Eyeworld Daily News

50 | EYEWORLD DAILY NEWS | MAY 5, 2019 ONSITE ASCRS ASOA ANNUAL MEETING EyeWorld events Phaco Fundamentals: Principles and Pearls for Optimizing Phaco Machine Settings for Different Cataracts T oday at 8:30 a.m., David F. Chang, MD, and Sumit "Sam" Garg, MD, will lead a panel of phacoemulsification experts in an EyeWorld CME Education event to discuss key elements in establishing, adjusting, and optimizing phaco machine settings to maximize surgical outcomes. The faculty includes Sumitra Khandelwal, MD, Bryan Lee, MD, and Jeff Pettey, MD. Didactic presentations will focus on modifying and customizing phaco machine settings to maximize outcomes for routine and complicated cataract surgeries. The facul- ty will discuss the essential principles of phacoemulsification: peri- staltic and venturi pumps, post-occlusion surge, power modulation, hydrodissection technology and techniques for nuclear disassembly. The faculty will present platform-specific cases of dense cata- racts and will give their expert recommendations when navigating common complicating factors and surgical issues in cataract surgery, including small pupils, weak zonules, and wound burn. The session will begin with a review of relevant data from the 2018 ASCRS Clinical Survey to highlight the educational goals of this symposium. According to the survey, 64% of ASCRS members are not very confident in customizing their phaco machine settings to optimally manage various types of cataract surgeries. This EyeWorld CME Education event will take place today in Hall E from 8:30 to 10:00 a.m. This program is supported by unre- stricted educational grants from Johnson & Johnson Vision, Alcon Laboratories, and Bausch + Lomb. Other treatments include the use of lid cleansing antibiotic oint- ments and lid scrubs. In-office treatments include mechanical blepharoexfoliation for cases of significant anterior blepharitis with biofilm scurf, collarettes, or debris. Additionally, LipiFlow (Johnson & Johnson Vi- sion) provides rapid improvement in the lipid layer, Dr. Farid said. Intense pulsed light is also used off-label to treat chron- ic MGD. It has been found to restore glandular function and improve symptoms. Other options that surgeons have to improve the ocular surface include autologous serum drops. "You have to be in an area where you have a lab that commu- nicates well with a compounding pharmacy that can provide a good product to a patient, and some- times this can take time—several weeks," Dr. Farid said. Self-retaining amniotic mem- brane has been shown to provide clearing of punctate keratitis with- in a few days. Therapeutic bandage contact lenses can be used and punctal occlusion leads to tear volume increases, if inflammation already is under control. Surgeons also should examine modifying systemic medications. "If the patient is on an oral antihistamine, put them on local antihistamines and get them off the orals," Dr. Farid said. Editors' note: This event was supported by educational grants from Allergan, Shire, Johnson & Johnson Vision, and Sun Pharmaceutical. continued from page 48 Lens-Based Astigmatism Correction: Pearls for Success with Toric IOLs T omorrow at 6:30 a.m., Douglas Koch, MD, will lead a panel of experts in an EyeWorld CME Education event to discuss key steps in astigmatism management for optimal surgical out- comes. The faculty includes Daniel Chang, MD, Nicole Fram, MD, and William Trattler, MD. The program will outline the importance of and best practices for pre-, intra- and postoperative planning and execution to improve outcomes in the surgical management of astigmatism. Didactic presentations will focus on the impact of astigmatism on cataract surgery outcomes; best practices for obtain- ing accurate preoperative measurements; and the integration of axial marking instruments, including advanced registration tools, to mark and identify the axis intraoperatively. An interactive panel discussion on managing postoperative residual refractive error will provide prac- tical guidance for managing patient dissatisfaction. The session will begin with a review of relevant data from the 2018 ASCRS Clinical Survey that helped substantiate the educational goals of this symposium. According to the survey, on average, only 22% of cataract patients with clinically significant astigmatism receive a toric IOL. When asked why they are not implanting toric IOLs, the top response (aside from cost to the patient) was "not enough surgi- cal training to integrate toric IOLs" at 39%. Overall, 17% of respon- dents thought that 10 degrees or more of postoperative rotational error is acceptable before visual quality and visual acuity are signifi- cantly affected. To align the intended axis of placement for a toric IOL, 51% of respondents reported marking with the aid of manual axial instruments. Overall, 24% of respondents do not consider pos- terior corneal astigmatism in their toric power calculations. This EyeWorld CME Education event will take place tomorrow in room 20D from 6:30 to 7:30 a.m. This program is supported by educational grants from Johnson & Johnson Vision and Carl Zeiss Meditec.

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