Eyeworld Supplements

ASCRS Clinical Survey 2018

This is a supplement to EyeWorld Magazine.

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2 • 2018 ASCRS Clinical Survey Key findings According to the survey, same-day bilateral cataract surgery remains a relatively uncommon practice. Only 9% of respondents perform cataract surgery in both eyes on the same day often or sometimes. More will do so in extenuating circumstances, but overall, 63% of respondents said they do not perform same-day bilateral cataract surgery. IOL power calculations for patients who have had laser vision correction can be challenging. Nearly half of respondents said they use the ASCRS Post-Refractive IOL Calculator for this. Most respondents, 67%, prefer bimanual anterior vit- rectomy through limbal incisions, while others prefer a coaxial technique through the main wound; even fewer will take a pars plana and limbal infusion approach. "I think that some of the respondents may have their own way of performing IOL power calculations for post-refractive surgery patients. Some biometers, for example, have post-refractive formulas within their software, so it might be easier for these surgeons to use the resource of their biometer rather than take the time to go online and enter individual data points into the ASCRS Post-Refractive IOL Calculator. It's also been my experience that overall the ASCRS cal- culator gives better results for the post-keratorefrac- tive eye than intraoperative wavefront aberrometry. With regard to most respondents preferring a biman- ual approach through limbal incisions for anterior vitrectomy, this shows that to this day, most anterior segment surgeons are still not entirely comfortable using a pars plana technique." —Warren Hill, MD ASCRS Cataract Clinical Committee How often do you perform simultaneous bilateral/same-day cataract surgery? • Overall, more than 60% of respondents do not perform bilateral cataract surgery, 63% • U.S. 22% higher than Non-U.S., 72% to 50% • Overall, only 9% perform Sometimes or Often n=385 15 When you perform cataract surgery post-laser vision correction, what method do you typically use to calculate the IOL power? • Overall, nearly half of respondents use thepost-refractive calculator on ASCRS website, 49% • U.S. respondents are slightly higher, 50% to 47% for Non-U.S. n=476 17 When you perform an anterior vitrectomy, what is your preferred technique? • Overall, two-thirds prefer Bimanual through limbal incisions, 67% • U.S. respondents are 5% points higher than Non-U.S., 68% compared to 63% n=474 21 Cataract surgery "I think that 5% of non-U.S. ophthalmologists performing same-day bilateral cataract surgery is misleading, at least according to this data. Other data shows a higher percentage of ophthalmologists outside of the U.S. performing imme- diate sequential bilateral cataract surgery (ISBCS). What's more, ISBCS is being performed in the U.S., without financial disincentive, in some integrated healthcare delivery systems. Our success with ISBCS goes hand-in-hand with continuous attention to the quality of our biometry and use of current generation formulas. As long as there continues to be a finan- cial penalty for same-day surgery, I do not expect meaningful conversion in the U.S. or other countries where there is a disincentive." —Richard (Kent) Stiverson, MD ASCRS Cataract Clinical Committee

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