NOV 2012

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

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November 2012 EW NEWS & OPINION In the journal … November 2012 Update on the most common causes of TASS Zachary Bodnar, M.D., Sue Clouser, R.N., Nick Mamalis, M.D. Investigators in this retrospective, cross-sectional study set out to elucidate how over the past 10 years risk factors for toxic anterior segment syndrome (TASS) have changed. The study centered on 1,454 cases of TASS that occurred from June 1, 2007 to March 1, 2012. One new trend here showed that there were 26% fewer sites now reporting inadequate handpiece flushing volumes. Investigators also noted that there had been both a 36% decrease in use of preserved epinephrine and of enzymatic detergents at site visits. On the rise was the handling of intraocular lenses or instrument tips with gloves, which increased by 21%, poor instrument maintenance, which went up by 47%, and use of inadequately cleaned ultrasound baths, which grew by 34%. Also, investigators determined that 27% more sites were now using a deionized distilled final rinse. Investigators concluded that on the upside, instrument cleaning and perioperative practices connected to TASS had improved thanks to education. On the other hand, some unfavorable practices, such as poor instrument maintenance and inadequate ultrasound bath cleaning, may be on the upswing. Femtosecond laser fragmentation with different softening grids Ina Conrad-Hengerer, M.D., Fritz H. Hengerer, M.D., Tim Schultz, M.D., H. Burkhard Dick, M.D. How feasible is it to use the femtosecond laser for lens fragmentation? The aim of this study was to see how a 350-micron femtosecond fragmentation grid for lens softening compared with one that was 500 microns when it came to effective phacoemulsification time (EPT). In this prospective randomized trial, 160 patients with LOCS III grade cataracts were divided into two equal groups. Each received cataract surgery with one of the grid patterns. Investigators determined that with the 350-micron grid pattern, the mean femtosecond treatment time was 66.4 seconds, compared with 52.8 seconds in the 500-micron group. When it came to EPT, this was just 0.03 seconds for those receiving the 350-micron femtosecond grid pattern compared with 0.21 seconds for those treated with the 500-micron pattern. Investigators concluded that there was a statistically significantly lower EPT with a 350-micron grid pattern than with the 500-micron pattern. Manifest versus aberrometric refraction in LASIK Dan Z. Reinstein, M.D., Merce Morral, M.D., Marine Gobbe, Ph.D., Timothy J. Archer, M.A. (Oxon) Investigators in this study considered how LASIK results compared when these were based on manifest versus aberrometric refraction, both with and without Seidel correction for sphere. Included here were 869 myopic and 413 hyperopic eyes that underwent LASIK using manifest refraction-based measurements. Pre-op, a Seidel aberrometric refraction, which takes spherical aberration into account in calculating the sphere, was done as well as a non-Seidel refraction. Investigators then used vectors to predict how aberrometric refraction would have affected LASIK outcome. When it came to spherical equivalent in myopic LASIK, investigators determined that the mean differences between manifest and Seidel aberrometric refraction were +0.03 D and +0.45 D for non- Seidel. In hyperopic LASIK cases involving Seidel aberrometric refrac- tion, the difference was –0.20 and for non-Seidel was +0.39 D. With manifest refraction for myopic LASIK, 81% of eyes were within 0.50 D of attempted correction, while with Seidel aberrometric refraction, 70% attained this mark and 67% with non-Seidel. Likewise, for hyperopic LASIK, when manifest refraction was used, 71% of eyes were within 0.50 D, with 61% for Seidel aberrometric refraction and 64% for non-Seidel. The conclusion reached here was that had aberrometric refractions been used, accuracy would not have been as good as that attained in actuality by manifest refraction. Meanwhile, with aberrometric refractions, accuracy in myopic eyes was enhanced by the Seidel method but not in hyperopic cases. Two luminaries in the field of ophthalmology to be Honored Guests at the ASCRS•ASOA Symposium & Congress by Cindy Sebrell ASCRS•ASOA Director of Public Affairs 9 Jeo Ho Kim, M.D. T wo physicians who have made an indelible—and invaluable—mark on ophthalmology will receive the Honored Guest Award at the 2013 ASCRS•ASOA Symposium & Congress this April in San Francisco. Jeo Ho Kim, M.D., a leading ophthalmologist based in Seoul, Korea, and Harold A. Stein, M.D., a distinguished professor of ophthal- mology, University of Toronto, will be this year's Honored Guests. Both will be recognized at the Opening General Session of the ASCRS•ASOA Symposium & Congress. Dr. Kim earned his bachelor of science at Seoul National University in 1957 and completed his medical degree 3 years later at the Catholic University of Korea. In 1966, he earned a Ph.D. from the Catholic University, where he went on to become an assistant professor of ophthalmology. During his studies, Dr. Kim also fulfilled military service. In 1970, he was named a National Institutes of Health Inter- national Post-Doctoral Fellow at the Wilmer Institute at Johns Hopkins University Hospital. By 1978, he was a full professor of ophthalmology at the University of Tokyo. Since then, he has served in many leadership roles at the Catholic University of Korea, including director of the Clinical Research Institute, chairman of the Department of Ophthalmol- ogy, and dean of the Graduate Harold A. Stein, M.D. School. In 1994, Dr. Kim founded the Cernsan Foundation for Eye Research (CFER). In recent years, Dr. Kim has served as director of the 21C Eye Hospital of the Seoul Paik Hospital of Inje University and the Myung- Dong St. Mary's Eye Clinic Center in Seoul. During his long career, he has held leadership positions for many organizations, including the Korean Ophthalmological Society, the continued on page 10 Previous honored guests include: Bo T. Philipson, M.D. (2012) John J. Darin, M.D. (2012) Ulf Stenevi, M.D. (2011) Gavin S. Herbert (2011) Paul R. Honan, M.D. (2010) Emanuel S. Rosen, M.D. (2010) Miguel Angelo Padilha, M.D. (2009) Patrick Ian Condon, M.B. (2009) John Shepherd, M.D. (2008) Karl Jacobi, M.D. (2008) Eric Arnott, M.D. (2007) Jared Emery, M.D. (2007) H. Dunbar Hoskins Jr., M.D. (2006) Thomas R. Mazzocco, M.D. (2006) Richard P. Kratz, M.D. (2005) Malcolm A. McCannel, M.D. (2004)

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