Eyeworld Daily News

EW SHOW DAILY 44 I n a spirited parody of programs such as ESPN's SportsCenter, a faculty of experts updated at- tendees on "Implementing the Next Generation of Femtosec- ond Cataract Surgery Today" Friday night. The live program, dubbed "Friday Night Lights at ASCRS," was held at the Wang Theatre of the Citi Performing Arts Center in Boston. The program began with a mock report of a "scandal" involving ASCRS outgoing president Eric D. Donnenfeld, MD, New York. In a segment called "The Beat," Dr. Donnenfeld, who had always been an excellent surgeon, was reported to have suddenly begun achieving unprecedentedly better outcomes. In 2014, said fellow ASCRS member Roger F. Steinert, MD, Irvine, Calif., "something changed." "Eric has taken [his cataract surgery practice] to a new level," said Dr. Steinert. He and Mark H. Blecher, MD, Philadelphia, "accused" Dr. Donnenfeld of using PED—not, however, meaning "performance enhancing drugs" as the term is commonly employed, but a "precision enabling device." Dr. Donnenfeld initially feigned denial. "When you're good, you're good," he said. "With these hands I've taken [my cataract surgery practice] to the next level." Later, however, the program re- ported finding a "video confession" in which Dr. Donnenfeld admitted: "My name is Eric Donnenfeld, and I use PEDs." The particular "PED" in question was the Catalys Precision Laser System (Abbott Medical Optics, AMO, Santa Ana, Calif.). Dr. Donnenfeld recorded the confession, he said in the video, because he came to the realization that he didn't care what others thought of his methods so long as he was doing what was best for his patients. Using the femtosecond laser to assist his cataract surgery, he said, up to 70% of cases did not even need any phacoemulsification to remove the lens and the entire procedure took on average less than 30 seconds. Among the laser system's features, Dr. Donnenfeld highlighted the water bath that serves as the laser's contact interface as one reason for its precision. The water bath means that the interface does not compress the cornea, allowing precise application of the femtosec- ond laser energy that lets every cataract surgeon "enter refractive surgery." "Precision is key to success with premium refractive cataract surgery," agreed Dr. Blecher. Pretending to report from the 2014 Sochi Winter Olympics, he compared femtosec- ond laser-assisted cataract surgery to luge. As with the luge racer, he said, a cataract surgeon achieves speed and the best outcomes through precision. The Catalys system, he said, can deliver that level of precision. In a subsequent segment of the program called "The Big Debate," Dr. Blecher and Dr. Donnenfeld offered pearls for a variety of situa- tions, including treatment planning, patient docking, intraoperative spikes in IOP, corneal interface folds, the performance of femtosecond laser-assisted cataract surgery, the question of using a Venturi or peristaltic pump, hard nuclei, small pupils, capsulotomy tags, postop eye redness, the question of where to put the laser, and how laser-assisted cataract surgery makes difficult cases easy. Among these situations, both of the doctors agreed that intraopera- tive IOP spikes, corneal interface folds, and capsulotomy tags were not a problem with the Catalys system. In the final segment of the program, Kerry K. Assil, MD, Santa Monica, Calif., offered some tips for how to deal with frequently seen scenarios with patients—patients who comment on the expense, who have done research on the internet and think they know exactly what they want or need, and who have already sought the opinion of other surgeons. In general, said Dr. Assil, "the mantra is to go with it"—agree with them initially and "peel them off slowly" from their beliefs. "As soon as you go with them, they soften up," he said. EW Editors' note: The program was sponsored by AMO. Sunday, April 27, 2014 Meeting Reporter "Friday Night [femto laser] Lights" by Chiles Aedam R. Samaniego EyeWorld AP Senior Staff Writer Eric D. Donnenfeld, MD, (right) explains his position on the use of "PEDs" to "Friday Night Lights at ASCRS" host Mark Carboni. Attendees enjoy cocktails in the lobby of the Citi Performing Arts Center's lavishly appointed Wang Theatre as they wait for the program to begin.

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