Eyeworld

EW NEWS & OPINION April 2017 39 Contact information Aiello: msheffer@regancomm.com Kunjukunju: don60@aol.com With cataract surgery, "it's essential to ensure that diabetic retinopathy has been treated and stabilized prior to surgery to reduce the risk of reactivation or worsening of retinopathy," Dr. Lauer said. Although diabetes comes with several risk factors, patients and their providers are fortunate to have more treatments available nowa- days, Dr. Aiello said. In the 1950s, PDR was a risk factor for mortality, with an only 30% chance of be- ing alive within 5 years, he said. That has obviously changed, and there have even been some signs of treatments helping to reduce vision loss. "If we can get a larger percent- age of patients to care early, we can prevent most severe visual loss," Dr. Aiello said. More collaboration and education Collaboration with other specialists can occur frequently for any patient seen by an ophthalmologist, but it's more common in patients with dia- betes. This may include communica- tion with the primary care physician as well as vascular, heart, and kidney specialists from time to time, Dr. Kunjukunju said. Endocrinologists play a particularly important part in the patient's care, Dr. Lauer said. Patients with diabetes need continuous education about nutri- tion, exercise, and the importance of getting certain numbers—like blood sugar—under control. Yet with oph- thalmologists already squeezed for time, how do they approach this? "Part of what we do is educate the patient about glycemic control, blood pressure control, and lipid control. We also make sure patients are seen regularly," Dr. Aiello said. "That's a critical aspect. If the patient remains out of control, it's hard to control the eye disease." "We can make recommenda- tions about improving diet and be- ing compliant, but it's important to have diabetes resource centers avail- able where patients can get plugged into a system," Dr. Pillai said. "If patients are more knowledge- able about nutrition and exercise, this can go a long way in preventing comorbidities," Dr. Kunjukunju said. EW Editors' note: The physicians inter- viewed have no financial interests relat- ed to their comments in this article. K1-5696 (17mm blades) K1-5697 (13mm blades) K3-2440 pointed K3-2442 blunted Double-X Speculums Incision Spatulas Nucleus Splitters Eric Donnenfeld, MD of Rockville Centre, NY Tarek Badawy, MD of Cairo, Egypt K3-2448 for use in the right hand K3-2449 for use in the left hand patent pending Ralph Chu, MD of Bloomington, MN 973-989-1600 • 800-225-1195 • www.katena.com ® This speculum combines arms that open in a parallel fashion with flattened, vaulted blades for the reduction of external pressure on the globe. This significantly aids in docking the laser to the eye. K3-2460 Instrumentation Two versions of this 0.3mm wide incision opening spatula are available. One has a pointed tip (K3-2440) for surgeons who occasionally find incisions challenging to find and open, while the other (K3-2442) has a blunt tip for entering these incisions. This double ended instrument features the blunted 0.3mm incision spatula on one end and a 2mm wide blunt, keratome-shape spatula for opening the main incision on the other. The ultra thin tips on these splitters are designed to fit into the laser created grooves in the nucleus to safely fragment down to the posterior plate. One instrument can be used in conjunction with the phaco tip or two through opposing incisions in a bimanual technique. Lauer: lauera@ohsu.edu Norden: acsedrik@gwpinc.com Pillai: don60@aol.com

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