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EW NEWS & OPINION 12 April 2017 World view Confronting contentious cataract topics C ataract and anterior segment surgery is an ever evolving and expanding field in ophthalmology. There are so many new techniques and technologies emerging on the market that sometimes the surgeon and clinician can become overwhelmed and even question the best way to approach a case. In this issue of EyeWorld we delve into some of these interesting difficulties and controversies. In our first article, Michael Snyder, MD, and Samuel Masket, MD, discuss the status of artificial iris implant devices in the U.S. Current- ly, none are approved by the U.S. Food and Drug Administration, but there are some ongoing studies looking to eventually gain approval. Drs. Snyder and Masket discuss the indications and contra- indications to implantation as well as the nuances involved in picking the right patients. In tackling another important debate in cataract, Bonnie An Hender- son, MD, Nick Mamalis, MD, and Andrzej Grzybowski, MD, discuss the risks and benefits of using intracameral antibiotics. It should be the surgeon's choice whether or not to utilize them for cataract surgery, but one must also be aware of other issues associated with the use of these injections such as TASS or hemorrhagic occlusive retinal vasculitis (HORV). It is a well-balanced article that will allow each reader to ponder this issue. In fact, in another timely article, Kevin Miller, MD, Nick Mamalis, MD, Andre Witkin, MD, and David Chang, MD, discuss vancomycin-associated HORV in detail. They explore the history of HORV, and the disease's signs, symptoms, and etiology. They then discuss treatment, prevention, and next steps in this rare but dev- astating issue, such as the ASCRS and American Society of Retina Specialists task force that formed to better help understand it. This series also includes an article with Stewart Galloway, MD, and Francis Mah, MD, discussing the topic of "dropless" cataract surgery with a transzonular or intracameral injection of an antibiotic/steroid mixture. They too discuss the risks and benefits associated with this newer technique to help minimize drop usage for patients and ultimately compliance. In another thought provoking article, Stephen J. Kim, MD, James P. Dunn, MD, Line Kessel, MD, PhD, John Sheppard, MD, and William G. Myers, MD, share their opinions on whether NSAID use in cataract surgery is beneficial for outcomes. Although there is some controversy for standard cases, there is some general agreement that they may be most beneficial for high-risk patients. And last but not least, we examine the topic of bilateral sequential cata- ract surgery. Kendall Donaldson, MD, Steve A. Arshinoff, MD, and Jona- than Solomon, MD, discuss the benefits of performing same day surgery on both eyes including patient convenience but also the potential drawbacks of Medicare reimbursement issues. Given all these interesting debates in cataract surgery and how eloquent- ly these dialogues are presented in this issue of EyeWorld, I hope our readers will find themselves more informed and ready to take on the controversies and challenges we face in the rapidly progressing and growing field of cata- ract surgery. EW Rosa Braga-Mele, MD Cataract editor The official publication of the American Society of Cataract & Refractive Surgery A S C R S April 2017 Volume 22 • No. 4 Publisher Donald Long don@eyeworld.org Editorial Editor Amy Goldenberg amy@eyeworld.org Managing Editor Stacy Jablonski stacy@eyeworld.org Senior Staff Writer/Digital Editor Ellen Stodola ellen@eyeworld.org Staff Writer Liz Hillman liz@eyeworld.org Production Graphic Designer Julio Guerrero julio@eyeworld.org Graphic Design Assistant Susan Steury susan@eyeworld.org Production Manager Cathy Stern cathy@eyeworld.org Production Assistant Carly Peterson carly@eyeworld.org Contributing Writers Stefanie Petrou Binder, MD Berlin, Germany Vanessa Caceres Bradenton, Florida Rich Daly Arlington, Virginia Lauren Lipuma Washington, D.C. Michelle Stephenson Roanoke, Virginia Senior Contributing Writer Maxine Lipner Nyack, New York Advertising Sales ASCRSMedia 4000 Legato Road Suite 700 Fairfax, VA 22033 703-591-2220 Fax: 703-591-0614 eyeworld@eyeworld.org www.eyeworld.org Paul Zelin paul@eyeworld.org Jaclyn Talon jaclyn@eyeworld.org Classified Sales Cathy Stern cathy@eyeworld.org EyeWorld Special Projects and Events Jessica Donohoe jessica@eyeworld.org Shelly Dixon shelly@eyeworld.org Anne Le anne@eyeworld.org ASCRS Publisher: EyeWorld (ISSN 1089-0084) is published monthly by ASCRS Ophthalmic Services Corp., 4000 Legato Road, Suite 700, Fairfax, VA 22033-4055; telephone: 703-591-2220; fax: 703-591-0614. Printed in the U.S. Editorial Offices: EyeWorld News Service, 4000 Legato Road, Suite 700, Fairfax, VA 22033-4055; toll-free: 800-451-1339, 703-591-2220; fax: 703-591-0614; email: eyeworld@eyeworld.org. 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