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EW SHOW DAILY
ASCRS•ASOA Symposium & Congress, San Diego 2015
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nies. Dr. Tanaka has financial interests
with Alcon and Allergan (Irvine, Calif.)
for incisions, more tightly sealed
wounds, less endothelial trauma,
and faster visual recovery. There is
also less ultrasound energy used,
as much as an 86% reduction per
recent studies, Dr. Donnenfeld said.
Although femtosecond laser
technology has great advantages
for glaucoma patients with mature
lenses or zonule weakness, surgeons
must also consider the effect of a
mild to moderate IOP elevation for 1
to 2 minutes, Dr. Donnenfeld added.
Choosing the right IOP
Surgeons want to know if there is an
ideal IOL to use in their glaucoma
patients with cataracts, although
the better question may actually
be which IOLs to avoid, said Alan
S. Crandall, MD, Salt Lake City.
"There is no perfect lens," he said.
In patients with pseudoexfolia-
tion syndrome or trauma, Dr.
Crandall recommends a spherical
rather than aspheric lens. He also
advised the use of a lens that the
surgeon is comfortable with and
that can be used in a zonule-friendly
way. However, he cautions against
the use of a multifocal IOL due to
contrast sensitivity issues and the
lack of long-term data.
When evaluating treatment
options for glaucoma patients
with concurrent cataracts, Steve
Sarkisian, MD, Oklahoma City,
advised discussing all possible op-
tions with patients, noting that the
best treatment option will depend
not only on IOP and how cupped
the nerve is but also patient occu-
pation and expectations. "Don't
assume you know what the patient
will want. Talk to them about their
options," he said.
Also during the session, Robert
Noecker, MD, New Haven, Conn.,
discussed combined cataract surgery
and endocyclophotocoagulation,
and Steve Kymes, PhD, St. Louis,
discussed the costs behind combined
treatment options. EW
Editors' note: Dr. Donnenfeld has
financial interests with Abbott Medical
Optics (Abbott Park, Ill.), Alcon
(Fort Worth, Texas), Bausch + Lomb
(Bridgewater, N.J.), and other oph-
thalmic companies. Dr. Sarkisian has
financial interests with Alcon, Endo
Optiks (Little Silver, N.J.), Glaukos
(Laguna Hills, Calif.), and other oph-
thalmic companies. Drs. Crandall and
Samuelson have financial interests with
Alcon, AqueSys (Aliso Viejo, Calif.),
Glaukos, and other ophthalmic compa-
