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5 EW SHOW DAILY ASCRS•ASOA Symposium & Congress, Los Angeles 2017 Honored continued from page 1 Connection continued from page 1 clear if it provides a value-added benefit, Dr. Herndon concluded. In another session focused on using microinvasive glaucoma surgery (MIGS) in cataract patients, Steven Mansberger, MD, Portland, Oregon, said some MIGS consid- erations include if the patient has early disease, has a target IOP in the early teens, is able to use eye med- ications, is willing to have another eye surgery, and if the procedure would be available at a lower cost to patients. "Our unmet need is figur- ing out which patients do best with MIGS," he said. In a talk that focused on neu- ro-ophthalmology and glaucoma, Mark Moster, MD, Philadelphia, pointed out that there are times when a glaucoma examination could also reveal signs of neurologic or neuro-ophthalmic conditions. Glaucoma specialists should be especially wary if a patient is young and has an abrupt change in visual acuity or a large disease progression. For further imaging analysis, an MRI is preferred, followed by a CT scan. Some surgeons have debated wheth- er all patients with normal tension glaucoma should have neuro-imag- ing. Although Dr. Moster thinks this is impractical, he does favor scan- ning patients with the aforemen- tioned red flags. Other morning sessions at Glaucoma Day focused on detecting glaucoma progression and structural and functional testing. For instance, newer approaches such as optical coherence tomography angiography, pattern electroretinography, anterior segment OCT, and aqueous angiog- raphy were discussed. EW Editors' note: Dr. Herndon has finan- cial interests with Alcon (Fort Worth, Texas), Glaukos (San Clemente, Cali- fornia), and other ophthalmic compa- nies. Dr. Lewis has financial interests with Aerie Pharmaceuticals (Irvine, California), Allergan (Dublin, Ireland), Glaukos, Ivantis (Irvine, California), and other ophthalmic companies. Dr. Mansberger has financial interests with Alcon, Allergan, and other ophthalmic companies. Dr. Moster has financial interests with Gensight (Paris, France). his internship at Good Samaritan Hospital in Phoenix. He completed his ophthalmology residency at the Kresge Eye Institute at Wayne State University in Detroit. Dr. Fry stays on the cutting edge of ophthalmic surgical technology by attending and giving lectures worldwide. Dr. Lee is the founder and chairman of Lee Eye Centre. He is currently the medical superinten- dent of Perak Community Specialist Hospital and a member of the Court of Examiners, College of Surgeons, Academy of Medicine, Malaysia. Dr. Lee is a recognized expert in cataract and anterior segment surgery, and he is renowned for his surgical innovations in the manage- ment of complicated cataracts. He has numerous scientific publications and has contributed book chapters in many reference text books. Specializing in phacoemul- sification, Dr. Lee has given 132 presentations on the subject and other related topics through vari- ous organizations including ASCRS, APACRS, Asia-Pacific Academy of Ophthalmology, and others. He has also served as an instructor of skills transfer courses, wet labs, and video symposia at these same organiza- tions. Dr. Lee is a fellow of the Inter- national Intraocular Implant Club, American Academy of Ophthal- mology, ASCRS, and is a founding member of APACRS. Currently, he is actively in- volved in clinical and academic work as he continues to travel wide- ly to share his expertise at numerous international ophthalmic conven- tions. The ASCRS Opening General Session will take place today from 10 a.m. to noon in lobby level, West Hall A of the convention center. EW Glaucoma Fighting Championship debate tackles question of 13 mm Hg or less I ke Ahmed, MD, Toronto, and Douglas Rhee, MD, Cleveland, were ready to rumble in the "mixed-weight" GFC—Glaucoma Fighting Championship—Friday over the topic: Should everyone be less than 13 mm Hg for target IOP? Dr. Ahmed stood in the red corner, debating in favor of a target IOP less than 13 mm Hg, while Dr. Rhee stood in the black corner, arguing against. "Twelve is the new 21," Dr. Ahmed said. "Twenty-one used to be the target many years ago. … Now the day has come where 12 should be the target." Why? "Glaucoma progression and blindness is still a problem today. Our current treatment modalities and our current [target] is not working," Dr. Ahmed said, going on to cite research that found a significant amount of glaucoma patients progressed over the duration of a study period, despite treatment. "Our current treatment guidelines and treatment targets are insufficient because our treated patients are still not doing well," he said. On the flip side, we know that lowering pressure helps, Dr. Ahmed said, referencing another study that found patients kept at a pressure of 12 do not progress, even those with advanced glaucoma. Next up was Dr. Rhee, who whipped off his dress shirt in true GFC fashion, wearing a shear tattooed shirt underneath. Does everybody need to be below 13 mm Hg? "I'm going to say to you, no way," Dr. Rhee said. Why? According to Dr. Rhee, not ev- eryone needs to be this low because below a certain point it probably doesn't matter, not to mention the cost. Dr. Rhee pointed to international consensus guidelines, specifical- ly calling out the Canadian Ophthalmological Society's as a particular dig to Dr. Ahmed, noting that "nowhere does it say IOP should be less than 13." Dr. Rhee also cited several studies that found a lower IOP does not correspond with a change in visual field, unless you had more than 10 decibels. In addition, Dr. Rhee said there is a cost in terms of finances, side effects, and complications when it comes to the proce- dures that he said would achieve these low IOPS, namely tubes and trabeculectomies. In the end, 171 audience members voted and Dr. Rhee won the GFC belt. Editors' note: Drs. Ahmed and Rhee have financial interests related to their comments. Ahmed vs. Rhee: Ophthalmologists face off on target IOP by Liz Hillman EyeWorld Staff Writer

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