Cataract & Refractive 360: Fundamentals, Techniques & Technology; Volume 4, Number 3
This activity is supported by educational grants from Alcon Vision, LLC; Carl Zeiss Meditec, Inc.; and J&J Vision
Overview
Provider Statement
This continuing medical education activity is provided by .
Support Statement
This activity is supported by educational grants from Alcon Vision, LLC; Carl Zeiss Meditec, Inc.; and J&J Vision.
Activity Description
Successful cataract surgery involves a multifactorial process that relies on numerous interconnected assessments, planning, and execution procedures. Phacodynamics, which is the effects of the equipment used to perform a cataract procedure on the internal environment of the eye, must be thoroughly understood to maintain a stable anterior chamber and to minimize damage from the heat produced by ultrasonic energy during phacoemulsification. New technologies, such as optical coherence tomography and femtosecond (FS) laser, can be applied to several diagnostic and procedural components of the surgery. Astigmatism can now be corrected during cataract surgery, using peripheral corneal relaxing incisions or toric intraocular lens implantation. The surgeon can select from a growing range of intraocular lenses to achieve the refractive outcomes desired by the patient. In refractive surgery, FS laser is also used to correct astigmatism, and it can be employed for high-precision cutting of LASIK flaps. New applications for FS laser, such as softening of the lens to improve accommodation, are under investigation. The educational goals of this publication series are widespread, encompassing multiple facets of both cataract and refractive surgery. This issue focuses on immediately sequential bilateral cataract surgery, IOL calculations for the post-refractive surgery patient, techniques and tips for choosing the right toric IOL for individual patients, an update on the MIGS portfolio, and the management of epithelial ingrowth after LASIK.
Target Audience
The intended audience for this activity is ophthalmologists and other health care professionals involved in the management of patients undergoing cataract surgery.
Learning Objective(s)
Upon successful completion of this publication series, participants should be better able to:
- Review the role of fluidics and ultrasound in cataract surgery and how the risk of associated complications may be minimized during their use.
- Evaluate advances in presurgical/surgical diagnostics and intraoperative guidance systems and their impact on improved refractive outcomes.
- List the benefits and limitations of femtosecond laser in cataract surgery.
- Investigate the surgical techniques necessary to optimize outcomes in complex cases.
- Review the impact on refractive outcomes of cataract surgery-induced and preexisting astigmatism.
- Explore diagnostic and surgical techniques that can be used to correct astigmatism before, during, and after cataract removal.
- Compare the available types of intraocular lenses and determine their influence on visual outcomes.
- Assess the importance of presurgical screening and discussion with the patient for intraocular lens selection to ensure patient satisfaction with outcomes.
- Summarize the need for presurgical planning prior to refractive procedures.
- Compare advanced techniques and technology for guiding refractive surgery to reduce complications and achieve better visual outcomes.
- Evaluate the evidence supporting the use of femtosecond laser in refractive surgery.
Chief Medical Editor
Terry Kim, MD
Professor of Ophthalmology
Duke University School of Medicine
Chief, Cornea and External Disease Division
Director, Refractive Surgery Service
Duke University Eye Center
Durham, NC
Editorial Board
Nicole R. Fram, MD
Partner, Advanced Vision Care
Clinical Instructor of Ophthalmology
Stein Eye Institute
Los Angeles, CA
Sumit (Sam) Garg, MD
Vice Chair of Clinical Ophthalmology
Medical Director
Associate Professor – Corneal, Cataract, and Refractive Surgery
Gavin Herbert Eye Institute
University of California
Irvine, CA
Elizabeth Yeu, MD
Assistant Professor of Ophthalmology
Eastern Virginia Medical School
Partner, Virginia Eye Consultants
Cornea, Cataract, Anterior Segment, and Refractive Surgery Specialist
Norfolk, VA
Faculty
Derek W. DelMonte, MD
Assistant Professor of Ophthalmology
Cornea, Cataract and Refractive Surgery Service
University of Colorado Medical School - Rocky Mountain Lions Eye Institute
Aurora, CO
Tanner J. Ferguson, MD
Resident
Cole Eye Institute, Cleveland Clinic
Cleveland, Ohio
David R. Hardten, MD
Adjunct Associate Professor of Ophthalmology
University of Minnesota
Partner, Minnesota Eye Consultants, PA
Minneapolis, MN
Yuri McKee, MD
Corneal and Refractive Surgeon
East Valley Ophthalmology
Mesa, AZ
Nathan M. Radcliffe, MD
Assistant Professor of Ophthalmology
Mount Sinai School of Medicine
New York, NY
William F. Wiley, MD
Assistant Clinical Professor of Ophthalmology
University Hospitals/Case Western University
Cleveland Eye Clinic
Cleveland, OH
Medical Writer
Valerie Zimmerman, PhD
Reviewer
Ronald A. Codario, MD, EMBA, FACP, FNLA, RPVI, CHCP
Accreditation
Vindico Medical Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Credit Designation
Vindico Medical Education designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
This enduring material is approved for 1 year from the date of original release, December 25, 2019, through December 25, 2020.
How to Participate in This Activity and Obtain CME Credit
To participate in this CME activity, you must read the objectives, answer the pretest questions, read the articles, and complete the posttest and evaluation. Provide only one (1) correct answer for each question. A satisfactory score is defined as answering 7 of 10 posttest questions correctly. Upon receipt of the completed materials, if a satisfactory score on the posttest is achieved, Vindico Medical Education will issue an AMA PRA Category 1 Credit(s)™ Certificate.
Disclosures
In accordance with the Accreditation Council for Continuing Medical Education’s Standards for Commercial Support, all CME providers are required to disclose to the activity audience the relevant financial relationships of the planners, teachers, and authors involved in the development of CME content. An individual has a relevant financial relationship if he or she has a financial relationship in any amount occurring in the past 12 months with a commercial interest whose products or services are discussed in the CME activity content over which the individual has control.
The authors disclose that they do have significant financial interests in any products or class of products discussed directly or indirectly in this activity, including research support.
Chief Medical Editor, Editorial Board, and Faculty report the following relationship(s):
Derek W. DelMonte, MD
No relevant financial relationships to disclose.
Tanner J. Ferguson, MD
Consulting Fee: Glaukos
Nicole R. Fram, MD
Consulting Fee: Aerie, Alcon, Allergan, CorneaGen, J&J Vision, Ocular Science, W.L. Gore, Zeiss
Speakers Bureau: Alcon, Bausch + Lomb, Dompè, J&J Vision, Novartis, Shire, Sun
Contracted Research: Alcon, Allergan
Ownership Interest: CorneaGen, Ocular Science
Sumit (Sam) Garg, MD
Consulting Fee: Avedro, CorneaGen, EyePoint, Eyevance, J&J Vision, Kala, Katena, Takeda, Verana Health, VisionCare, Zeiss
Speakers Bureau: J&J Vision, Takeda
Ownership Interest: Equinox, Expert Opinion, LensGen, Ocutrx, RPS
David R. Hardten, MD
No relevant financial relationships to disclose.
Terry Kim, MD
Consulting Fee: Aerie, Alcon/Novartis, Allergan/Actavis, Avedro, Avellino Labs, Bausch + Lomb/Valeant, BlephEx, CoDa/Ocunexus Therapeutics, Kala, NovaBay, Ocular Therapeutix, Omeros, PowerVision, Presbyopia Therapies, Shire, Simple Contacts, TearLab, Zeiss
Ownership Interest: Avellino Labs, CorneaGen, Kala, NovaBay, Ocular Therapeutix, Omeros, Simple Contacts
Yuri McKee, MD
Consulting Fee: LENSAR, Zeiss
Contracted Research: Ivantis
Nathan M. Radcliffe, MD
Consulting Fee: Aerie, Alcon, Alimera, Allergan, Bausch + Lomb, CATS, Ellex, Endo Optiks, Equinox, Glaukos, Iridex, Ivantis, Lumenis, New World Medical, Novartis, Ocular Science, Omeros, Reichert, Shire, Sight Sciences, Zeiss
Speakers Bureau: Aerie, Alcon, Alimera, Allergan, Bausch + Lomb, CATS, Ellex, Endo Optiks, Equinox, Glaukos, Iridex, Ivantis, Lumenis, New World Medical, Novartis, Ocular Science, Omeros, Reichert, Shire, Sight Sciences, Zeiss
William F. Wiley, MD
Royalty: Imprimis
Consulting Fee: Alcon, Allergan, CorneaGen, J&J Vision, RxSight, Zeiss
Contracted Research: Bausch + Lomb, RxSight, Zeiss
Elizabeth Yeu, MD
Consulting Fee: Alcon, Allergan, ArcScan, Aurea Medical, Avedro, Bausch + Lomb, Bio-Tissue, BVI, EyePoint, Expert Opinion, Glaukos, i-Optics, J&J Vision, Kala, LENSAR, Merck, Mynosys, Novartis, Ocular Science, Ocular Therapeutix, OCuSOFT, Oyster Point, Science Based Health, Shire, Sun, TearLab, Veracity, Zeiss
Speakers Bureau: Alcon, Allergan, BioTissue, J&J Vision, Ocular Therapeutix, Omeros, Shire, TearLab
Contracted Research: Alcon, Allergan, Bausch + Lomb, Bio-Tissue, i-Optics, Kala, Topcon
Ownership Interest: ArcScan, CorneaGen, Modernizing Medicine, Ocular Science, Oyster Point, Strathspey Crown
Medical Writer reports the following relationship(s)
Valerie Zimmerman, PhD
No relevant financial relationships to disclose.
Reviewer reports the following relationship(s)
Ronald A. Codario, MD, EMBA, FACP, FNLA, RPVI, CHCP
No relevant financial relationships to disclose.
Vindico Medical Education staff report the following relationship(s)
No relevant financial relationships to disclose.
Signed disclosures are on file at Vindico Medical Education, Office of Medical Affairs and Compliance.
Unlabeled and Investigational Usage
The audience is advised that this continuing medical education activity may contain references to unlabeled uses of US Food and Drug Administration (FDA)-approved products or to products not approved by the FDA for use in the United States. The faculty members have been made aware of their obligation to disclose such usage. All activity participants will be informed if any speakers/authors intend to discuss either non–FDA-approved or investigational use of products/devices.
Copyright Statement
Created and published by Vindico Medical Education, 6900 Grove Road, Building 100, Thorofare, NJ 08086-9447. Telephone: 856-994-9400; Fax: 856-384-6680. Printed in the USA. Copyright © 2019 Vindico Medical Education. All rights reserved. No part of this publication may be reproduced without written permission from the publisher. The material presented at or in any of Vindico Medical Education continuing medical education activities does not necessarily reflect the views and opinions of Vindico Medical Education. Neither Vindico Medical Education nor the faculty endorse or recommend any techniques, commercial products, or manufacturers. The faculty/authors may discuss the use of materials and/or products that have not yet been approved by the US Food and Drug Administration. All readers and continuing education participants should verify all information before treating patients or utilizing any product.
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