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2013 ASCRS•ASOA San Francisco Daily News Sunday

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22 Sunday, April 21, 2013 EW SHOW DAILY ASCRS Symposia Practical pearls: Facing the new reality of refractive cataract surgery by Vanessa Caceres EyeWorld Contributing Writer sponsored by the ASCRS Refractive Surgery Clinical Committee, thoroughly addressed the topic. In an informal poll at the symposium, a number of attendees said that they plan to incorporate femtosecond technology into their cataract surgery going forward— which will come at a price tag of about $450,000 for the equipment and an additional $350 per patient interface, said John Vukich, MD, Madison, Wis. Using figures compiled from a survey done by SM2 Strategic, a consulting firm in Pleasanton, Calif., Dr. Vukich said the breakeven point for a femtosecond cataract laser is treatment on more than 1,100 eyes. Although ophthalmologists were struggling for some time over how to charge for this technology, that dilemma is now a little clearer, Dr. Vukich said. The Centers for Medicare and Medicaid Services stated in November 2012 that oph- Warren Hill, MD T he incorporation of refractive approaches into cataract surgery is an increasing reality for many ophthalmic practices. The Saturday symposium "Refractive Aspects of Cataract Surgery," thalmologists can bill for the cost incurred with noncovered additional imaging and diagnostics in femtosecond laser cataract surgery— even if the surgeon performs conventional cataract surgery and not premium IOL-related surgery. From the same survey data, Dr. Vukich stated that 71% of surgeons said they were at the breakeven point or better with their purchase of a femtosecond laser for cataract surgery. Focusing on the clinical aspect, Warren Hill, MD, Mesa, Ariz., said to expect a large wave of patients for refractive cataract surgery, particularly ones who have previously had refractive surgery. "This is an enormous population headed to your practice," he said. However, he urged surgeons to be realistic with patients about costly refractive options and efficacy for each individual's visual needs. It is crucial with refractive cataract patients to check for retinal disease in advance of surgery, said Keith A. Warren, MD, Overland Park, Kan. Options such as multifocal IOLs will not work as well if significant macula pathology is present, he said. Dr. Warren addressed various retinal pathologies that proop retinal exams might identify. He also said that a 78 or 90 D exam on patients with a history of retinopathy is crucial to screen for retinal risk factors. He recommended use of a preop ocular coherence tomography exam (OCT) for all refractive patients regardless of retinal risk factors. Similarly, patients should receive a preop evaluation of their cornea before surgery, said William B. Trattler, MD, Miami. If the patient has dry eye, the surgeon should treat it and optimize the ocucontinued on page 24 Help shape the future of ASCRS Programming ASCRS needs your help. Beginning in 2013, ASCRS will look to tie future educational programming to measurable improvements in practice patterns and patient outcomes. We need you to identify the gaps between your thinking and our current programming. Your help, through a 15-minute survey, will enable ASCRS to tailor future programming and to track our educational progress. Scan the QR code or go to www.eyeworld.org/survey to begin the ASCRS 2013 Annual Clinical Trends Survey. Look for our survey staff to take the survey during the meeting. Survey will close May 10, 2013 In 15 minutes, you can make a difference. If you ... Identify your area(s) of principle interest and answer key questions questions that will govern the future decisions made by ASCRS' Programming and Clinical Committees and its CME and non-CME event developers. We will ... Send you a preliminary results report before they're published in a future EyeWorld supplement. All respondents will be entered into a drawing to receive one of 15 iPads. Make ASCRS work better for you. Complete the 2013 survey today.

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