Eyeworld CME Supplements

EW DEC_Supported by an unrestricted educational grant from EyePoint Pharmaceuticals, ImprimisRx, Ocular Therapeutix, and Omeros

This is a supplement to EyeWorld Magazine that doctors can take a test after reading and receive CME credits for.

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Improving the cataract patient experience by managing pain and inflammation W e are at the precipice of an exciting era in ophthalmology. Two new drugs have been approved—a dexamethasone intraocular suspension and a dexamethasone intracanalicular insert. Additional promising options are in the pipeline. In the 2018 ASCRS Clinical Survey, almost 90% of participants agreed that low to moderate intraocular inflamma- tion after cataract surgery can significantly affect visual quality, vision recovery time, and pa- tient comfort and satisfaction. 1 Nearly 50% of respon- dents dose NSAIDs 4 weeks after surgery for most patients, whereas 18% do not prescribe them at all. Figure 1 shows NSAID practices for high-risk patients vs. standard patients. More than 70% prescribe steroids for most standard pa- tients for 4 weeks after surgery, and 14% dose them for 2 weeks or less. More than half continue or increase steroid use postop in high-risk patients, but 16% do not use steroids differently in high-risk patients. continued on page 2 Accreditation Statement This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of the American Society of Cataract and Refractive Surgery (ASCRS) and EyeWorld magazine. ASCRS is accredited by the ACCME to provide continuing medical education for physicians. Educational Objectives • Compare and contrast current and emerging regimens and pharmaceutical approaches for the prevention of pain and inflammation in cataract surgery, including alternative therapeutic options designed to overcome patient compliance concerns and reduce ocular toxicity: • Advanced topical medications • Intracameral medications • Sustained-release technologies • Determine adjustments needed to pre-, intra-, and postoperative steroid and NSAID regimens for patients at greater risk for inflammation • Discuss cataract patients' perceptions of intra- and postoperative pain and the impact that it has on surgical outcomes and patient satisfaction • Describe evolving reimbursement models to expand access to new approaches to control pain and inflammation after cataract surgery Designation Statement The American Society of Cataract and Refractive Sur- gery designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credits ™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity. Notice of Off-Label Use Presentations This activity may include presentations on drugs or devices or uses of drugs or devices that may not have been approved by the Food and Drug Administration (FDA) or have been approved by the FDA for specific uses. Claiming Credit To claim credit, participants must visit bit.ly/2PyXJgN to review content and download the post-activity test and credit claim. All participants must pass the post-activity test with score of 75% or higher to earn credit. Alternatively, the post-test form included in this supplement may be mailed or emailed in for credit to be awarded, and a certificate will be mailed within 2 weeks. When viewing online or downloading the material, standard internet access is required. Adobe Acrobat Reader is needed to view the materials. CME credit is valid through May 31, 2020. CME credit will not be awarded after that date. Financial Interest Disclosures Eric Donnenfeld, MD, has received a retainer, ad hoc fees, or other consulting income from AcuFocus, Alcon, Allergan, Bausch + Lomb, BVI, Elenza, CRST, Fore- sight, Icon Biosciences, Johnson & Johnson Vision, Kala, Katena, Lacripen, Merck, Novaliq, Odyssey, Ome- ga Ophthalmics, and Oys. He has received a retainer, ad hoc fees, or other consulting income and has received research support from EyePoint Pharmaceuticals. He has an investment interest in, has received a retainer, ad hoc fees, or other consulting income from, is a member of the speaker's bureau for, and has received research support from Aquesys, AcuFocus, Avedro, Elenza, Glaukos, Lacripen, LensGen, Mati Pharmac- ueticals, Mimetogen, Novabay, Ocuhub, Pogotec, RPS, Sarcode, Strathspey Crown, TearLab, TrueVision, Veracity, Versant Ventures, and Visionary Ventures. Alice Epitropoulos, MD, has an investment interest in EyeVance, NovaBay, and Physician Recommended Nutriceuticals. She has received a retainer, ad hoc fees, or other consulting income from Allergan, Bausch + Lomb, EyePoint, Johnson & Johnson Vision, Kala, Omeros, Physician Recommended Nutriceuticals, and Shire. She is a member of the speaker's bureau for Allergan, Bausch + Lomb, BioTissue, Johnson & Johnson Vision, NovaBay, Omeros, Physician Recom- mended Nutriceuticals, and Shire. She has received research support from Bausch + Lomb, Johnson & Johnson Vision, and Kala. Edward Holland, MD, is a member of the speaker's bureau for Aerie, Akros, Avedro, Azura, Bio-Tissue, BlephEx, BRIM biotech, Claris, CorneaGen, Corneat, Dompe, EyePoint, Glaukos, Hanall, IanTECH, Imprimis Pharma, Invirsa, Johnson & Johnson Vision, Kala, Katena, Licrieye, Mati, Merck KGgA, MG Thera, Mintz, Nanowafer, Novaliq, Novartis, Ocunexus, Ocuphire, Omeros, Ophthotech, OysterPoint, Precis Bio, Prometic, ReGenTee, Retear, Senju, and Shire. He has received re- search support from Mati, Novartis, Omeros, and Senju. William Wiley, MD, earns royalty or derives other financial gain from Imprimis. He has an investment interest in Clarity, Equinox, Omega, and RxSight. He has received a retainer, ad hoc fees, or other consulting income from AcuFocus, ArcScan, CorneaGen, Glaukos, Imprimis, Ivantis, Johnson & Johnson Vision, New World Medical, Omega, Surgiorythm, and Carl Zeiss Meditec. He is a member of the speaker's bureau for Alcon, Revision, and RxSight. He has received research support from Allergan, Calhoun, and RxSight. Denise Visco, MD, has received a retainer, ad hoc fees, or other consulting income from Bruder, EyePoint, EyeVance, LENSAR, Omeros, Shire, Sun Ophthalmics, and Carl Zeiss Meditec. She is a member of the speaker's bureau for LENSAR, Omeros, Shire, Sun Ophthalmics, and Carl Zeiss Meditec. She provides practice management of marking consultant services to Omeros and Carl Zeiss Meditec. She has received research support from LENSAR and Omeros. Staff member Kate Fehlhaber, PhD, has no ophthal- mic-related financial disclosures. Supported by an unrestricted educational grant from EyePoint Pharmaceuticals, ImprimisRx, Ocular Therapeutix, and Omeros. Eric Donnenfeld, MD improving the cataract patient experience: Minimizing pain and inflammation while reducing the need for topical drops By Eric Donnenfeld, MD Figure 1. Responses from the 2018 ASCRS Clinical Survey showing NSAID practices for high-risk patients vs. standard patients. Do you use NSAIDs differently in high-risk patients vs. standard patients? (Select all that apply) Inflammation/Infection Yes, I begin/increase the use of NSAIDs prior to surgery in high-risk patients Yes, I continue/increase the use of NSAIDs postoperatively No difference I don't perform cataract surgery on high-risk patients 0% 10% 20% 30% 40% 50% Click to read and claim CME credit

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