Eyeworld

MAR 2017

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

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UPDATE 17 In the journal Failure modes and effects analysis for bilateral same-day cataract surgery Neal H. Shorstein, MD, Carol Lucido, MSN, James Carolan, MD, Liyan Liu, MD, MS, Geraldine Slean, MD, Lisa J. Herrinton, PhD In this retrospective study, investigators looked at bilateral same-day cataract surgery to improve safety by considering possible points of process failures. When investigators considered a host of factors, including biometry sterile pro- cessing, medications given, and doctor visits, they found 15 significant areas where failure tended to occur. Among these were compounding issues with intracameral antibiotics as well as breaks with instrument processing protocols, both of which could lead to cases of TASS or endophthalmitis. Also, investiga- tors noted issues with unclear notations on IOL selections that left open the possibility of implanting the wrong lens in a patient. To combat such issues investigators urged practitioners to strengthen IOL lens verification proce- dures, as well as heighten supervision of cleaning and sterilization practices. In addition, they stressed the need to use different lots of compounded drugs for each eye. When investigators looked at complications that occurred as a result of bilateral same-day surgery, they found that in the 4,754 eyes, there was case of endophthalmitis occurring in one eye, and also an erroneous implantation of an IOL in one eye. In no eyes were there instances of TASS. Investigators concluded that with the aid of Failure Modes and Effects Analysis in bilateral same-day cataract surgery, they could pinpoint potential areas of concern and make recommendations. Swept-source optical coherence tomography as a screening tool for detecting macular pathology in patients having routine cataract surgery Sidra Zafar, MB BS, M.A. Rehman Siddiqui, MSc, FRCS(Ed), FRCOphth, Rida Shahzad, MB BS, Masroor H. Shahzad, FRCS Investigators in this prospective case series set out to determine how swept- source optical coherence tomography (SS-OCT) fared in routine cataract surgery cases, for identifying preoperative occult macular disease. In all cataract surgery cases between January and March 2016, investigators performed preoperative SS-OCT scans. They excluded any patients in which retinal pathologies were clinically detectable. Ultimately included here were 155 patients. With the scans, investigators determined that 10.9% of the patients had macular pathol- ogy. Of those with these conditions, five had age-related macular degeneration, four had idiopathic epiretinal membrane, another four had vitreomacular interactive abnormalities, two had cystoid macular edema, and another two had ellipsoid zone abnormalities. Investigators concluded that especially in the presence of media opacities, the non-invasive SS-OCT was beneficial for identifying macular structural abnormalities. They urged practitioners, particu- larly in cases where premium IOLs were being contemplated, to use SS-OCT for macular evaluation in addition to the routine dilated fundus exam. Greater vertical spot spacing to improve femtosecond laser capsulotomy quality Tim Schultz, MD, FEBO, Stephanie C. Joachim, MD, Rozina Noristani, MD, Wendell Scott, MD, H. Burkhard Dick, MD, PhD This prospective randomized case series honed in on how modified capsuloto- my laser settings affected femtosecond laser-assisted cutting quality in cataract surgery. Included here were 100 eyes, 50 of which were placed in group 1 and the other 50 in group 2. Those in group 1 received standard pulse energy of 4 µJ at a depth of 600 µm with 5 µm horizontal spot spacing and 10 µm vertical spot spacing for a total treatment time of 1.2 seconds. For those in group 2, to- tal treatment time went down to 1 second and vertical spacing increased by 15 µm. Investigators here determined that overall there were no cases of anterior capsule tears during treatment and the cataract surgery itself was successfully completed in 100% of cases. However, with the new capsulotomy laser setting use in group 2 fewer tags were seen and the size of free tags was also signifi- cantly lower. Investigators concluded that with the new settings the number of the tags was reduced and the quality of the cut improved. They believe that for femtosecond laser-assisted cataract surgery there is the opportunity to reduce the risk for capsular tears with a change to this new setting. March 2017 networking with colleagues in between education sessions. The lounges will also offer complimentary flavored ice water stations. Industry Spotlight Theater For the first time ever, the ASCRS•ASOA Symposium & Congress will offer meeting attendees a series of corporate-focused education sessions in the Exhibit Hall. The ASCRS Programming Committee has selected a variety of topics of interest to attendees and are working with our exhibitors to sched- ule product-specific presentations. Los Angeles food trucks One unique feature of the 2017 ASCRS•ASOA Symposium & Congress is the food. This year, we will offer a variety of food trucks for lunch in different lo- cations in the Los Angeles Convention Center during lunch hours. The food trucks will give attendees the opportunity to get a taste of L.A. during the meeting. The food trucks will offer several food options such as tacos, Korean BBQ, and other cuisines that capture the eclectic L.A. food scene. Don't miss out on these exciting activities and much more. You can find more information and register for the 2017 ASCRS•ASOA Symposium & Congress at AnnualMeeting.ASCRS.org. EW Contact information Monasterio: dmonasterio@ascrs.org

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