Eyeworld CME Supplements

EW AUG 2015 - Supported by unrestricted educational grants from Abbott Medical Optics, Alcon Laboratories, and Bausch + Lomb

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

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by John Vukich, MD 2014 ASCRS Clinical Survey: Trends in toric IOL implementation Accreditation Statement This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint providership of the American Society of Cataract & Refractive Surgery (ASCRS) and EyeWorld. ASCRS is accredited by the ACCME to provide continuing medical education for physicians. Educational Objectives Ophthalmologists who participate in this activity will: • Outline the importance of accurate preopera- tive measurements with advanced diagnostic tools, for axial length, keratometric data, and IOL power—as well as the magnitude and pattern of astigmatism—in the achievement of positive outcomes in the management of astigmatism in cataract patients with toric IOLs and the best methods for collecting such data; discuss the optimal therapeutic target for residual cylinder that should be part of "best practices" in the management of astigmatism with toric IOLs; • Describe the critical steps necessary for accurately aligning the preoperative and surgical axis of astigmatism through use of modern marking and alignment technologies, as well as intraoperative means for "locking" of the IOL after implantation; • Recognize the significance of all sources of astigmatic error, and develop a toolkit to manage appropriately; and • Identify the impact of incremental rotational misalignment from intended axis and its direct impact on visual quality and patient satisfaction. • Assess current knowledge regarding the prevalence of rotation with toric IOLs and why it occurs • Discuss the approaches to preventing and/ or resolving IOL rotational error Designation Statement The American Society of Cataract and Refractive Surgery designates this enduring materials activity for a maximum of 1.0 AMA PRA Category 1 Credits.™ Physicians should claim only credit commensurate with the extent of their participa- tion in the activity. Claiming Credit To claim credit, participants must visit bit.ly/1NON4UF to review content and download the post-activity test and credit claim. All participants must pass the post-activity test with a score of 75% or higher to earn credit. Alternatively, the post-test form included in this supplement may be faxed to the number indicat- ed 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 February 29, 2016. CME credit will not be awarded after that date. 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 only. ADA/Special Accommodations ASCRS and EyeWorld fully comply with the legal requirements of the Americans with Disabilities Act (ADA) and the rules and regulations thereof. Any participant in this educational program who requires special accommodations or services should contact Laura Johnson at ljohnson@ ascrs.org or 703-591-2220. Financial Interest Disclosures John Berdahl, MD, receives a retainer, ad hoc fees, or other consulting income from and is a member of the speakers bureau of: Alcon Laboratories Inc., Allergan Inc., Avedro Inc., Glaukos Corporation, and Omega Ophthalmics. He has received a retainer, ad hoc fees, or other consulting income from: Abbott Medical Optics Inc. and ClarVista. Dr. Berdahl has an investment interest in Avedro Inc. and Glaukos Corporation, and has received research funding from Alcon and Glaukos. Dr. Berdahl has received travel expense reimbursement from Alcon. David R. Hardten, MD, has an investment in- terest in ESI Inc. and OSD Inc. He has received a retainer, ad hoc fees, or other consulting income from Abbott Medical Optics Inc. and Allergan. Dr. Hardten has received research funding (full or partial) from Abbott Medical Optics Inc., Calhoun Vision Inc., and DREAM. He is a member of the speakers bureau of Allegan. Bonnie An Henderson, MD, has received a retainer, ad hoc fees, or other consulting income from Alcon Laboratories Inc. and Bausch + Lomb. She is a member of the speakers bureaus of Abbott Medical Optics Inc. and Genzyme. Douglas D. Koch, MD, has received a retainer, ad hoc fees, or other consulting income from Abbott Medical Optics Inc. He is a member of the speakers bureau of Alcon Laboratories Inc. Dr. Koch has received research funding (full or partial) from i-Optics, Revision Optics Inc., TrueVision, and Ziemer Inc. John A. Vukich, MD, is a member of the speakers bureaus of: Abbott Medical Optics Inc., AcuFocus Inc., and STAAR Surgical. Staff members Laura Johnson and Erin Schallhorn have no ophthalmic-related financial interests. Driving adoption and outcomes with toric IOLs: Pre-, intra-, and postoperative pearls for success Supplement to EyeWorld August 2015 Supported by an unrestricted educational grant from Abbott Medical Optics, Alcon Laboratories, and Bausch + Lomb continued on page 2 John Vukich, MD Survey reveals practices in employing toric IOLs and managing astigmatism T oric intraocular lens- es (IOLs) are of major interest among today's cataract surgeons. To gauge current practices pertaining to this technology, ASCRS included questions regard- ing astigmatism management and toric IOLs in the annual ASCRS Clinical Survey. This analysis, which focuses on the most com- pelling and controversial issues facing ASCRS members, identifies areas where there may be educa- tional opportunities. Designed to determine members' clinical opinions and practice patterns, the 2014 ASCRS Clinical Survey produced 268 data points from 137 questions, with responses from more than 1,500 unique respondents. 1 The 2014 survey revealed important information regarding ways surgeons are implementing toric IOLs and managing astigma- tism in their patients. Factors that guide management When respondents were asked about the primary preop measure- ment driving their astigmatism axis decisions when implanting a toric IOL, overall, 11% use manual or autokeratometry when making their choices, whereas 45% use topography. When they were asked how they align the preoperative axis assessed with their diagnostic tools with their intraoperative axis where they are placing the toric IOL during surgery, 37% used anatomic landmarks with no marking or used ink marking without instruments. We think this technique may be prone to increased error. However, I think clinicians are changing direction in this area as we increasingly understand how to optimize outcomes with toric IOLs. Less than half of ASCRS members responding to the sur- vey reported that they calculate Click to read and claim CME credit

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