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2 | 2022 ASCRS CLINICAL SURVEY HIGHLIGHTS FROM THE 2022 ASCRS CLINICAL SURVEY There are multiple ways to look at this data. In a "glass half full" perspective, one would think, "Isn't it great how many surgeons are comfortable with customizing machine settings?" While in a "glass half empty" perspective, one would wonder why the numbers, though good, aren't higher. Another way to look at this data is to really drill down on what it means to customize machine settings for different cataracts as well as vitrectomy settings. Does this mean the surgeon is comfortable increasing the phaco energy for denser lenses or adjusting the cut rate during vitrectomy? While these maneuvers would certainly qualify as "customization," they don't allow the surgeon to take full advantage of an individual machine's technology and capabilities. The type of customization required can obviously vary depending on a phaco machine's pumping system and fluidics control. Rather than understanding how to modify a specific machine's settings, surgeons benefit more by learning how phaco energy, vacuum, and fluidics interact. A good understanding of these essential concepts allows the surgeon to be more facile with customization of all cases, and because these essentials are "platform agnostic," it allows a surgeon to transfer their knowledge should they need to use a different manufacturer's technology. Each year at the ASCRS Annual Meeting there are excellent courses, symposia, and paper sessions for surgeons who want to "up their game" in the understanding of these concepts. —Richard Tipperman, MD Chair, ASCRS Cataract Clinical Committee CATARACT On the topic of machine settings, participants were asked about their confidence customizing phaco machine settings to manage different types of cataracts or to perform anterior vitrectomy. The majority were confident or very confident (72%) in customizing machine settings as needed for different cataracts, with confidence increasing, as expected, with more years in practice. Respondents who practiced internationally were more confident or very confident (77%) compared to U.S. surgeons (69%), and those who performed surgery in an office were more confident than those who operated in a hospital outpatient department (93% vs. 63%). When it came to phaco settings for an anterior vitrectomy, 41% of surgeons said they were very confident in their understanding of these settings, but 52% said they would benefit from learning more. As far as practice location, 45% of international surgeons were very confident vs. 38% in the U.S. In terms of comfort level for different approaches to anterior vitrectomy, most surgeons (61%) said they were only comfortable with the limbal approach; 26% were comfortable with both the limbal and pars plana approach. n=819 What is your comfort level performing anterior vitrectomy? I am comfortable with the limbal approach only I am comfortable with the pars plana approach only I am comfortable with limbal and pars plana approaches I am comfortable with either approach I do not perform anterior vitrectomy 4% 26% 6% 3% 61%

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