Eyeworld Daily News

37 EW SHOW DAILY ASCRS•ASOA Symposium & Congress, New Orleans 2016 Indication LOTEMAX ® GEL (loteprednol etabonate ophthalmic gel) 0.5% is indicated for the treatment of post-operative infl ammation and pain following ocular surgery. Important Safety Information about LOTEMAX ® GEL • LOTEMAX ® GEL is contraindicated in most viral diseases of the cornea and conjunctiva including epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, and varicella, and also in mycobacterial infection of the eye and fungal diseases of ocular structures. • Prolonged use of corticosteroids may result in glaucoma with damage to the optic nerve, defects in visual acuity and fields of vision. If this product is used for 10 days or longer, IOP should be monitored. • Use of corticosteroids may result in posterior subcapsular cataract formation. • Use of steroids after cataract surgery may delay healing and increase the incidence of bleb formation and occurrence of perforations in those with diseases causing corneal and scleral thinning. The initial prescription and renewal of the medication order should be made by a physician only after examination of the patient with the aid of magnification, and where appropriate, fluorescein staining. • Prolonged use of corticosteroids may suppress the host response and thus increase the hazard of secondary ocular infection. In acute purulent conditions, steroids may mask infection or enhance existing infection. • Use of a corticosteroid medication in the treatment of patients with a history of herpes simplex requires great caution. Use of ocular steroids may prolong the course and exacerbate the severity of many viral infections of the eye (including herpes simplex). • Fungal infections of the cornea are particularly prone to develop coincidentally with long-term local steroid application. Fungus invasion must be considered in any persistent corneal ulceration where a steroid has been used or is in use. • Patients should not wear contact lenses when using LOTEMAX ® GEL. • The most common ocular adverse drug reactions reported were anterior chamber inflammation (5%), eye pain (2%) and foreign body sensation (2%). Please see brief summary of Prescribing Information on adjacent page. ®/™ are trademarks of Bausch & Lomb Incorporated or its a liates. © 2015 Bausch & Lomb Incorporated. All rights reserved. Printed in USA. US/LGX/15/0041(1) Down, Boy. Help Tame Postoperative Ocular Inflammation and Pain With LOTEMAX ® GEL measurements are unclear. "If there is a 10-degree difference in axis and a more than 0.5 D difference in cylinder, hold on or repeat the measurements," he advised. Surgeons should also consider patients' tear film quality, the pros and cons of their measurement devices, and the ability of the office technicians to obtain good measure- ments. Dr. Berdahl addressed the strengths of various calculators used for astigmatism and said that he uses the Barrett Toric Calculator, which is available on the ASCRS website. Surgeons can become more con- fident managing astigmatism with the use of better measurement tools to account for surgically induced astigmatism (SIA) as well as posterior corneal astigmatism, said Douglas D. Koch, MD, Houston. One pearl to consider: Account for SIA. Until a few years ago, even some of the physician leaders in cataract surgery were measuring SIA wrong, Dr. Koch said. The current benchmark is for incisions less than or equal to 2.4 mm, consider 0.1 D of SIA, he advised. Another pearl Dr. Koch shared: If you're unsure how much to correct based on the measurements you're getting, hold off until you see the postop results. If you explain to patients why you're waiting, they will be appreciative, Dr. Koch said. Surgeons should also account for posterior corneal astigmatism, said Dr. Koch, who has pioneered research in that area. The use of Scheimpflug imaging and optical coherence tomography can help measure posterior astigmatism. The Barrett Toric Calculator will measure it as well. Optimal refractive targets with the use of toric IOLs were the focus of a talk from John Vukich, MD, Madison, Wisconsin. He shared some potential causes of residual astigmatism, including a wrong loca- tion (due to poor axis measurements or IOL rotation), a wrong lens, and ocular surface disease. Surgeons can use the site astigmatismfix.com, developed by Dr. Berdahl and David Hardten, MD, to find a recommend- ed adjustment, Dr. Vukich said. This event is part of a new initiative from ASCRS and EyeWorld called 365 Curriculum that will fo- cus on astigmatism management for 12 months. EW Editors' note: This event was support- ed by educational grants from Abbott Medical Optics (Abbott Park, Illinois) and Alcon (Fort Worth, Texas).

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