Shepard co-founded the GenSpan Foundation, a Santa Maria-based group dedicated to bringing together different generations. He is also cred- ited with chairing the largest med- ical alumni fundraising campaign for George Washington University Medical School. Dr. Shepard is survived by his wife, Franziska, his son, Daniel Shepard, MD, daughter, Nancy Martz, son-in-law, Michael Martz, and four grandsons. EW In the journal ... Sequential intrastromal corneal ring segment and monofocal intraocular lens implantation in patients with keratoconus and cataract: Long-term follow-up José Alfonso, MD, PhD, Carlos Lisa, MD, Luis Fernández-Vega Cueto, MD, Arancha Poo-López, OD, David Madrid-Costa, PhD, Luis Fernández-Vega, MD, PhD In this retrospective case series, investigators examined how sequential Ferrara intrastromal corneal ring segment (ICRS) and IOL implantation fared in terms of safety, efficacy, stability, and predictability for those with cataract and keratoco- nus. The 70 eyes included in the study first received the intrastromal corneal ring segment and 6 months later underwent cataract removal and were implanted with an IOL. While preoperatively the mean uncorrected distance visual acuity was 1.08 log MAR, 6 months after ICRS implantation this was at 0.95 logMAR and at the 6-month post IOL implantation mark was at 0.44 logMAR. When it came to corrected distance visual acuity, preoperatively this was at a mean of 0.35 logMAR, after ICRS implantation went to 0.28 logMAR, and finally 6 months after IOL implantation was at 0.16 logMAR. After IOL implantation, spherical equivalent and refractive cylinder were stable, and both the UDVA and CDVA were stable. Investigators concluded that for patients with keratoconus and cataract, safe, stable outcomes could be attained with sequential Ferrara ICRS and IOL implantation. Intraocular lens power calculations in eyes with previous hyperopic laser in situ keratomileusis or photorefractive keratectomy Eric Hamill, MD, Li Wang, MD, PhD, Hayley Chopra, MD, Warren Hill, MD, Douglas Koch, MD For patients who had previously undergone hyperopic LASIK or excimer laser photorefractive keratectomy, investigators here honed in on the accuracy of seven different IOL formulas. Included in this study were 21 eyes of 21 patients. For the study, investigators examined the Atlas 0-3, Barrett True-K, Barrett True-K No-History, Haigis-L, Masket, Modified Masket, and the Shammas P-L. When investigators considered the percentages of eyes within 0.5 D of predicted refraction as well as variations in the median absolute refractive prediction error, they determined that there were no significant differences among the formulas. Also comparable were the IOL mean prediction errors between the Hoffer Q and Holladay 1 methods. The only exception was that the double-K version of the Hoffer Q of the adjusted Atlas 0-3 had greater error. Investigators concluded that there was no significant difference in accuracy for the seven formulas considered in eyes that had previously undergone hyperopic LASIK or PRK. Comparison between femtosecond laser-assisted and conventional cataract surgery Anna Mursch-Edlmayr, MD, Matthias Bolz, MD, Nikolaus Luft, MD, Michael Ring, PhD, Thomas Kreutzer, MD, Christoph Ortner, MD, Matthias Rohleder, MD, Siegfried Priglinger, MD How does use of femtosecond-assisted cataract surgery compare to the con- ventional approach? Investigators in this prospective, randomized case series examined how cataract removal with the femtosecond laser-assisted approach stacked up to that using conventional cataract removal. The 50 patients includ- ed were randomized to receive femtosecond laser-assisted cataract surgery or conventional removal in both eyes. Investigators found that both groups were free of intraoperative complications. During all the follow-up examinations, they determined that endothelial cell density, central corneal thickness, and central retinal thickness were similar regardless of the group. Likewise, there was no statistically significant difference when it came to effective phacoemulsification time. In addition, IOL centration was comparable. Investigators concluded that the femtosecond approach and conventional cataract removal were comparable in terms of safety and efficacy. February 2017 by Liz Hillman EyeWorld Staff Writer Tribute to Dennis Shepard, MD

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