Eyeworld Daily News

72 | EYEWORLD DAILY NEWS | MAY 4, 2019 ONSITE ASCRS ASOA ANNUAL MEETING by Vanessa Caceres EyeWorld Contributing Writer Surgeons must be prepared for the increased demands of refractive cataract surgery, includ- ing correction of spherical error, astigmatism, and vision at all distances. In addition, improving ocular health is important, Dr. McCabe said. The use of MIGS in refractive cataract settings can help patients lower glaucoma medica- tion use and decrease morbidity. Despite best intentions, the efforts of glaucoma treatment are thwarted if patients don't take their drops, said Marlene Moster, MD, Philadelphia. It is a team effort to help ensure patients use their medications, and even then results are variable. Dr. Moster said about 50% of glaucoma pa- tients are somewhat noncompliant with drops use, 16% are totally noncompliant, and 35% improper- ly administer their drops. Problems with burning on ap- plication, forgetfulness, and diffi- culty using drops all contribute to adherence problems, Dr. Moster said. Some patients may require more than one drop, but this can cause more problems with usage and toxicity on the eye surface. Dr. Moster shared ways to improve adherence, including some future choices such as the bimatoprost ring (Allergan), iDose (Glaukos), and punctal plug deliv- ery systems. Combination therapy is available now, SLT is still a good option, and MIGS may be per- formed earlier going forward. Editors' note: This event was support- ed by educational grants from Aerie Pharmaceuticals, Allergan, Bausch + Lomb, Glaukos, Ivantis, and Santen Pharmaceutical. A dvancing glaucoma therapies offer sur- geons and their patients a growing range of treatment options, but patient adherence to drop-based therapy continues to pose a challenge. These themes were part of the discussion during Friday morning's "Advancing Glaucoma Medical Therapies, Making MIGS Treat- ment Decisions, and Combining Procedures in the Context of Cat- aract Surgery." The session was an EyeWorld CME Education event. Focusing on glaucoma medi- cal therapies, Nathan Radcliffe, MD, New York, noted that new pharmacological options provide more choices and MIGS can help reduce but not entirely eliminate patient use of drops. Treatment options that Dr. Radcliffe discussed included netarsudil (Rhopressa, Aerie Pharmaceuticals), selective laser trabeculoplasty (SLT), MicroPulse (IRIDEX), and various MIGS options. Regarding SLT, a study pub- lished this year in The Lancet from British physicians found that SLT was preferable to eye drops and led to better patient control of glaucoma. This likely will lead to greater use of SLT in England and possibly in the U.S., Dr. Radcliffe said. With the explosion of MIGS, physicians are seeing consistent reductions in medication use and IOP and that surgeons continue to evolve with their techniques. For instance, Dr. Radcliffe shared that although the XEN Gel Stent (Allergan) is designed for ab interno use, a growing number of surgeons are using it ab externo. Cathleen McCabe, MD, Bradenton, Florida, said about 20% of her patients have con- comitant glaucoma and cataract surgery. Some patients come to her for a cataract but also have undiagnosed glaucoma. Surgical procedures that help manage both cataract and glaucoma boost efficiency, which benefits patients, Dr. McCabe said. To help identify patients who may benefit from MIGS, Dr. McCabe's office uses a short survey that asks about glaucoma medication cost and any problems patients may have in using drops. Boosting glaucoma treatment options Dr. Moster discusses issues with eye drops such as noncompliance. Resident Excellence Awards recognize outstanding students E leven of ophthalmology's most outstanding young residents are able to attend this year's ASCRS ASOA Annual Meeting as a result of the ASCRS Foundation's Resident Excellence Awards program. Each year, the foundation gives 10 travel grants to extraordinary residents through a competitive application process. Applicants must be nominated by their program directors. Thanks to the generosity of an anonymous donor and the excep- tional quality of candidates for this year's award, 11 outstanding ophthalmology residents have been selected to receive the 2019 Resident Excellence Award. The categories for consideration include research, patient care, leadership, and education. Congratu- lations to the selected 2019 winners. • Katia Chavez, MD Ohio State University, Havener Eye Institute, Westerville, Ohio • Priyanka Chhadva, MD University of Illinois Eye and Ear Infirmary, Chicago • Martin De la Pressa, MD University of Minnesota De- partment of Ophthalmology, Minneapolis • Austin Fox, MD University of Iowa Depart- ment of Ophthalmology and Visual Sciences, Iowa City • Nathan Lambert, MD Oregon Health & Science University, Casey Eye Insti- tute, Portland, Oregon • Emily Li, MD Yale University, Yale New Haven Hospital, New Haven, Connecticut • Austin Nakatsuka, MD University of Texas Medical Branch, Galveston, Texas • Eric Rosenberg, DO New York Medical College, Valhalla, New York • Ryan Smith, MD Stanford University Medical Center, Stanford, California • Nandini Venkateswaran, MD University of Miami, Bascom Palmer Eye Institute, Miami • Angela Zhu, MD John Hopkins Wilmer Eye Institute, Baltimore

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