Eyeworld

SEP 2012

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

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12 EW NEWS & OPINION September 2012 In the journal … September 2012 Review/update: applications of wavefront technology Glauco Reggiani Mello, M.D., Karolinne Maia Rocha, M.D., Marcony R. Santhiago, M.D., David Smadja, M.D., Ronald R. Krueger, M.D. Two major parts of wavefront technology were considered in this review. The first aspect highlighted was the science, including the underlying principles involved in decomposing and interpreting the wavefront, while taking into consideration the basic optics of the eye, as well as looking at how visual acuity is affected by wavefront aberrations. The diverse array of wavefront sensors was also highlighted. Each system was reviewed with the advantages and limitations outlined. The second major part of wavefront technology emphasized was clinical uses. Investigators looked at how wavefront profile enhancements might prove clinically beneficial as well as weighing limitations. Also highlighted were other innovations that have grown out of having wavefront technology now available. ASCRS Task Force recommends non-surgical educational program for advancement of integrated eyecare model by Cindy Sebrell ASCRS director of communications T Single- and dual-optic IOL Jorge L. Alió, M.D., Ana B. Plaza-Puche, M.Sc., Raúl Montalban, M.Sc., Paula Ortega, M.Sc. Investigators in this prospective, nonrandomized, consecutive study compared how single- versus dual-optic accommodating lenses per- formed clinically, particularly at near. The 27 eyes in group A received the Crystalens HD (Bausch + Lomb, Rochester, N.Y.), a single-piece ac- commodating IOL. Meanwhile, the 26 eyes in group B were given the Synchrony (Abbott Medical Optics, AMO, Santa Ana, Calif.) dual-optic accommodating lens. When it came to near and intermediate vision, investigators determined that there were no significant differences between the groups. However, in terms of defocus, ocular Strehl ratio, and contrast sensitivity, eyes in group B fared better. Both total and higher order aberrations were greater for those in group A. Investigators concluded that following cataract surgery both lenses restored distance acuity with some limitations in near vision, but optical quality was better for those that received the dual-optic lens. he Integrated Ophthalmic- Managed Eyecare Delivery (IOMED) Task Force has recommended non-surgical educational programs for integrated optometrists be added at the American Society of Cataract and Refractive Surgery Symposium & Congress, in San Francisco in April 2013. This track will be designed specifically to promote and advance the integrated eyecare model and will provide the opportu- nity for optometrists to earn contin- uing education credits and to attend a networking job fair. The IOMED Task Force also con- cluded that a new membership soci- ety for integrated optometrists is not needed to advance these goals and did not recommend a new member- ship category for optometry within ASCRS. The Governing Board has accepted and endorsed this recom- mendation as well. The IOMED Task Force was formed by ASCRS earlier this year to investigate ways in which the organization and its continued on page 14 August 17, 2012 Dear Colleagues, We are writing to update you with a recent decision regarding the ASCRS Integrated Ophthalmic-Managed Eyecare Delivery (IOMED) initiative. The principle underlying this initiative has been to explore and support the clinically appropriate integration of optometrists within an ophthalmology-led IOMED model. Vertical integration of MDs, ODs, and other personnel into such a patient-centered model would aim to improve efficiency and capacity in the face of a predicted future physician manpower shortage in eye care delivery. Our board initially anticipated that this would involve non-surgical education of ASCRS member-employed ODs at our Annual Meeting or the establishment of an affiliated society for ODs working in IOMED systems. A 2008 member survey indicated that approximately half of our membership works with employed ODs. Based on this information, optometrists employed by ASCRS members have been allowed to attend the ASCRS Annual Meeting for the past four years. Prophylactic NSAID in uneventful cataract surgery David R.P. Almeida, M.D., Zainab Khan, B.Sc., Lin Xing, B.Sc., Shahrukh N. Bakar, B.Sc., Karim Rahim, M.Sc., Todd Urton, M.D., Sherif R. El-Defrawy, M.D. In this prospective, double-masked, randomized trial, investigators considered how following uneventful phacoemulsification those who received prophylactic ketorolac 0.5% fared compared with those given either nepafenac 0.1% or placebo. Beginning 1 day before surgery the drops were dosed four times a day and continued for 4 weeks. At the 1- month mark, those in each of the three groups fared the same with no differences found in frequency or trouble with side effects, in tolerability, or in compliance. There was also no difference in macular volume found between the groups. Both NSAIDs were well tolerated. However, investigators concluded that NSAIDS should not be recommended for patients undergoing routine cataract procedures who have no risk factors. Our intention has been to support only those optometrists who want to work in an integrated practice model by offering educational and membership options beyond what is currently available to them through their optometric societies. However, we understand that such support of ANY optometrist is a controversial issue because of the contentious scope of practice legislative battles. We have listened to the varying opinions of many ASCRS members and are sensitive to the concerns expressed to us by many state society leaders. This thoughtful feedback has been taken into serious consideration by our board throughout this process. Under the leadership of Stephen Lane, an IOMED Task Force was formed to advise the ASCRS Governing Board. This advisory task force is comprised of three ASCRS past presidents (Doctors Lane, Howard Fine, and Doug Koch) and five optometric leaders currently working within IOMED systems. After careful consideration, the IOMED Task Force has recommended that ASCRS develop specific non-surgical educational programs for IOMED optometrists at the next ASCRS Annual Symposium, which will be held in San Francisco in April 2013. The ASCRS Governing Board has decided to accept the Task FŽƌĐĞƐ formal recommendation to focus on advancing appropriate non-surgical education for IOMED ODs ʹ without any optometric membership opportunities within ASCRS or through an ASCRS-affiliated organization. The conclusion and recommendation of the task force that a new membership society for optometrists is not needed to advance our goals has been accepted and endorsed by the ASCRS Governing Board.

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