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Perfection Achieved (But Nobody Seems to Care)

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Perfection Achieved (But Nobody Seems to Care) FEBRUARY 2018 # 18 Upfront In My View In Practice Sitting Down With Statins for PTA for post-LASIK SICS - another feather Walter Sekundo, vitrectomy surgery ectasia: pro and con in your cap? a.k.a., Mr. SMILE 12 14 – 17 28 – 32 48 – 50 Perfection Achieved (but Nobody Seems to Care) There’s a gold-standard procedure for pterygium surgery, so why are people ignoring it? 18–25 NORTH AMERICA www.theophthalmologist.com 100 MILLION IMPLANTED WORLDWIDE Only MOMENTS MADE. withAcrySof Thanks to you, AcrySof ® IOLs have created more memories than any other lens. Over the last 25 years, the AcrySof®SRUWIROLRRIPRQRIRFDOWRULFDQGPXOWLIRFDOΖ2/VKDVEHHQFKRVHQZLWKFRQȴGHQFH Ask your Alcon representative what makes AcrySof® the most implanted lens in the world*. $OFRQGDWDRQȴOH © 2017 Novartis 10/17 US-ACR-17-E-2756 Image of the Month The Astrocyte Fight Against Glaucoma This confocal microscopy image features the delicate neurovascular plexus of the inner retina, and shows retinal ganglion cells (green), astrocytes (red) and vascular endothelial cells (white) in the inner retina of a rat. This image was taken in the Sivak lab at the Krembil Research Institute, University Health Network and University of Toronto School of Medicine, Canada, and forms part of multi-center research project that has identified that lipoxins – lipid inflammatory mediators – secreted by astrocytes can protect against retinal ganglion cell degeneration in rodent models of glaucoma. I Livne-Bar et al., J Clin Invest, [Epub ahead of print], (2017). PMID: 29106385. Credit: Xiaxin Guo and Jeremy Sivak. Do you have an image you’d like to see featured in The Ophthalmologist? Contact [email protected] www.theophthalmologist.com ISSUE 18 - FEBRUARY 2018 Contentstents Editor - Mark Hillen [email protected] Managing Editor - Ruth Steer [email protected] Content Director - Rich Whitworth [email protected] Publishing Director - Neil Hanley [email protected] 10 VP Sales North America - Molly Phillips [email protected] Sales Manager - Abigail Mackrill [email protected] Head of Design - Marc Bird [email protected] Designer - Hannah Ennis [email protected] Digital Team Lead - David Roberts [email protected] Digital Producer Web/Email - Peter Bartley [email protected] Digital Producer Web/App - Abygail Bradley [email protected] Audience Insight Manager - Tracey Nicholls [email protected] Traff ic & Audience Database Coordinator - Hayley Atiz [email protected] Traffic and Audience Associate - Lindsey Vickers [email protected] Traffic Manager Jody- Fryett [email protected] Social Media / Analytics Associate - Ben Holah [email protected] Events Manager - Alice Daniels-Wright [email protected] Marketing Manager - Katy Pearson [email protected] Financial Controller - Phil Dale [email protected] Accounts Assistant - Kerri Benson [email protected] Editorial Director - Fedra Pavlou [email protected] Chief Executive Officer - Andy Davies [email protected] Chief Operating Officer - Tracey Peers [email protected] Change of address [email protected] Hayley Atiz, The Ophthalmologist, Texere Publishing Ltd, Haig House, Haig Road, Knutsford, Cheshire, WA16 8DX, UK General enquiries www.texerepublishing.com [email protected] 03 Image of The Month Upfront +44 (0) 1565 745 200 [email protected] Distribution 10 Sweet Tears The Ophthalmologist (ISSN 2051-4093) 09 Editorial and The Ophthalmologist North America (ISSN 2398-9270), is published monthly by Dangerous Déjà Vu... 11 Night Guard Texere Publishing Ltd and is distributed in the US by UKP Worldwide, 3390 Rand Road, by Ruth Steer. 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Single copy sales £15/$20 On The Cover 12 Reducing Revitrectomy RiskR (plus postage, cost available on request [email protected]) FEBRUARY 2018 # 18 Annual subscription for non-qualified recipients £110/$140 Upfront In My View In Practice Sitting Down With Doctors picking the low-hanginganging 13 Central Corneal Connection Statins for PTA for post-LASIK SICS - another feather Walter Sekundo, vitrectomy surgery ectasia: pro and con in your cap? a.k.a., Mr SMILE 10 14 – 17 28 – 35 48 – 50 Perfection Achieved (But Nobody Seems to Care) Reprints & Permissions – [email protected] There’s a gold-standard procedure for pterygium surgery, so why are fruit, but avoiding the approach to people ignoring it? 18–25 The opinions presented within this publication are those of the authors the true gold-standardrd at the top and do not reflect the opinions of The Ophthalmologist or its publishers, Texere Publishing. Authors are required to disclose any relevant financial NORTH AMERICA www.theophthalmologist.com of the tree. arrangements, which are presented at the end of each article, where relevant. © 2017 Texere Publishing Limited. All rights reserved. Reproduction in whole or in parts is prohibited. TRS-5100 Product/Model name: REFRACTOR RT-5100 The TRS-5100RIIHUVDVSOLWSULVP-DFNVRQ&URVVF\OLQGHUZLWKVLPXOWDQHRXVWDUJHWFRPSDULVRQVIRUIDVWHUPRUH AND DFFXUDWHDQGPRUHSRVLWLYHH[DPH[SHULHQFHV0D[LPL]HH[DPHIÀDESIRED OUTCOMESFLHQF\SDWLHQWÁRZDQGRYHUDOOSUDFWLFHUHYHQXH Mitchell A. Jackson, MD Larry Patterson, MD Charles Collins, MD Faisal Haq, MD Lake Villa, Illinois Crossville, TN Middleton, RI Plano, Texas The TRS-5100 rapidly The TRS-5100 takes 7KH756LVKLJKO\ The TRS provides our practice completes all refractions accuracy to a new level valued. It is extremely ZLWKDGLDJQRVWLFWRROWKDWERWK and the split prism and provides the ultimate accurate and I’m very improves clinical outcomes while allows immediate patient refraction information that FRQÀGHQWLQWKHTXDOLW\ LQFUHDVLQJSDWLHQWÁRZDQGRYHUDOO FRPSDULVRQDQGYHULÀFDWLRQ ZH·YHEHHQVHHNLQJ1RZ of refraction. It is such a HIÀFLHQF\7KHLQYHVWPHQWWKDWSD\V of old vs. new prescriptions we have fewer remakes timesaver, has cut down for itself. Wait times are reduced, ²ZLWKRXWÁLSSLQJWKURXJK ZLWKPRUHVDWLVÀHG on remakes, reduced our we see more patients, and we’re OHQVHVDQGDVNLQJ´ZKLFKLV patients who enjoy shorter frustrations and increased SHUIRUPLQJPRUHVXUJHU\WKDQHYHU better, 1 or 2?” refraction exam times. our bottom line. Designed and Manufactured by NIDEK - Represented by Marco 800-874-5274 • marco.com 46 48 38 In Practice 28 Scleral Buckling 101 Alexander Ringeisen, Edwin Ryan and David Almeida review the occasions when scleral buckling should be considered – and how Profession In My View to succeed. 44 Is Twitter Dead? 14 Playing Our Cards Right, 33 A Small Solution to a Pavan Angadi and Robert by Marcony Santhiago Significant Problem F. Melendez examine how M. Scott Hickman explains ophthalmologists use Twitter 15 PTA Is Not the Way, what small incision cataract and offer their advice on getting by Alain Saad surgery (SICS) is, plus how to the most out of social media. do it – and when to use it. 17 The Anti-Social Network, 46 Decision Diagnosis by Martine Jager Procrastination is the first step on the path towards the NextGen calamity of inaction. David Almeida shows how he Feature 38 Making the approaches problems by taking a Subjective Objective “Decision Diagnosis” approach. 18 Perfection Achieved (But How off the shelf electronics Nobody Seems to Care) components are being combined There’s a clear gold standard in in a smart device that should pterygium removal that gives enable cataract and refractive Sitting Down With almost perfect outcomes with surgeons to stop relying on almost no recurrence... but chair time and questionnaires 48 Walter Sekundo, Chairman there’s also a quick and dirty fix. to understand their lifestyle and of the Department of Guess which one most people vision needsneeds – and use Ophthalmology, Philipps choose to perform. hard data instead. University of Marburg, Germany. www.theophthalmologist.com Oldie Goodiebut a SINCE 1986 Some things are just too good to change. OCuSOFT® T Lid Scrub® Family of Eyelid Cleansers includes mild, non- uSOF irritating cleansers that effectively remove contaminants OC UB from the eyelids to provide relief of symptoms associated CR with conditions ranging from mild to severe. Trusted and S LID recommended by optometrists and ophthalmologists, OCuSOFT® is still the leading brand of eyelid cleansers on the market. It’s trusted. It works. #1 Doctor Recommended Brand (800) 233-5469 | www.ocusoft.com © 2017 OCuSOFT, Inc., Rosenberg, TX 77471 Dangerous Déjà Vu... And the threat of a rising problem Editorial n early 2017, I was shocked – along with the rest of the world – to hear that three AMD patients had suffered permanent vision loss after receiving an unapproved Istem cell therapy at a clinic in Florida (1). Disturbingly, the story got murkier: the patients had paid $5,000 each to receive the autologous-derived stem cell injections (AASCIs). And despite a clinical trial being registered at the clinic (NCT02024269; withdrawn in September 2015 – three months after the experimental ‘treatments’), none of the patients actually knew that they
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