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EW SHOW DAILY 3 ASCRS•ASOA SYMPOSIUM & CONGRESS, BOSTON 2014 ASCRS News Today by Vanessa Caceres EyeWorld Contributing Writer ASCRS Glaucoma Day celebrates 10th anniversary, tackles glaucoma's hot issues A SCRS Glaucoma Day celebrated its 10th anniversary in Boston with Reay Brown, MD, Atlanta, sharing how the meeting's attendance has nearly doubled since its inception. Glau- coma Day in 2005 had 245 atten- dees vs. 550 attendees last year, he said. In 2005, more of the meeting was devoted to medical therapy but in recent years, two-thirds of the sessions have focused on surgical approaches. Other highlights regarding the growth of Glaucoma Day in general and within ASCRS include the regular inclusion of a video compli- cations session and a cornea/cataract crossover talk, said Dr. Brown. Three ASCRS presidents have come from the Glaucoma Clinical Committee, he added. This year's ASCRS Binkhorst lecturer, Ike Ahmed, MD, Toronto, spoke at Glaucoma Day about the future of glaucoma surgery. In 5 years, he believes there will be five approved devices for microinvasive glaucoma surgery (MIGS). These devices will have synergies with drug delivery systems, all with the goal of achieving an even lower IOP than currently targeted on average. Some patients may have two MIGS procedures when medically neces- sary, and the MIGS devices that will be available will have three possible outflow targets. In 5 years, the tra- beculectomy will almost be retired, but tube shunts will continue to be used. Surgeons will continue to try to reduce medication use and per- form phacoemulsification when it can help lower IOP, Dr. Ahmed said. Glaucoma Day also featured ses- sions on imaging, including optical coherence tomography (OCT) pearls from Vikas Chopra, MD, Los Angeles. Surgeons should consider signal strength (aiming for at least a 7 out of 10), proper centration, and alignment when interpreting im- ages, he said. "Inserting artificial tears pretesting can help improve OCT image quality," Dr. Chopra said. OCT should not be used to make a diagnosis, Dr. Chopra said. "Any abnormality on OCT always requires a clinical correlation," he said. However, even with the growth of sophisticated imaging within glaucoma, surgeons will continue to need gonioscopy training and skills, said Brian Francis, MD, Los Angeles. Addressing the ever-growing interest in MIGS procedures, John Berdahl, MD, Sioux Falls, S.D., described his technique to insert the iStent trabecular micro-bypass (Glaukos, Laguna Hills, Calif.). Some of his pearls prior to insertion in- clude tilting the scope 30 degrees away from the surgeon, tilting the patient's head 30 degrees away, ad- justing the oculars, asking patients to look at their contralateral ear, applying the gonio lens and viscoelastic material, and obtaining an accurate focus. Turning toward regulatory and governmental challenges, Cynthia Mattox, MD, Boston, pointed out the many different ways that glaucoma specialists advocate for their patients and educate staff, col- leagues, and non-medical represen- tatives about the subspecialty. When advocating with government, Dr. Mattox recommended finding willing allies (including patients), understanding the structure of the governmental group you will speak with, and bringing challenging issues to light and repeating them when necessary. ASCRS 2014 Glaucoma Day also featured talks on the surgical management of angle closure glaucoma, medical and laser treat- ments, ab interno trabeculotomy, laser procedures, and video case pre- sentations. Thomas W. Samuelson, MD, Minneapolis, delivered the 2014 Stephen A. Obstbaum, MD, Honored Lecture on glaucoma management in what he called the "post-renaissance" era. EW Editors' note: Dr. Ahmed has financial interests with Abbott Medical Optics (AMO, Santa Ana, Calif.), Alcon (Fort Worth, Texas), Glaukos, and other ophthalmic companies. Dr. Berdahl has financial interests with Alcon, Bausch + Lomb (Rochester, N.Y.), Glaukos, and other ophthalmic compa- nies. Dr. Brown has financial interests with Glaukos, Ivantis (Irvine, Calif.), Transcend Medical (Menlo Park, Calif.), and other ophthalmic compa- nies. Dr. Chopra has financial interests with Allergan (Irvine, Calif.). Dr. Francis has financial interests with Allergan (Irvine, Calif.), Endo Optiks (Little Silver, N.J.), Merck (Whitehouse Station, N.J.), and other ophthalmic companies. Dr. Mattox has financial interests with Alcon, Allergan, and Transcend Medical. Thomas W. Samuelson, MD, delivered the 2014 Stephen A. Obstbaum, MD, Honored Lecture. Douglas Rhee, MD, presents him with the award. At the ASCRS•ASOA booth, attendees can select the information from the meeting that they want sent back to their office in PDF format. ASCRS•ASOA E-Resource Center

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