EyeWorld Asia-Pacific June 2012 Issue

June 2012 48 EWAP NEWS & OPINION and Iridodialysis,” by Lisa B. Arbisser, MD , Bettendorf, Iowa, USA, highlighted the advantages of patience and transparency. Dr. Arbisser said she hoped the attendees would take home several learning points, among them that surgeons need to be “vigilant and prepared for what might happen next,” she told EyeWorld . “Wait for nature to take its c ourse and create fibrosis.” Other take-home points Dr. Arbisser hopes the audience learned are to control the situation by not creating turbulence, developing a plan to restore the natural anatomy, and to communicate and counsel patients that the injury may need more than one surgery to repair properly. Some other teaching points of the ASCRS Cataract Clinical Committee session: vitreous tapping should be toward the optic nerve, and surgeons should try to avoid taking out too much (which is easier with the vitrector); if the patient has weak zonules it may increase the risk of lens expulsion; ensure surgical tools are prepped and functioning properly before beginning surgery; in posterior polar cataracts, be careful not to overinflate with viscoelastic. Ethics: How to deal with trying patients All surgeons have, at one point or another, encountered unhappy, demanding, or outright furious patients. Pearls for how to respond ethically in these trying situations were offered Sunday evening at the “Ethics in the Premium Era: Informed Consent, Outcomes, and Patient Management” seminar. During the seminar, chair Rosa Braga-Mele, MD , ethicist John Banja, PhD , and panelists David Dillman MD, Audrey Talley-Rostov, MD, Rich Hoffman, MD , and Gary Foster, MD, discussed several cases ranging from a “highly motivated” patient to one who is irate. The panelists first debated whether surgeons are ethically required to tell all patients about multifocal options, even if they don’t believe in the technology. “It does border on unethical to not offer them the option,” Dr. Hoffman said. “Whether you use them or not, you need to make every patient aware. I start with the cost, and many times the discussion ends there.” Dr. Banja said doctors tend to speak too fast when laying out the options for patients, especially those with type A personalities. “You don’t realize when you’re speaking rapidly that it makes it much harder for the listener to encode and interpret,” he said, adding that it would help the informed consent process now and cut down on complaints later. For the angry patient with the suboptimal outcome, Dr. Banja said remaining calm is the first step. Innovators: ‘The patients are waiting …’ Over the years, Douglas D. Koch, MD , Houston, Texas, USA, said he had always been amazed by the Charles D. Kelman Innovator’s Lecturers and their work. “I’m kind of bowled over still,” he said. In his Innovator’s Lecture, Dr. Koch took a concise, comprehensive look at optimizing IOL surgery. A new nomogram for toric IOLs is needed, he said, making three recommendations: account for the against-the-rule shift of astigmatism; account for posterior corneal astigmatism; and, when feasible, measure posterior corneal astigmatism pre- and intraoperatively. Paying tribute to the Kelman Lecture’s namesake, Dr. Koch quoted the last sentence of Dr. Kelman’s autobiography, Through My Eyes : “But right now, they’re waiting for me in the operating room…” Dr. Kelman, said Dr. Koch, was always focused on the patients. “Right now, our patients are waiting for us to solve these problems and provide them with the best possible vision for their lifetimes,” said Dr. Koch. “I think the future is extremely promising, there’s a lot to be done, but we’re up to this task.” Film Festival presents ‘Infinite possibilities’ The ASCRS celebrated “three decades of cutting edge videos from the world’s leading ophthalmic surgeons.” The ASCRS Film Festival now attracts more than 170 submissions a year from all over the world— this year, the judges selected the winners from 180 submissions. This year’s panel of judges was graced by the presence of two visionaries from the early days of the festival. Danièle Aron- Rosá, MD , Paris, France, this year’s international guest judge, was winner of the first grand prize video on YAG laser capsulotomy. Spencer P. Thornton, MD , Nashville, Tenn., USA, the Film Festival’s historian, was a co- founder of the festival. Out of the 21 videos selected to win places in each of the 11 categories, three were chosen as the “Best of the Best.” Still, said William J. Fishkind, MD , Tucson, Ariz., USA, chair of the panel of judges, “all producers, winners or not, will have hit a home run.” One of the three “Best of the Best” videos, “Corneal biomechanics: What all refractive surgery should be aware of?” produced by Isaac Cavalho de Olivera Ramos, MD , Rio de Janeiro, Brazil, was the winner of the Quality Teaching category. Another, “Zen and the Art of Monovision Maintenance,” produced by Graham D. Barrett, MD , Nedlands, Australia, holds the distinction this year of being the only video to win in two different categories. As the title of the video suggests, Dr. Barrett based his video on the philosophy of Zen and the Art of Motorcycle Maintenance by Robert M. Pirsig. The grand prize winner, “Infinite possibilities: Using small aperture corneal inlay to treat variety of presbyopic patients”, produced by Minoru Tomita, MD , Tokyo, Japan, also won the Refractive/Cornea Surgery Category. Dr. Tomita’s video structures an informative lesson on the pinhole corneal inlay around a narrative based on an episode of Twilight Zone. Dr. Fishkind invited attendees to join next year’s Film Festival. “Remember if you have an idea, an inspiration, a story, a technique, a yearning to be creative, take a chance,” he said. “Produce a video and submit it here.” Marguerite McDonald, MD, ‘Visionary Woman’ At this year’s Ophthalmic Women Leaders’ (OWL) traditional ASCRS Monday night reception, Marguerite McDonald, MD , Long Island, NY, USA, was named the organization’s inaugural Visionary Woman Award recipient. The award was created to honor “extraordinary nominees who have worked to advance women in eyecare”, according to OWL. Among Dr. McDonald’s many accomplishments, she is heralded as being the first surgeon to perform laser vision correction and was the first female president of both ASCRS and International Society of Refractive Surgery (ISRS). Jaci Lindstom introduced Dr. McDonald to the attendees and noted she has “trailblazing partnerships with industry that paved the way for other women to serve in this capacity,” Ms. Lindstrom said. “She was the first female president of ASCRS and ISRS, a founding member of OWL, and now we have seen women become presidents of other world organizations.” Noting Dr. McDonald had “advocated, taught, mentored, and trained” numerous women in the early phases of their careers, Ms. Lindstrom said Dr. McDonald had achieved it all “with integrity, intelligence, respect for others, and humor.” As she accepted her award, Dr. McDonald said she hoped to continue to be “inspired and educated by you all in the many years to come.” “As our winner, Marguerite McDonald exemplifies what the award was created to celebrate,” said Jan Beiting , OWL president. “She has long been someone that I personally turn to for advice, and as a founding member of our first advisory board, she was instrumental in helping OWL take flight.” The Lindstrom Family Foundation sponsored the award. 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