Eyeworld

EW NEWS & OPINION 8 May 2017 is exemplified in the vast array of ethnic cuisine. The monuments are inspiring and remind us of the short but rich history of our country. D.C. is an easy location to reach from all around the world. Spring will have arrived by April, and the cherry blossoms should be in full bloom. I invite everyone to attend the 2018 Annual ASCRS meeting in D.C. You won't be disappointed! EW we can shape legislation to im- prove the quality and availability of healthcare. EyeWorld: What will you focus on during your time as ASCRS president? Dr. Henderson: I want to build upon the great work that has been started by the previous leaders of ASCRS. Outgoing president Kerry Solomon, MD, has improved our communications by improving our social media and online offerings. Ed Holland, MD, Eric Donnen- feld, MD, and David Chang, MD, have implemented various educa- tional initiatives that have focused on young physicians and those in training. Rick Lewis, MD, and Bob Cionni, MD, have created a robust ASCRS survey with The Funding- sland Group. Doug Koch, MD, Warren Hill, MD, Li Wang, MD, and Graham Barrett, MD, have generously donated their expertise to teach us about IOL calculations. All of these initiatives are important and will continue to be supported during my term. This year is unique for several reasons. First, because of the current political upheaval in our nation's capital, we physicians have the opportunity to assemble and impact decisions regarding healthcare pol- icy. Regardless of people's political leanings, physicians can unite over common concerns and attempt to improve the delivery of care while decreasing the regulatory burdens on the clinical practices. Second, many of the largest ophthalmology organizations are headed by women this year (Amer- ican Academy of Ophthalmology [AAO], American Glaucoma Society, Association for Research and Vision in Ophthalmology, and European Society of Cataract and Refractive Surgeons). This has never happened before and probably won't happen again for a long time. I would like to capitalize on this historic year to forge closer relationships and find ways to collaborate in a meaningful way. EyeWorld: What role does the ASCRS annual meeting have in improving the career and clinical experience for ophthalmologists? Dr. Henderson: Ophthalmology is a tech-focused specialty. We rely on complex machines and insert artificial devices in our patients. Additionally, technology changes rapidly. Ophthalmologists need to stay current on these changes to offer the advantages of the newest improvements to their patients. The ASCRS annual meeting and EyeWorld publication provide education on all of the relevant topics for anterior segment doctors. By attending the meeting, a physician can learn about surgical techniques, hear about management of complications, and participate in hands-on labs. The annual meeting is also a great place to catch up with colleagues and network with collaborators and industry partners. EyeWorld: Could you say a little about the 2018 ASCRS meeting in Washington, D.C.? Why is it a good location and time of year? Dr. Henderson: Washington D.C., is a great town. I love the multi- cultural aspect of the city, which Bonnie An Henderson, MD, continued from page 3 " I would like to capitalize on this historic year to forge closer relationships and find ways to collaborate in a meaningful way. " —Bonnie An Henderson, MD Dr. Henderson is an internationally-recog- nized expert in cataract and refractive surgery, specializing in complicated anterior segment surgery. Dr. Henderson is the asso- ciate editor for the Journal of Refractive Surgery and was an associate editor for EyeWorld. Dr. Henderson has authored more than 125 articles, papers, book chapters, and abstracts and has delivered over 275 invited lectures worldwide. She has published five textbooks in cataract and refractive surgery. Her textbook Es- sentials of Cataract Surgery is one of the most commonly used textbooks to teach cataract surgery in the United States. Dr. Henderson's principal research involves cataract surgery outcomes and innovative methods of teaching, including the development of a digital-based method for teaching cataract surgery, supported by a Department of Defense TATRIC grant. She has invented and commercialized a number of medical instruments, including a modified capsule tension ring, astigmatism correcting markers, and a capsule polisher, for which she donates her interests to charity. More about Dr. Henderson View the EyeWorld CME and non-CME supplements at: cmesupplements. eyeworld.org supplements. eyeworld.org Supported by an unrestricted educational grant from Abbott Medical Optics Designation Statement The American Society of Cataract and Refractive Surgery designates this enduring materials educational activity for a maximum of 1.0 AMA PRA Category 1 Credits. ™ Physi- cians should claim only credit commensurate with the extent of their participation in the activity. Claiming Credit To claim credit, participants must visit bit.ly/2gVjCDk to review content and down- load the post-activity test and credit claim. All participants must pass the post-activity test with a score of 75% or higher to earn credit. Alternatively, the post-test form included in this supplement may be faxed to the number indicated for credit to be awarded, and a certificate will be mailed within 2 weeks. When viewing online or downloading the ma- terial, standard internet access is required. Adobe Acrobat Reader is needed to view the materials. CME credit is valid through June 30, 2017. CME credit will not be awarded after that date. Notice of Off-Label Use Presentations This activity may include presentations on drugs or devices or uses of drugs or devices that may not have been approved by the Food and Drug Administration (FDA) or have been approved by the FDA for specific uses only. ADA/Special Accommodations ASCRS and EyeWorld fully comply with the legal requirements of the Americans with Disabilities Act (ADA) and the rules and regulations thereof. Any participant in this educational program who requires special accommodations or services should contact Laura Johnson at ljohnson@ascrs.org or 703-591-2220. Financial Interest Disclosures John Berdahl, MD, has earned a royalty or derived other financial gain from Imprimis and Ocular Surgical Data. He has an investment interest in DigiSight, Omega Ophthalmics, and Vision 5. Dr. Berdahl has received a retainer, ad hoc fees or other con- sulting income from: Abbott Medical Optics, Alcon Laboratories, Avedro, Bausch + Lomb, Calhoun Vision, ClarVista, DigiSight, Enviseo, Glaukos, Imprimis, Ocular Therapeutix, Omega Ophthalmics, Ocular Surgical Data, Vision 5, and Vittamed. He is a member of the speakers bureaus of Glaukos and Ocular Therapeutix. Rosa Braga-Mele, MD, FRCSC, is a member of the speakers bureaus of Alcon Laborato- ries and Allergan. Daniel Chang, MD, has an investment inter- est in Omega Ophthalmics. He has received a retainer, ad hoc fees, or other consulting income from: Abbott Medical Optics, Allergan, Carl Zeiss Meditec, Mynosys Cellular Devices, and Omega Ophthalmics. Dr. Chang has received expense reimbursement from and is a member of the speakers bureaus of Abbott Medical Optics and Carl Zeiss Meditec. He has received research funding from Abbott Medical Optics and Mynosys Cellular Devices. Daniel Durrie, MD, has an investment inter- est in, has received expense reimbursement from, and has received a retainer, ad hoc fees or other consulting income from AcuFocus, Alphaeon, and Strathspey Crown. He has received research funding from AcuFocus, Alcon, Allergan, Avedro, and EyeGate Pharma. Dr. Durrie has received expense reimburse- ment from Avedro and Hoopes Durrie Rivera Research. Staff members: Kristen Covington and Laura Johnson have no ophthalmic-related financial interests. 365 Curriculum Presbyopia Presbyopia correction: Exploring surgical options, expectations, and postoperative error continued on page 2 by Daniel Durrie, MD Describing the stages of presbyopia: Understanding its onset and progression DLS stages Patients usually enter stage 1 of DLS at an average age of 43. In stage 1, the lens is clear and colorless, but the lens los- es the ability to change power. As a result, most patients have When we explain this to our patients, they understand it well. Previously, patients knew their eyes changed during middle age and that cataracts may develop later, but no one explained how the lens was changing. New terminology gains momentum in ophthalmic practices A new three-stage classification system is helping cataract surgeons communicate with their colleagues and patients about the normal phases of crystalline lens change that occur with aging. When we review the stages of dysfunc- tional lens syndrome (DLS), we not only describe the way the lens changes but can correlate these changes with treatments that are most ap- propriate at each stage. 1,2 Illustrative analogy During human embryon- ic development, a piece of ectodermal tissue splits off to become the crystalline lens. Consequently, it ages simi- larly to the skin. As disulfide bonds accumulate inside the lens through all three stages, the lens loses flexibility and density increases. " With new diagnostic tools, we can show patients the color, appearance, and density of the lens and how they affect vision. " –Daniel Durrie, MD Accreditation Statement This activity has been planned and imple- mented in accordance with the accreditation requirements and policies of the Accredi- tation Council for Continuing Medical Edu- cation through the joint providership of the American Society of Cataract and Refractive Surgery (ASCRS) and EyeWorld. ASCRS is ac- credited by the ACCME to provide continuing medical education for physicians. Educational Objectives Ophthalmologists who participate in this activity will: • Accurately describe the progressive diagnosis of presbyopia and the optical fundamentals of correction options, uti- lizing the appropriate current terminology of presbyopia to describe all stages of the disease state • Compare and contrast presbyopia treatment options to match solutions to patients' needs, and describe range of vision functions as related to patients' needs • Implement a lower threshold for accept- able pseudophakic refractive error levels in presbyopia-corrected patients, and identify steps to mitigate refractive sur- prises and other key variables to increase postoperative success EyeWorld January 2017 365 Curriculum OSD: Honing diagnostic protocols to pinpoint disease, enhance surgical outcomes Supported by unrestricted educational grants from Alcon Laboratories Inc., Allergan Inc., Shire Pharmaceuticals, TearLab, and TearScience continued on page 2 Accreditation Statement This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of the American Society of Cataract and Refractive Surgery (ASCRS) and EyeWorld. ASCRS is accredited by the ACCME to provide continuing medical education for physicians. Educational Objectives Ophthalmologists who participate in this activity will: • Identify the true impact of a dysfunc- tional ocular surface on cataract and refractive outcomes, identify the conse- quences that accompany an unstable tear film, and discuss the presentation of symptomatic vs. asymptomatic OSD • Describe the objective evidence supporting the use of new OSD diagnostic tools and develop strategies for incorporating new diagnostic tools into practice, including: inclusion in point-of-care and preoperative testing, use of diagnostic information to guide treatment, and utilization of diagnostics to follow success of interventions or treatment • Improve practice protocols for the screening, diagnosis, and classifica- tion of OSD and integrate consistent treatment regimens Designation Statement The American Society of Cataract and Refractive Surgery designates this enduring materials educational activity for a maximum of 1.0 AMA PRA Category 1 Credits. ™ Physicians should claim only credit commensurate with the extent of their participation in the activity. Claiming Credit To claim credit, participants must visit bit.ly/2j9eZpt to review content and download the post-activity test and credit claim. All participants must pass the post-activity test with a score of 75% or higher to earn credit. Alternatively, the post-test form included in this supplement may be faxed to the number indicated for credit to be awarded, and a certificate will be mailed within 2 weeks. When viewing online or downloading the material, standard internet access is required. Adobe Acrobat Reader is needed to view the materials. CME credit is valid through August 31, 2017. CME credit will not be awarded after that date. Notice of Off-Label Use Presentations This activity may include presentations on drugs or devices or uses of drugs or devices that may not have been approved by the Food and Drug Administration (FDA) or have been approved by the FDA for specific uses only. ADA/Special Accommodations ASCRS and EyeWorld fully comply with the legal requirements of the Americans with Disabilities Act (ADA) and the rules and regulations thereof. Any participant in this educational program who requires special accommodations or services should contact Laura Johnson at ljohnson@ascrs. org or 703-591-2220. Financial Interest Disclosures Jessica Ciralsky, MD, has received a retainer, ad hoc fees or other consulting income from Abbott Medical Optics, Allergan, Bausch + Lomb, and Shire. Preeya Gupta, MD, has received a retainer, ad hoc fees or other consulting income from: Abbott Medical Optics, Alcon Laboratories, Allergan, Bio-Tissue, NovaBay Pharmaceuticals, RPS, Shire, TearLab, and TearScience. Francis Mah, MD, has received a retainer, ad hoc fees, or other consulting income from Abbott Medical Optics, Aerie Phar- maceuticals, Alcon Laboratories, Allergan, Bausch + Lomb, CoDa, NovaBay, Ocular Science, Okogen, Omeros, PolyActiva, Shire, Sun Pharma, Sydnexis, and TearLab. He is a member of the speakers bureaus of Alcon, Allergan, Abbott Medical Optics, and Bausch + Lomb. Dr. Mah has received research funding from Abbott Medical Optics and Allergan. William Trattler, MD, has an investment interest in Alphaeon, ArcScan, and CXLO. He has received a retainer, ad hoc fees, or other consulting income from, and is a member of the speakers bureau of: Abbott Medical Optics, Allergan, Avedro, Bausch + Lomb, Shire, and Sun Pharma. He has received a retainer, ad hoc fees or other consulting income from Alcon Laborato- ries, and is a member of the speakers bu- reau of NovaBay. Dr. Trattler has received research funding from Allergan. Staff members: Kristen Covington and Laura Johnson have no ophthalmic-related financial interests. I n our quest to im- prove cataract surgery outcomes, we use the latest formulas, IOLs, and surgical technologies. To make the most of the newest innovations, we need accurate preoperative measurements, but dry eye can interfere with these readings. To help patients achieve the best refractive outcomes, surgeons need to enhance their dry eye assessment protocols to more accurate- ly diagnose dry eye before surgery. Dry eye impact Many patients who are eval- uated for cataract surgery do Undiagnosed dry eye can have far-reaching consequences in cataract patients by William Trattler, MD The ocular surface: A key factor in patient dissatisfaction William Trattler, MD " To make the most of the newest innovations, we need accurate preoperative measurements, but dry eye can interfere with these readings. " –William Trattler, MD not have significant symp- toms of dry eye. However, during an objective examina- tion, which includes corneal staining, tear break-up time, and other tests, patients may have findings of ocular surface disease (OSD), which can impact preoperative imaging and IOL power calculations. EyeWorld February 2017 Ocular surface disease (OSD) The news magazine of the American Society of Cataract & Refractive Surgery digital.eyeworld.org Supplement to EyeWorld Daily News, Sunday, May 8, 2016 The news magazine of the American Society of Cataract & Refractive Surgery digital.eyeworld.org Supplement to EyeWorld Daily News, Monday, May 9, 2016 Innovative IOL technologies for the cataract surgeon

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