Eyeworld

OCT 2017

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

Issue link: https://digital.eyeworld.org/i/880217

Contents of this Issue

Navigation

Page 12 of 150

World view In the face of ocular comorbidities C ataract surgery can be challenging and requires preparation, precision, and at- tention to detail. Outcomes are gener- ally very good with newer technologies that help minimize complications and maximize visual performance for out patients. However, when dealing with eyes or patients who are not necessarily straightforward, cataract surgeons need to be fully aware of the situation and have an armamentarium of techniques and technologies to help optimize outcomes and minimize surprises. In this issue of EyeWorld, we look at cataract surgery in the face of ocular and physical comorbidities. Steve Charles, MD, and Robert Osher, MD, help us to better understand the issues with cataract surgery in the macular degeneration patient. It is important to work with a retinal specialist to ensure proper timing of intravitreal injections and to be aware of the possibility of either capsular or zonular damage due to previous manipulation of the eye for treatments. In an article on cataract surgery with advanced glaucoma, Won Kim, MD, Yuri McKee, MD, and John Odette, MD, review the challenges of oper- ating on these patients with respect to their potentially compromised anato- my. They delve into the world of MIGS in conjunction with cataract surgery and when to use these as an adjuvant to controlling intraocular pressure and potentially minimizing the need for eye drops. Corneal health is always an issue when trying to optimize visual out- comes in patients, but especially in those patients who choose to have a premium IOL. Elizabeth Yeu, MD, Shahzad Mian, MD, and Clara Chan, MD, explore the need for accurate and meticulous preoperative assessments of the cornea and tear health with multiple technologies. In addition to dis- cussing preop treatment of corneal issues before cataract surgery, they discuss cataract surgery timing relative to corneal surgery timing in those patients who may require both procedures. Uveitis can be daunting in trying to diagnose and treat patients with intraocular inflammation. Michael Raizmann, MD, and Thomas Oetting, MD, help us better understand preop considerations depending on the type of uveitis. They share tips for intraoperative issues to be aware of such as weak zonules and CME risk, and discuss optimized inflammation control. The diabetic patient poses many challenges and can present systemic co- morbidities as well as ocular ones. We learn from David Boyer, MD, Bonnie Henderson, MD, Keith Warren, MD, and Walter Stark, MD, the need to evaluate and assess the full eye and the need for the cataract surgeon to work with a retinal specialist to optimize outcomes for these patients. Last but not least, we cover cataract surgery in the patient with demen- tia. This can be difficult as it can be challenging to examine them and de- termine visual impediments. According to Cynthia Matossian, MD, Susan MacDonald, MD, and John Hart, MD, these patients deserve special consid- erations. We need to discuss the procedure and choices with them and their power of care to be able to provide true informed consent. We need to help simplify the pre- and postoperative care for them and their caregivers and modify anesthesia loads to minimize side effects. It is important to discuss target refraction and perhaps multifocal IOLs to help simplify their lives. This issue presents a potpourri of challenging cases and offers guidance on how best to approach them to optimize outcomes. In reality, we are just revealing the tip of the iceberg as there are many more comorbidities and challenges that we face. But it is always worthwhile to review and learn from each other and offer best practices to help our patients see better. EW Rosa Braga-Mele, MD, Cataract editor The official publication of the American Society of Cataract & Refractive Surgery A S C R S October 2017 Vol. 22 • No. 10 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 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. Advertising Offices: ASCRSMedia, 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. Copyright 2017, ASCRS Ophthalmic Services Corp., 4000 Legato Road, Suite 700, Fairfax, VA 22033-4055. All rights reserved. No part of this publication may be reproduced without written permission from the publisher. Letters to the editor and other unsolicited material are assumed intended for publication and are subject to editorial review and acceptance. Subscriptions: Requests should be addressed to the publisher. Annual subscription prices: Individual: 1 year, $120; 2 years, $220; 3 years, $320. Institutional: 1 year, $250; 2 years, $330; 3 years, $425. Foreign: 1 year, $240, 2 years $470, 3 years, $700. Back copies: Subject to availability. Contact the publisher. Cost per copy is $15; $30 foreign. All orders for individual or back copies must be accompanied by payment. Requests to reprint, use, or republish: Requests to reprint or use material published herein should be made in writing only to Cathy Stern, EyeWorld, 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. EyeWorld reprints: To order reprints of material published in EyeWorld, contact Cathy Stern, EyeWorld, 4000 Legato Road, Suite 700, Fairfax, VA 22033-4055; toll-free: 800-451-1339, 703-591-2220; fax: 703-591-0614; email: cathy@eyeworld.org or your salesperson. Change of address: Notice should be sent to the publisher six weeks in advance of effective date. Include old and new addresses and label from recent issue. The publisher cannot accept responsibility for undelivered copies. POSTMASTER: Send change of address to EyeWorld, 4000 Legato Road, Suite 700, Fairfax, VA 22033. Periodical postage paid at Fairfax, VA 22033 and at additional mailing offices. The ideas and opinions expressed in EyeWorld do not necessarily reflect those of the editors, publisher, or its advertisers. P U B L I S H I N G S T A F F

Articles in this issue

Links on this page

Archives of this issue

view archives of Eyeworld - OCT 2017