DOCSLIB.ORG

Subjective Quality of Vision

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Subjective Quality of Vision LETTERS TO THE EDITOR Subjective Quality of Vision Colm McAlinden, PhD Jyoti Khadka, PhD To the Editor: Konrad Pesudovs, PhD We read with interest the study by Sia et al,1 which Bedford Park, South Australia appeared in the January 2012 issue of the Journal of Eirini Skiadaresi, MD Refractive Surgery, comparing epi-LASIK and photore- Swansea, United Kingdom fractive keratectomy, particularly with regards to the questionnaire used to assess quality of vision. The The authors have no proprietary interest in the materials presented questionnaire consisted of a 10-point scale ranging herein. from 1 (no symptoms) to 10 (severe, disabling symp- toms). The results found the subjective optical quality REFERENCES was the same between the two procedures for vision 1. Sia RK, Coe CD, Edwards JD, Ryan DS, Bower KS. Visual out- fl uctuations, double vision, glare, light sensitivity, comes after epi-LASIK and PRK for low and moderate myopia. J Refract Surg. 2012;28(1):65-71. halos, starbursts, patient satisfaction, postoperative 2. Thomee R, Grimby G, Wright BD, Linacre JM. Rasch analysis of vision quality, and the chance to have the procedure Visual Analog Scale measurements before and after treatment again. of Patellofemoral Pain Syndrome in women. Scand J Rehabil Med. We would like to propose that a potential reason 1995;27(3):145-151. why no difference was found between the two proce- 3. Pesudovs K, Noble BA. Improving subjective scaling of pain dures is the quality of the questionnaire, which has a using Rasch analysis. J Pain. 2005;6(9):630-636. number of fl aws. First, with 10 response options per 4. Pesudovs K, Burr JM, Harley C, Elliott DB. The development, assessment, and selection of questionnaires. Optom Vis Sci. question, it is unlikely that respondents will be able 2007;84(8):663-674. to adequately differentiate 10 levels for each ques- 5. Schallhorn SC, Kaupp SE, Tanzer DJ, Tidwell J, Laurent J, tion, which will introduce error.2 Respondents typi- Bourque LB. Pupil size and quality of vision after LASIK. cally use only 4 or 5 categories.3 Second, with ordinal Ophthalmology. 2003;110(8):1606-1614. response options (1, 2, 3…etc), the differences be- 6. McAlinden C, Pesudovs K, Moore JE. The development of an in- strument to measure quality of vision: the Quality of Vision (QoV) tween each response may be unequal. Using a Rasch- questionnaire. Invest Ophthalmol Vis Sci. 2010;51(11):5537-5545. scaled questionnaire would overcome this issue, as 7. McAlinden C, Skiadaresi E, Pesudovs K, Moore JE. Quality of it provides a linear-estimated measure with a known vision after myopic and hyperopic laser-assisted subepithelial step size between each response. Additional benefi ts keratectomy. J Cataract Refract Surg. 2011;37(6):1097-1100. of Rasch analysis in the context of questionnaire de- velopment and scoring are described elsewhere.4 Third, the questions asked may not represent the full Reply: extent of potential quality of vision symptoms. Poten- We thank McAlinden and coauthors for their in- tial questions should be derived from existing ques- terest in our article1 and we are eager to discuss their tionnaires, literature reviews, focus groups, and pa- concerns regarding the fi ndings of our study. McAlin- tient interviews. Lastly, the authors cited a study by den et al believe that the reason we did not fi nd a sig- Schallhorn et al5 after the description of their ques- nifi cant difference in postoperative subjective optical tionnaire, presumably to indicate they used the same quality (eg, vision fl uctuations, double vision, glare, questionnaire. However, the description does not ap- light sensitivity, halos, starbursts, patient satisfaction, pear to match the questionnaire used in the Schall- postoperative vision quality, and the chance to have horn et al study. the procedure again) and patient satisfaction was be- We would encourage researchers wishing to in- cause of the inadequate quality of the questionnaire. vestigate subjective quality of vision in future stud- We respectfully disagree with these assertions and ap- ies to apply a validated questionnaire scored using preciate the opportunity to address them sequentially. Rasch analysis, such as the Quality of Vision (QoV) First, McAlinden et al believe the number of points questionnaire.6,7 This questionnaire consists of 10 that comprised our Likert scale (10) was in fact too questions and measures quality of vision with simu- many, patients could not adequately differentiate 10 lation photographs across the three scales: symptom levels for each question, and that ideally we should frequency, severity, and bothersome nature. The QoV have used 4 to 5 categories. We disagree with this as- questionnaire has been shown to be highly sensitive sertion for several reasons. The literature is rich with to changes in quality of vision that occur over time authors who claim that a Likert scale should consist after surface ablation6 and would have ideally suited of various X number of points.2 In the end, it depends the Sia et al study. on the goals of the study, the scientifi c question, and Journal of Refractive Surgery • Vol. 28, No. 5, 2012 313 Letters to the Editor Rose K. Sia, MD the sample subjects. Our main concern entering the Charles D. Coe, PhD study was distinguishing between two similar sur- Denise S. Ryan, MS gical procedures. By confi ning the possible alterna- Washington, DC tives to 4 or 5 categories, a signifi cant loss of statis- Jayson D. Edwards, MD tical power may occur, and an inability to show a Jacksonville, Florida signifi cant difference when one exists would result. Kraig S. Bower, MD With the large number of patients in our study, we Baltimore, Maryland believed variability would be benefi cial, providing a more accurate refl ection of our patients’ subjec- The authors have no financial interest in the materials presented herein. tive assessments. The large (N) in our study would The views expressed in this letter are those of the authors and do not then result in much smaller standard deviations (SD), reflect the official policy of the Department of Army/Navy/Air Force, critical when determining statistical signifi cance. Department of Defense, or U.S. Government. Finally, we believed the large number of points of our Likert scales without an associated description REFERENCES for each point approximated a continuous variable 1. Sia RK, Coe CD, Edwards JD, Ryan DS, Bower KS. Visual out- and negating one of the hallmark criticisms of ordinal comes after epi-LASIK and PRK for low and moderate myopia. J Refract Surg. 2012;28(1):65-71. data. We would like to point out that McAlinden et 2. Cox EP. The optimal number of response alternatives for a al, using the instrument that they developed in their scale: a review. J Marketing Res. 1980;17(4):407-422. 3 previous study, a comparison between hyperopic 3. McAlinden C, Pesudovs K, Moore JE. The development of an in- and myopic laser-assisted subepithelial keratectomy strument to measure quality of vision: the Quality of Vision (QoV) utilizing their Rasch-scaled Quality of Vision (QoV) questionnaire. Invest Ophthalmol Vis Sci. 2010;51(11):5537-5545. questionnaire, did not fi nd a signifi cant difference 4. McAlinden C, Skiadaresi E, Pesudovs K, Moore JE. Quality of either.4 There is a much greater difference in surgical vision after myopic and hyperopic laser-assisted subepithelial keratectomy. J Cataract Refract Surg. 2011;37(6):1097-1100. technique, ablation profi le, and refractive correction 5. Schallhorn SC, Kaupp SE, Tanzer DJ, Tidwell J, Laurent J, between these two surgical procedures (hyperopic Bourque LB. Pupil size and quality of vision after LASIK. and myopic LASEK) than in myopic epi-LASIK and Ophthalmology. 2003;110(8):1606-1614. photorefractive keratectomy. 6. Bourque LB, Kaupp SE, Riopelle D, Pangelinan C Schallhorn Second, the instrument we used was derived from SC. Characteristics of PRK patients pre- and post-surgery: the 5 U.S. Navy Aviation Retention Study [ARVO abstract, poster the questionnaire used by Schallhorn et al. At the 2646]. Invest Ophthalmol Vis Sci. 2001. time our study was done, the questionnaire scale 7. Hays RD, Morales LS, Reise SP. Item response theory and structure had been examined and refi ned to include health outcomes measurement in the 21st century. Med Care. questions that were considered most relevant and to 2000;38(9 Suppl):II28-II42. which statistical analysis of responses had the greatest 6 correlation to associated clinical fi ndings. Although IOL Scaffold Technique for Posterior respondents typically use only 4 or 5 categories, the change from the 5-point ordinal rating scale to a Capsule Rupture VIDEO Video available on 10-point scale more closely approximates an interval To the Editor: www.Healio.com/JRS scale. Also, the scale was assumed to be a multidimen- We present a new technique called “IOL scaffold” sional scale. The Rasch model works only with ordi- to prevent nucleus drop without extending the origi- nal variables and is restricted by defi nition to a single nal corneal incision. We used a three-piece foldable dimension.7 The instrument we used was also shown intraocular lens (IOL) as a “scaffold” for preventing the to be reliable by a high level of internal consistency, nucleus drop in soft to moderate nucleus after poste- and Cronbach’s ␣-coeffi cients were approximately rior capsular rupture (PCR). 0.8 (PRK: μ=0.78, SD=0.05, range=0.74 to 0.83; epi- When PCR occurs, anterior vitrectomy is performed LASIK: μ=0.80, SD=0.04, range=0.76 to 0.86). Rasch- through the main port with the vitrectomy cutter. A scaled questionnaire, such as the QoV, may be highly viscoelastic substance is injected into the anterior sensitive to changes in quality of vision over time in a chamber and the nuclear fragments are brought into within-group comparison; however, it might not offer the anterior chamber.
Load more

Recommended publications
  • Visually Significant Traumatic Cataract
    CATARACT SURGERY COMPLEX CASE MANAGEMENT Section Editors: Thomas A. Oetting, MS, MD; Tal Raviv, MD; and Audrey R. Talley Rostov, MD eyetube.net Visually Significant Traumatic Cataract BY PRIYA NARANG, MS; AMAR AGARWAL, MS, FRCS, FRCOPHTH; H. BURKHARD DICK, MD, PHD; TIM SCHULTZ, MD; RICHARD J. MACKOOL, MD; RICHARD J. MACKOOL JR, MD; AND TAL RAVIV, MD CASE PRESENTATION A 50-year-old man presents with a visually significant (Courtesy of Priya Narang, MS, and Amar Agarwal, FRCS, FRCOphth.) traumatic cataract (following blunt trauma 5 years ago). About 7 clock hours of zonular loss (Figure 1) and phaco- donesis are present. Small wisps of vitreous are visible at the edge of the lens. How would you approach this case? —Case prepared by Tal Raviv, MD. (Courtesy of Tal Raviv, MD.) Figure 2. The design of the glued ECR and its positioning in the direction of dialysis. the hemi-ring segment portion and are designed to sit Figure 1. A traumatic cataract with 7 clock hours of zonu- within the fornix of the capsular bag. The scrolls engage lar loss and mild vitreous prolapse in a young patient. the margin of the capsulorhexis, and the haptic anchors the entire bag transsclerally (Figure 2). Once the scrolls PRIYA NARANG, MS, AND have engaged the capsulorhexis’ margin, pulling on the AMAR AGARWAL, MS, FRCS, FRCOPHTH exteriorized haptic centers the entire capsular bag com- Figure 1 shows traumatic subluxation of the lens with plex. Phacoemulsification then commences. The choice 7 clock hours of zonular loss. The clinical picture is sug- and positioning of the IOL depend on the degree and gestive of phacodonesis, and small wisps of vitreous are location of zonular disruption.
    [Show full text]
  • Multifocal Intraocular Lens Exchange in Patients with Ocular Comorbidities: Indications and Outcomes
    Multifocal Intraocular Lens Exchange in Patients with Ocular Comorbidities: Indications and Outcomes Brian Kenny Armstrong ( [email protected] ) Cleveland Clinic Abu Dhabi https://orcid.org/0000-0001-6337-6265 Jason Goldsmith Cleveland Clinic Abu Dhabi Terrence Lee St John Cleveland Clinic Abu Dhabi Samuel Navon Cleveland Clinic Abu Dhabi Research Article Keywords: multifocal IOL intolerance, trifocal IOLs, IOL exchange, ocular comorbidities, patient dissatisfaction Posted Date: March 13th, 2021 DOI: https://doi.org/10.21203/rs.3.rs-284924/v1 License: This work is licensed under a Creative Commons Attribution 4.0 International License. Read Full License Page 1/10 Abstract Purpose: To investigate all cases of multifocal intraocular lens (MFIOL) exchange, with specic focus on indications for exchange and evaluation of postoperative outcomes, in a tertiary care, multi-specialty ophthalmology practice. Setting/Venue: Academic Referral Center/Cleveland Clinic Abu Dhabi – Abu Dhabi, United Arab Emirates Methods: This retrospective case series identied all patients that presented to a large academic practice over a 4-year period that were intolerant to MFIOL technology and thus required intraocular lens (IOL) exchange. All patients reported poor vision despite correction of reversible ocular comorbidities, including dry eye and residual refractive error. Outcomes reviewed include subjective visual complaints, IOL-type, visual acuity, refractive error, ocular comorbidities, and surgical outcomes. Endpoints examined include mean uncorrected distance visual acuity (UDVA), mean corrected distance visual acuity (CDVA), mean refractive spherical equivalent (MRSE), and residual refractive astigmatism. Results: Six eyes of ve patients required MFIOL exchange. All IOL’s exchanged were trifocal IOL’s. IOL exchange occurred between 6 to 72 months following primary phacoemulsication.
    [Show full text]
  • 44 • M a R C H 2 0
    44 • MARCH 2018 Cataract Complications Eight difficult cases that require complex management decisions. HIS PAST NOVEMBER, THE 16TH ANNUAL SPOTLIGHT ON CATARACT SURGERY Symposium at AAO 2017 was entitled “Clinical Decision-Making With Cataract Complications: TYou Make the Call.” Cochaired by Mitchell P. Weikert, MD, and myself, this 4-hour symposium was organized around 8 video cases that presented a range of cataract surgical challenges and complications. The 8 cases were selected from my own practice. As I presented the videos, I would pause at selected points to note a complication or introduce the need to make a management decision. The attendees were then asked to make clinical decisions using their electronic audience response keypads. This was followed by several rapid-fire didactic presentations by invited experts on topics of relevance to the case. Next, a rotating panel of 2 discussants (who had never viewed the case) was asked to make a manage- ment recommendation before the video of the outcome was shown. Following additional audience polling about preferences and practices, the 2 panelists would provide their own opinions and pearls. In all, nearly 40 presenters and panelists spoke about a wide variety of topics, including managing a postvitrectomy cataract, posterior capsular rupture in a multifocal or toric IOL patient, traumatic cataracts, ultrabrunescent cataracts, small pupils, crowded anterior segments, unhappy multifocal IOL patients, iris prolapse, traumatic iris defects, and retained cortex. Alan S. Crandall, MD, concluded the symposium by delivering the 13th annual Academy Charles D. Kelman Lecture, “Phaco at 50: The Collision of Cataract and Glaucoma (Plus).” This EyeNet article reports the results of the 35 audience response questions, accompanied by written commentary from the symposium speakers and panelists.
    [Show full text]
  • IOL Scaffold in Phacoemulsification to Prevent Posterior Capsule Tear
    Title: IOL scaffold in phacoemulsification to prevent posterior capsule tear. 1 Dr. Ashraful Huq Ridoy, 2 Dr. Niaz Abdur Rahman 3 Dr. Mahziba Rahman Chowdhury, 4 Dr. Syeed Mehbub Ul Kadir, 5 Dr. Mahbubur Rahman Chowdhury Purpose – To prevent posterior capsule tear and evaluate the post-operative outcomes of phacoemulsification with IOL scaffold technique. Design – Single-center, prospective, interventional, non-comparative, consecutive case series. Materials and Methods – A total of 17 eyes of 17 patients with morgagnian (04 eyes) and hard (nuclear sclerosis grade – IV of 13 eyes) cataract who had undergone phacoemulsification with IOL scaffold technique to prevent posterior capsule tear in a tertiary clinic. All surgeries were performed by a single surgeon. 6.0 mm optic, acrylic, foldable IOL was implanted in all eyes. The pre- operative and post-operative parameters evaluated were uncorrected distance visual acuity, corrected distance visual acuity, cornea status, intraocular pressure and anterior segment inflammation. Results – Posterior capsule tear were prevented in all eyes. At 1-month follow- up, a significant improvement was noted in uncorrected distance visual acuity post-operatively (P-value <0.0001) and 6/6 visual acuity achieved in 71% eyes. Corrected visual acuity 6/6 achieved in 18% eyes. Mean post-operative IOP at 1-day and 1-month follow-up without any medication were 12.79 mmHg and 13.06 mmHg respectively. Immediate post-operative grade-2 anterior segment reaction (02 eyes) and minimal corneal edema (03 eyes) noted which were resolved by 1-month. Conclusion - IOL scaffold provides a safe and effective way to prevent posterior capsule tear in phacoemulsification of morgagnian and hard cataracts, with a good visual outcome.
    [Show full text]
  • Glued IOL Scaffold Technique
    TACKLING POSTERIOR CAPSULE RUPTURE AND IOL IMPLANTATION: A VIDEO BASED COURSE MONDAY - 20 th APRIL, 2015: 10.00 AM-11.30 AM, SD CC, ROOM 6 F ; SESSION 20-202 COURSE DESCRIPTION BASIC FUNDAMENTALS Early recognition and management of PC rupture is a key to prevent the sequential complications which can trail and have an adverse effect on the visual output. The following signs should be watched upon for early recognition of a PC rupture. • Sudden deepening of anterior chamber with momentary dilation of pupil • Sudden transitory appearance of red reflex • Difficulty in rotating a previously mobile nucleus • Undue tilting of one pole of nucleus …THE COURSE WILL HIGHLIGHT THE METHODS OF HANDLING POSTERIOR CAPSULE (PC) RUPTURE, ITS EFFECTIVE MANAGEMENT AND VARIOUS MODALITIES OF IOL IMPLANTATION. MANAGEMENT PROTOCOL OF PC BASICS RUPTURE AND IOL IMPLANTATION • In the context of a ruptured posterior capsule, the immediate reflex • Lower down phaco parameters action to be deterred on behalf of the surgeon is to withdraw the • Low flow rate phacoemulsification probe suddenly from the eye. A dispersive OVD from the side port incision should be used to plug-in the posterior • Moderate vacuum capsule defect and fill and stabilise the anterior chamber followed by withdrawal of the phacoemulsification probe. • Low to moderate phaco burst energy to promote • The posterior capsule rupture when small is converted into a posterior capsulorhexis with stable margin facilitating the follow ability implantation of a one piece foldable acrylic IOL in the capsular bag. But if the capsular rupture opening is large, sulcus fixation of an IOL is preferable in cases with adequate anterior capsular margin support.
    [Show full text]
  • IIRSI 2015 Brochure Inside Pages
    SCIENTIFIC PROGRAM 3 OCTOBER, 2015 HALL A HALL B HALL C HALL D HALL E HALL F Phaco Panorama-1 Phaco Fundamentals LASIK Lessons IOL Issues Wet Lab (8 am-9:30 am) Cataract-Back 2 the (8 am-10 am) (8 am-10 am) (8 am-10:30 am) (8 am-10 am) Basics (8 am-10:30 am) Phaco Panorama-2 Premium IOL Pointers Women in Ophthalmology Cornea Callisthenics Wet Lab (9:30 am-11 am) (10 am-11:30 am) (10 am-11:30 am) (10:30 am-12:45 pm) (10 am-11:30 am) Cataract-Advancing The Femtorevoluon Techniques &Technology Phaco Fears & Tears Kracking Keratoconus Ophthalmology 20/30- Wet Lab in Cataract Surgery Exploring the Future (10:30 am-1:30 pm) (11:30 am-1:30 pm) (11:30 am-1:30 pm) (11:30 am-1:30 pm) (11 am-1:30 pm) (12:45 pm-1:30 pm) LUNCH BREAK Tips & Tricks Free Papers I: Free Papers II: Cornea & Wet Lab Live Surgery and Inauguraon Cataract & IOL Refracve Surgery (2 pm-6 pm) (2 pm-5 pm) (2 pm-6 pm) (2 pm-6 pm) (2 pm-6 pm) 4 OCTOBER, 2015 HALL A HALL B HALL C HALL D HALL E HALL F The Femto Revoluon in Refracve Surgery-Back 2 the Rena Revisited Phaco Phobia Phakic IOL & (8 am-10 am) Presbyopia Refracve Surgery (8 am-10 am) Basics (8 am-10:30 am) (8 am-10:20 am) (8 am-10 am) New Technology IOLs- Learn from Eye Quest- The Quiz IOL in scky situaons Phaco Fights Cornea Corner the Masters (10 am-12 noon) (10:30 am-12 noon) (10:20 am-12 noon) (10 am-12 noon) (10 am-12 noon) Snags & Soluons OPL (12 noon-1:45 pm) OPL (12 noon-1:45 pm) Mixed Bag (12 noon-2 pm) (12 noon-2 pm) LUNCH BREAK A to Z of Phaco in your Court Maral in Ophthalmology Invenng the Future- Innovaons
    [Show full text]
  • Management of Posterior Capsular Tear
    Dr. Harbansh Lal Hony. Treasurer AIOS Co-Chairman, Dept. of Ophthalmology, Sir Ganga Ram Hospital, Delhi Director, Delhi Eye Centre Email: [email protected] Mob: 9810239206 All India Ophthalmological Society Office Bearers PRESIDENT Dr. Anita Panda PRESIDENT ELECT Dr. Quresh B. Maskati VICE PRESIDENT Dr. Debasish Bhattacharya HONY. GENERAL SECRETARY Dr. Lalit Verma JOINT SECRETARY Dr. Sambasiva Rao V. HONY. TREASURER Dr. Harbansh Lal JOINT TREASURER Dr. Ruchi Goel EDITOR - JOURNAL Dr. S. Natarajan EDITOR PROCEEDINGS Dr. Samar Kumar Basak CHAIRMAN SCIENTIFIC COMMITTEE Dr. D. Ramamurthy CHAIRMAN - ARC Dr. Ajit Babu Majji IMMEDIATE PAST PRESIDENT Dr. N.S.D. Raju Posterior capsular tear or PCT is one of the disastrous complications of cataract surgery. Although common in the learning stages, it can occur even in the hands of experienced surgeons – specially if they are in hurry or overconfident. The situation does create panic in the mind of operating surgeon – the surgeon sometimes tends to do lot of unwarranted steps. If not managed properly, the outcome can be disastrous for the eye; however, if managed properly the results can be quite rewarding. This booklet by Dr. Harbansh Lal, one of the pioneers of Cataract Surgery, describes in a very lucid and practical way the do’s & don’ts of PCR. Complications do happen in the best of hands but the true competence of a surgeon is judged by how he handles complications. I am sure this masterpiece by Dr Harbansh Lal will help everyone. Dr. Anita Panda President, AIOS All India Ophthalmological Society (Academic & Research Committee) Chairman Dr. Ajit Babu Majji Medical Director, Centre for Sight Ashoka Capitol Building, Road # 2, Banjara Hills, Hyderabad - 500 034 Ph: 040-40045500 Mobile: 09391026292 E-mail: [email protected] Members Dr.
    [Show full text]
  • Prevention, Management of Subluxated Crystalline Lenses and Iols Glued Endocapsular Ring, Glued IOL, and IOL Scaffold Techniques May Address These Issues
    CATARACT SURGERY BONUS FEATURE Prevention, Management of Subluxated Crystalline Lenses and IOLs Glued endocapsular ring, glued IOL, and IOL scaffold techniques may address these issues. BY SOOSAN JACOB, MS, FRCS, DNB; AND AMAR AGARWAL, MS, FRCS, FRCOPHTH n cataract surgery, avoiding subluxation or enlarge- frank dialysis has not yet occurred. The endocapsular ment of an existing subluxation of the crystalline lens is ring expands and stabilizes the capsular bag during of prime importance. Similarly, intra- or postoperative cataract surgery. It creates centrifugal forces that result subluxation of an IOL is a complication that all sur- in redistribution from stronger to weaker areas. The Igeons wish to avoid. Basic principles in pre- and intraop- endocapsular ring also makes the capsule taut and gives erative planning can help greatly to minimize the risk of counter-traction to all traction maneuvers. The surgeon these events and to manage them if they occur. may opt to place capsular hooks initially to stabilize Preoperatively, factors that can predispose a patient the bag and then implant the endocapsular ring after to intraoperative subluxation should be evaluated and cortex aspiration. dealt with appropriately. These include conditions that If, despite these precautions, subluxation does occur, convey zonular weakness, such as pseudoexfoliation, it should be managed according to the degree of zonular trauma, Marfan syndrome, ectopia lentis, hypermature dialysis. Smaller subluxations (up to 3 or 4 clock hours) cataract, high myopia, megalophthalmos, postvitrectomy can be managed by inserting an endocapsular ring. Larger status, and any other cause of preoperative phacodonesis. subluxations require scleral anchoring of the capsular bag Additionally, any cataract that is expected to entail difficult and its contents; we prefer to do this through the use of and complicated surgery can lead to an increased risk of a glued endocapsular ring.
    [Show full text]
  • 1-10-14 CSEP Program.Pdf
    Eye M.D. Education Mission Statement: We are committed to advancing the highest standards of eye care through continuing education activities. The CSEP Semi-annual Scientific Education Programs arededicated to improving and protecting our patient’s vision and eye health by presenting advances in the diagnosis and treatment of eye disease. Our target audience includes ophthalmologists and their staff, including office managers and technicians. Activities range from didactic lectures to participatory activities, and whenever possible are approved for CME credit. We expect that our audience will incorporate best practices, as presented, into their daily practice. Specific competency, performance and patient outcome goals that will result from the program will be proposed by the presenters and evaluated by the participants. The CSEP Annual Scientific Education Programs are an opportunity for ophthalmologists to identify and discuss critical issues facing their profession. These programs are designed to present recent advances in the diagnosis and treatment of eye disease, offer - ing symposia, scientific papers and videos. The CSEP programs are designed to meet the clinical and ed - ucational needs of its members and the objectives set forth by the CSEP education committee. Vincent deLuise, M.D. CSEP Education Chair SPECIAL ACKNOWLEDGMENT AND THANKS to our Sponsors TITANIUM Genentech Regeneron PLATINUM Alcon Laboratories Allergan GOLD McLeod Optical Company Precision Optical Company SILVER Carl Zeiss Medical Connecticut State Library for the Blind & Physically Handicapped Diopsys, Inc. Eaglevision and Rhein Medical Eye Formatics SILVER (cont’d) EyeMD EMR Healthcare Systems, Inc. Fallon Wellness Pharmacy Glaukos Heidelberg Engineering Hoya Vision Care ifa united i-tech, Inc. IOP Ophthalmic0 Lion Low Vision Center Marco MEDENT Mobius Therapeutics, LLC MST (Micro Surgical Technology) New World Medical, Inc.
    [Show full text]
  • Cataract Surgical Complications
    Cataract Surgical Complications Eighteen cases cover the full spectrum of surgical complications, from the common to the rare—and from the spectacular save to the demoralizing outcome. HIS PAST OCTOBER, THE 17TH ANNUAL SPOTLIGHT ON CATARACT SURGERY SYM- posium at AAO 2018 was entitled “Pressure Cooker: Managing Nerve-racking Complications.” TCochaired by Mitchell P. Weikert, MD, and myself, this four-hour case-based video symposium focused on cataract and IOL surgical complications. Even the very best cataract surgeons suffer complications that challenge us to react, think, and operate under pressure. How and what we learn from our mistakes makes us better ophthalmologists. For this symposium, 18 cataract experts presented stressful cases in which something went wrong, with complications that tested their skills, decision-making, and nerves. What did they learn, and what would they do differently? At critical decision points during the case, the video was paused, and the attendees were asked to make clinical decisions using electronic audience response pads. Next, two discussants (who had never viewed the case) were asked to make their own management recommendations and to comment on the audience responses before the video of the outcome was shown. The audience voted for the best teaching cases and for those surgeons who displayed the most courage, both in the OR and at the podium. Complications included anterior capsule tears (with and without posterior capsular extension), implantation of the wrong IOL, intraocular bleeding, haptic misadventures and subluxated IOLs, iris prolapse and iatrogenic iridodialysis, aqueous misdirection, suprachoroidal hemorrhage, descending nuclei and IOLs, IOL exchange complications, and capsules or zonules torn at virtually every stage of surgery.
    [Show full text]
  • Dr Ashvin Agarwal
    DR ASHVIN AGARWAL WORK TITLE Executive Director Chief Clinical Officer & Chairman of Clinical Board @ Dr. Agarwal’s Eye Hospital INTERNATIONAL COMMITTEE POSITIONS EyeConnect International – Co founder ISRS Webinar Task Force Chair 222, TTK Road, Alwarpet, ISRS Cataract Refractive committee member Chennai – 600018, India AAO ONE Network Member PROFILE +91 94450 21736 After completing his med school and post-graduation in ophthalmology, Ashvin gave his International Council of [email protected] Ophthalmology - ICO Part 1. He then worked with in Bascom Palmer Institute, Miami, Florida & Price Vision Group, Indianapolis. Trained in Refractive and Corneal Surgeries. Headed back to Dr Agarwal eye hospital Chennai, India. Worked in cataract division and had been www.drashvinagarwal.com working ever Since then he has been practicing at Dr. Agarwal’s Eye Hospital till date and is the Managing Director of Orbit Healthcare Pvt Ltd. Dr. Ashvin has performed over 15000 surgeries so far. He EDUCATIONAL QUALIFICATIONS specializes in a niche segment of complex Cataract care M.B.,B.S. - (April 2007) management, Corneal refractive surgeries and anterior segment R.Ramaiah Medical College, Bangalore repair procedures. M.S. Ophthalmology - (Apr 2010) He is the Chief clinical officer of Dr. Agarwal’s eye hospitals group Rajah Muthiah Medical College, which have over 95 locations globally, he takes strategic & Raja Annamalai Nagar, Chidambaram administrative decisions towards sustenance and clinical quality across the group. ORGANIZING EVENTS World Webinar on Cataract and Refractive Surgery – Co Founder IIRSI – Organizer since 2011 Rising Stars in Ophthalmology – Co Founder HOBBIES RETICON - Programme director since 2014 Reading, Swimming, Squash, Dr. Agarwal’s Grand Rounds – Organizer, Monthly Since 2018 Cricket, Tennis & Watching Movies.
    [Show full text]