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6 | EYEWORLD DAILY NEWS | JULY 24, 2021 ASCRS ANNUAL MEETING DAILY NEWS ASCRS EXECUTIVE DIRECTOR Steve Speares PUBLISHER Don Bell MANAGING DIRECTOR Stacy Jablonski EDITORIAL CO-DIRECTORS Ellen Stodola Liz Hillman GRAPHIC DESIGNERS Susan Steury Katherine Beutner PRODUCTION MANAGER Cathy Stern SALES, SPONSORSHIPS, AND CORPORATE PROGRAMS Jessica Donohoe Joe Dooley Cathy Stern Omidria (phenylephrine and ketorolac, Omeros), and performs intraoperative gonioscopy and goniosynechialysis, as needed. She decompresses the eye to low- er pressure and uses a dispersive viscoelastic. Garrick Chak, MD, spoke about cataract surgery in patients with pseudoexfoliation glaucoma. He said to protect the Z axis as much as possible, inject a little viscoelastic through the sideport prior to removing the handpiece to prevent chamber shallowing. Dr. Chak also said to be ready to lower the bottle height. He uses a capsular tension ring for most of these cases, prefers a thicker, heavier viscoelastic, and has capsular tension hooks and segments on standby. He said to use carbachol at the end of the case and encouraged surgeons not to be afraid of creating an incision nasally, if needed. Editors' note: Dr. Shah and Dr. Smith have financial interests with various ophthalmic companies. Dr. Pappas has financial interests with Aerie Pharmaceuticals. Dr. Chak has no relevant financial interests. contrast sensitivity and, as such, Dr. Shah presented, patients with severe glaucoma, central depres- sions, or high-progression risk should be avoided. More recently approved "monofocal-plus" IOLs present an opportunity to increase some depth of field without com- promising contrast sensitivity, Dr. Shah said. Another opportunity in cataract surgery is to reduce or eliminate medications with MIGS. Oluwatosin Smith, MD, present- ed on the range of MIGS options available, sharing efficacy and safety data. Dr. Smith noted that matching patients to the right MIGS procedure based on glauco- ma type, severity, and treatment goals is important. Possible complications that surgeons could encounter in cataract surgery with glaucoma patients include no chamber and no zonules. Cataract surgery can be performed successfully in the setting of primary angle closure with limited to no chamber, but it's nuanced. Regine Pappas, MD, described the complication, its risk factors, diagnosis, and management. She said she has a Malyugin ring on hand, pre-orders ASCRS/AGS symposium tackles cataract surgery opportunities, complications with glaucoma T he joint symposium spon- sored by ASCRS and the American Glaucoma Soci- ety (AGS) at ASCRS Glau- coma Day featured presentations that covered cataract surgery opportunities and complications in patients with glaucoma. Opportunities included cata- ract surgery with premium IOLs and cataract surgery with MIGS. Manjool Shah, MD, discussed refractive cataract surgery in pa- tients with glaucoma. "Glaucoma patients present a unique challenge," Dr. Shah said, adding that there is "a lot for us to navigate, but I think we can make a big impact and take a bite out of their visual impairment." Toric IOLs, Dr. Shah pre- sented, are suitable for some patients with glaucoma and can be used when there is confidence in refractive predictability and surgically induced astigmatism. Trabeculectomy presents more of a challenge for toric correc- tion, but Dr. Shah said other procedures (canal-based and sub- conjunctival MIGS and potentially glaucoma drainage devices) are more astigmatically neutral. All current presbyopia-cor- recting IOLs result in some loss of

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