EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/78716
124
EW MEETING REPORTER
March 2012
Reporting live from the 2012 ASCRS Winter Update meeting, Riviera Maya, Mexico
W. Samuelson, M.D., director, Glaucoma Service, instructor, oph- thalmic pharmacology, Regions Hospital, St. Paul, Minn., and attending surgeon, Minnesota Eye Consultants, Minneapolis, asked the panel, which was made up of cornea, refractive, glaucoma, and retina specialists, whether they dis- cussed generic versus name-brand medications with patients. "My pa- tients' biggest complaint is the cost of the NSAIDs," said Richard A. Lewis, M.D., cataract surgeon and glaucoma specialist, Sacra- mento, Calif. Dr. Donnenfeld said his office provides patients with a sheet of paper that has a picture of the name-brand drug they recom- mend, as well as the generics. He said about 85% usually choose branded medications, while the other 15% ask for generics.
Tarsorrhaphy suggested for patient
Vincent P. de Luise, M.D., assistant clinical professor of ophthalmology, Yale School of Medicine, New Haven, Conn., presented one severe
case of post-herpetic zoster keratou- veitis with inflammation and high IOP. The 71-year-old woman pre- sented with a 2-day history of headache in her right forehead and a non-vesicular rash on her face but no ocular involvement. Dr. de Luise started the patient on topical pred- nisolone 1% every 2 hours, as well as dorzolamide-timolol combination and homatropine 5%, both taken two times a day. "Even if your knee- jerk reaction is to withhold topical
steroids (because of IOP pressure), you should blast them with steroids every couple of hours," Dr. de Luise said. Three months later, the patient subsequently developed a neu- rotrophic corneal ulcer and cataract, which Dr. de Luise surgically man- aged with conjunctival flap. Two panel members said they would strongly suggest tarsorrhaphy, but Dr. de Luise reported that the patient refused the procedure.
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