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EW SHOW DAILY 50 Monday, May 9, 2016 Meeting Reporter many different ways, including con- ducting manual, topography, and biometry. Using intraoperative guid- ance for positioning is not necessary, Dr. Garg said, but it can be helpful. Dr. Tipperman offered similar tips for patient selection when it comes to presbyopia-correcting IOLs, such as starting with healthy eyes, low levels of astigmatism, a desire for spectacle independence, and setting realistic expectations. The ideal patient has hyperopic refractive error, is a happy multifocal contact lens wearer or a blended/ monovision patient. Dr. Tipperman recommended that all biometry and topography be done before any topical drops are added to achieve the most accurate measurements and thus come closer to hitting your target refraction. The educational event conclud- ed with William Trattler, MD, Mi- ami, speaking about how surgeons can advocate to bring advanced technologies into their surgical cen- ters, while Dr. Tipperman presented on how to make premium IOLs eco- nomically attractive to patients. EW Editors' note: This event supported by educational grants from Abbott Medical Optics (Abbott Park, Illinois), Bausch + Lomb (Bridgewater, New Jersey), and i-Optics (The Hague, the Netherlands). by Liz Hillman EyeWorld Staff Writer they're not cooperating, and they're going to be fighting you, that's go- ing to make it more difficult because the laser is not going to work well if it's not docked," Dr. Mamalis said. The panelists also said choosing a patient with not too soft and not too hard of a cataract is beneficial as well for early laser-assisted cases. "We joke about the Goldilocks cataract—not too hard, not too soft, just right—so you really want to go with a 2+ nucleus. We've got a saying with our residents that soft is hard. What I mean by that is soft nuclei are difficult," Dr. Mamalis said. Sumit "Sam" Garg, MD, Irvine, California, presented on toric IOLs. When it comes to selecting a pa- tient, Dr. Garg said patients should have regular, moderate astigmatism and should have reasonable expec- tations. "I never say someone is going to be completely spectacle indepen- dent. I say they're going to be less spectacle dependent," he said. "They need to understand that a toric lens is not a multifocal lens, and I think if you take the time up front to explain that, it will mean less head- ache down the line." Measurements to select a toric IOL are key to a successful outcome, Dr. Garg said, adding that he thinks it's useful to measure the cornea in training was at least adequate, if not excessive. As for young eye surgeons' exposure to advanced technologies, Dr. Yeu said 41% of those surveyed felt their residency experience with toric IOLs was either somewhat or very inadequate. With regard to presbyopia-correcting IOLs, 51% rated their residency experience as either somewhat or very inadequate. Forty-one percent of respondents said they had performed 10 or fewer limbal relaxing incisions. "If we do not know how to per- form relaxing incisions—be it femto or manual—then we are not able to jump into becoming a refractive cataract surgeon because that is an essential component," Dr. Yeu said. When it comes to using a femtosecond laser, Dr. Yeu admitted that there are some nuances and a learning curve. She and her fellow speakers emphasized in particu- lar the importance of docking the patient correctly. Some of that can be affected by patient selection, the speakers said during a panel discus- sion. While the ideal patient is a straightforward case, you also want an "easy going" patient, as Richard Tipperman, MD, Bala Cynwyd, Pennsylvania, put it. "The most important step, in my mind, is the docking, and if you have someone who is a squeezer, Young eye surgeons learn the nuances of using laser, toric and presbyopia- correcting IOLs B efore the speakers at the "Young Eye Surgeons: Increasing Exposure to Laser-Assisted Cataract Surgery and Advanced Pre- mium IOLs for Successful Refractive Outcomes" began their presenta- tions, Nick Mamalis, MD, Salt Lake City, said he asked them what they still do now that they learned in residency. Answering this question himself as he stood at the podium for the EyeWorld CME Educational Sympo- sium, Dr. Mamalis said zero. "You don't stop learning after residency, so you need to keep up with your training," he said at the event sponsored by the ASCRS Young Eye Surgeons Clinical Com- mittee. According to the ASCRS Clin- ical Survey, Elizabeth Yeu, MD, Norfolk, Virginia, said young eye surgeons—residents, fellows, and those within their first 5 years of practice—reported performing less than 100 cataract surgeries annually, but about 90% felt their exposure to basic phacoemulsification in their How to effectively use and market premium technologies Dr. Mamalis moderates an EyeWorld event directed toward young eye surgeons about successfully using advanced technologies and premium IOLs in practice. Dr. Tipperman says that surgeons just starting to learn how to use the femtosecond laser in cataract surgery should pick patients who are "easy going" and present a straightforward surgical case.

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