Anterior Segment Surgery: Discussion and Debate

American Society of Cataract and Refractive Surgery (ASCRS) 2015 Symposium

Roger F. Steinert, MD


July 01, 2015

One of the highlights at the recent American Society of Cataract and Refractive Surgery (ASCRS) meeting was the session "60 Minutes: Controversies in Anterior Segment Surgery,"[1] held as part of the Sunday Summit. Dr Ed Holland moderated this session, and was accompanied by three panelists, during which some of our top issues were presented and explored in detail.

The first controversy, from Dr Eric Donnenfeld,[2] explored whether we are now at the point where we can move away from eye drops as a method of administration of medications and move toward other forms of drug delivery that are more convenient for patients, thereby improving their compliance.

The second controversy focused on intraocular lenses (IOLs), and whether we have the best possible designs for IOLs. Dr Doug Koch,[3] who is well known in this area, talked about where we are and where we might go to optimize the optical details in the IOL designs of the future.

The third question was very controversial and has been for several years. Dr Rosa Braga-Mele[4] presented the issue of immediate sequential bilateral cataract surgery, including a look at not only the potential cost savings but also the safety of performing cataract surgery on both eyes at the same time in patients. As part of her presentation, she included her own specific results.

Certainly, many people have wondered about this approach, not only in terms of its safety but also in terms of its benefits—in that if it could be done safely, and with the same low complication rate, it would be less burdensome and more convenient for patients, and include fewer office visits.

The final of the four presentations was from Dr Rick Lewis,[5] on glaucoma surgery. He discussed not only the procedures that we currently have, but also the new procedures that we know are very close to being implemented in the United States with approval from the US Food and Drug Administration. Some of them are already available internationally.

Many interesting ideas were presented during this session, along with some humor injected by the "60 Minutes" approach—particularly Dr Ed Holland acting like the famous and now late Andy Rooney. So if you didn't make this session this year, be sure to make it a part of your Sunday morning at next year's meeting.


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