Eyeworld Supplements

11 • 2018 ASCRS Clinical Survey Retina In what percentage of your diabetic retinopathy patients, where the view of the fundus is adequate, do you perform OCT or FA prior to cataract surgery? • Overall, on average perform OCT or FA on 31% of their diabetic retinopathy patients prior to cataract surgery • 40% perform OCT or FA on 100% of their diabetic retinopathy patients All 31% US 32% NonUS 29% Average Pct n=363 137 What is the primary role of anti-VEGF medications in cataract patients? • Overall, more than 80% of respondents think it is both, 82% • U.S.: 86% • Non-U.S.: 75% n=345 138 In patients undergoing multifocal IOL implantation, do you routinely obtain a preoperative macular OCT? • Overall 67% of respondents routinely obtain a preoperative macular OCT • U.S.: 68% • Non-U.S.: 65% n=202 141 Key findings Respondents, overall, reported performing OCT or fundus autofluorescence (FA) on an average of 31% of diabetic retinopathy patients, where the fundus view is adequate, before cataract surgery. Forty percent of respondents, however, reported performing these diagnostic tests prior to cataract surgery in 100% of diabetic retinopathy patients. Sixty-seven percent of respondents said they will routinely perform OCT preoperatively in all patients who wish to have a multifocal IOL. "The percentage of diabetic retinopathy patients receiving OCT prior to cataract surgery should be 100%. As for patients receiving anti-VEGF injections for diabetic macular edema, wet age-related mac- ular degeneration, retinal vein occlusion, etc., these should proceed on schedule, independently of cata- ract surgery indications and timing. Patients should have cataract surgery whenever indicated, midway between anti-VEGF injection dates. If endophthalmi- tis, toxic anterior segment syndrome, sterile inflam- mation, or hemorrhagic occlusive retinal vasculitis occur, causation will be assigned appropriately. Next day or simultaneous anti-VEGF injection is inappropriate." —Steve Charles, MD ASCRS Retina Clinical Committee chair "My opinion on obtaining preoperative macular OCTs on patients being considered for multifocal IOLs has evolved. Currently, I think that 100% of these patients should be imaged in both eyes, simply because there is too much pathology out there that trips up their performance. This pathology can be difficult to see, especially through a cataract and especially if it's subtle. You have to image both eyes because you need to implant a multifocal in each eye to get the best results. I think any resistance on this issue has to do with who will pay for this testing." —Kevin M. Miller, MD ASCRS Retina Clinical Committee anterior segment liaison

• Cover