- ASCRS Annual Meeting kicks off 50th anniversary celebration
- Steinert Refractive Lecture: ‘RLE: What Would Roger Do?’
- Obstbaum Lecture reviews 30 years of glaucoma innovation
- Medical management of limbal stem cell deficiency
ASCRS Annual Meeting kicks off 50th anniversary celebration
The ASCRS Annual Meeting officially kicked off on Friday afternoon with the opening session and reception. ASCRS is celebrating its 50th anniversary this year.
Thomas Samuelson, MD, in his first meeting as ASCRS Program Chair, kicked off the session. “It’s great to be back in Boston, and finally our meeting is back in April where it belongs,” Dr. Samuelson said.
“This year, we celebrate the 50th anniversary of this storied organization,” he said. Dr. Samuelson acknowledged Kenneth Hoffer, MD, who founded ASCRS, then known as AIOIS, in 1974, and he also acknowledged David Karcher, former ASCRS Executive Director for 37 years.
Later in the session, Dr. Samuelson took the stage with Steve Speares, ASCRS Executive Director, Mr. Karcher, Marguerite McDonald, MD, Richard Lindstrom, MD, Dr. Hoffer, and Elizabeth Yeu, MD.
Dr. Hoffer described forming AIOIS in 1974, including recruiting people to join and establishing credibility. Early on, he began putting together a newsletter, which would later become the Journal of Cataract and Refractive Surgery.
Mr. Karcher discussed how he first got involved with ASCRS, having previously worked in the hotel business, when the meeting was being held at the Century Plaza Hotel. Mr. Karcher said he got a call about how the Society was undergoing a reorganization and was looking for someone to run the Annual Meeting.
Discussing the name change from AIOIS to ASCRS, Dr. Lindstrom said that it was the right thing to do. “Refractive surgery was exploding,” he said. “And we were the forum where people could share honest ideas about that.”
ASCRS relocated to the Washington, D.C., area, and both Dr. Samuelson and Dr. Yeu highlighted the important advocacy efforts of ASCRS through the years.
Commenting on her time as the first female president of ASCRS, Dr. McDonald said, “I felt like any other president. You have one year to be the steward of this amazing organization.” You want to grow it, offer better things to the members, and your goal in your 1-year term is to leave the Society better than when you first took the reins, she said.
Steinert Refractive Lecture: ‘RLE: What Would Roger Do?’
This year, Stephen Slade, MD, delivered the Steinert Refractive Lecture. “I’m extremely grateful to get this award. … I believe I’ve made every ASCRS [meeting] since it became ASCRS. ASCRS is sort of our ‘forever fellowship.’ It’s certainly where I come to learn, and I feel like a fellow at these meetings. Named lectures are special to me, and I’ve been privileged to give some. The thing is, if you know the person, it’s really special. I knew Roger. … To give his named lecture is a distinct honor.”
Dr. Slade went on to discuss refractive lens exchange (RLE). This is something that patients “get,” he said. Why are we doing all this RLE? It’s because there are lenses that are finally good enough. We’re doing surgery at a younger age, and that translates to more surgery.
Dr. Slade went on to discuss operating on demanding Baby Boomers. “I know these people, and it’s a value proposition because they’re paying for it, so they’re going to value and look at risks versus benefits.” They don’t necessarily understand cataract risks, but he said he hopes the audience understands malpractice risk. Any accommodation is hard to give up, and myopia is hard to give up, too. Be comfortable with lens exchanges, he said.
One lesson that Dr. Slade said he learned from LASIK was that uncorrected visual acuity drives satisfaction, and “we’ve seen that with RLE.” You have to see really well at distance with no glasses.
Another lesson he learned was about presbyopia. It’s what almost all of our patients have and what we have the fewest options for. If you have a chance to alleviate that, that’s a huge win, Dr. Slade said.
When you sit down with these patients, Dr. Slade said to realize expectations. Are you doing both eyes? What will the result be? What’s the astigmatism? Make sure they understand that they may need a YAG or enhancement or glasses. Dr. Slade stressed that patients may not get the planned lens, so it’s important that they know and understand this.
Editors’ note: Dr. Slade has financial interests with a variety of ophthalmic companies.
Obstbaum Lecture reviews 30 years of glaucoma innovation
Leon Herndon Jr., MD, delivered the Stephen A. Obstbaum, MD, Honored Lecture on “30 Years of Glaucoma Practice: Why I am Still Excited to go to Work Every Day!” during Glaucoma Day.
Dr. Herndon, who serves on the faculty at Duke University, has published more than 100 peer-reviewed papers, 17 chapters, and one textbook. He has given 159 national lectures, 23 international lectures, 16 named lectures, and has 17 visiting professorships. Dr. Herndon has had 89 glaucoma fellows and helped train hundreds of residents. With ASCRS, he served as chair of the Glaucoma Clinical Committee from 2020–2023 and has been on the committee since 2014. He also served on the 2018 CyPass Recommendations Task Force.
Dr. Herndon has served more than 144,000 patients and performed more than 14,000 surgeries. “I’m honored to add my name to the list of distinguished Obstbaum lecturers,” he said. In his lecture, Dr. Herndon focused on the evolution of glaucoma diagnostics, medications, surgical options, and the up-and-coming innovations.
In the 1980s, Dr. Herndon said he thinks the top glaucoma innovation was in the field of pharmacology. He also said that there was a time when intraocular lens implantation was not standard of care for glaucoma patients receiving cataract surgery; Dr. Obstbaum helped guide it to become standard of care.
In the 1990s, Dr. Herndon said he thinks wound modulation and OCT were the top glaucoma advances. He said during this time you had to line up paper printouts of visual fields to monitor for progression.
Now visual field monitoring is digital and there are head-mounted virtual reality perimeters making taking visual fields easier for the patient and the practice.
While OCT for glaucoma was published in the 1990s, it didn’t become widely clinically available until the early 2000s, and it has since become an invaluable tool for patient care, Dr. Herndon said. When he was a fellow, Dr. Herndon said optic nerves were drawn.
Dr. Herndon also took the audience through the different means of IOP measure measurements. He said newer advances are allowing patients to monitor IOP more frequently at home, and future implant sensors could allow for the “holy grail” of continuous monitoring. These newer IOP monitoring technologies are adding to our understanding of some glaucoma procedures.
Other technological advances Dr. Herndon highlighted were the Ocular Pressure Adjusting Pump (Balance Ophthalmics), contactless SLT with the Eagle device (Belkin Vision), and upcoming possibilities with artificial intelligence and genetic testing. He also described the evolution of glaucoma medical therapy and MIGS.
Dr. Herndon mentioned a paper that projects a concerning shortage of ophthalmologists amid high patient demand. “I’m making an appeal to all young medical students and residents in the audience to consider glaucoma as a profession. As you see, we’ve had great advances that will lead to a fulfilling career before you,” he said.
Editors’ note: Dr. Herndon has financial interests with various ophthalmic companies.
Medical management of limbal stem cell deficiency
In the final session of ASCRS Cornea Day, which focused on the ocular surface, Clara Chan, MD, presented on the medical management of limbal stem cell deficiency (LSCD).
Early diagnosis of LSCD can improve prognosis, she said. Medical therapies to optimize the ocular surface environment can reverse mild LSCD, and it’s important to eliminate causative factors and treat comorbid conditions. Treatment options depend on disease severity/laterality and epithelium stability. A scleral contact lens may obviate or delay the need for surgical intervention, Dr. Chan said.
When you look at staging, Dr. Chan said that if the central 5 mm is involved, it automatically becomes Stage II or III. She spoke about a landmark paper on how medical treatment can reverse LSCD, published in Ophthalmology in 2014, which discussed how you can rebuild the stressed niche area.
Dr. Chan also discussed medical treatment principles for LSCD. First, eliminate toxicities, inciting factors, and physical trauma to LSCD niche. Reduce inflammation and provide nutritional support to the limbal stem cells.
Dr. Chan shared a chart of options in the ocular surface optimization toolbox. These included categories of lubricants, anti-inflammatories, nutritional support, lid margin disease management, and adjuncts. She suggested to “throw in one thing from each category to be aggressive.”
Editors’ note: Dr. Chan has financial interests with a variety of ophthalmic companies.
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