- ASCRS Opening General Session kicks off Annual Meeting
- Rosa Braga-Mele, MD, gives Binkhorst Lecture on her journey in ophthalmology
- ASOA Opening General Session features recognitions and inspiring keynote
- Good to Great Surgeon symposium
ASCRS Opening General Session kicks off Annual Meeting
The ASCRS Annual Meeting officially kicked off on Saturday morning with the Opening General Session. Edward Holland, MD, chair of the Program Committee, welcomed attendees to the meeting. The session continued with Dr. Holland interviewing Richard Hoffman, MD, outgoing ASCRS president, and Douglas Rhee, MD, incoming ASCRS president.
Discussing the accomplishments during his presidency, Dr. Hoffman noted the successful Annual Meeting last year in Las Vegas, Nevada. This helped improve the finances of the organization, and “we’re going to come out of this pandemic in a great financial position,” he said.
Another success, or partial success, he said, was reducing/postponing some of the medical cuts happening. Hopefully, with grassroots efforts and legislation being worked on, it will reduce the effect of the policy, he said, adding that eyePAC has recently been reinstated.
ASCRS is continuing to improve the diversity of its leadership, Dr. Hoffman said, and has recently increased the number of women in leadership positions in the organization.
When asked about advice he would give to young ophthalmologists, Dr. Hoffman encouraged them to start presenting papers and volunteering to help at skills labs and on committees. ASCRS is a meritocracy, he said, if you volunteer, work hard, and do a good job, you’ll be given more and more responsibility.
Dr. Rhee shared his history in ophthalmology and how he became involved with ASCRS, noting that he first attended the Annual Meeting in 1999 in Philadelphia. “I can truly say I fell in love with this organization over time,” he said, noting that besides his training programs, he learned more from ASCRS and the meeting about how to take care of patients than anywhere else. “The practical information you get here is second to none,” he said.
Dr. Rhee also discussed the various leadership positions he has had within ASCRS. He started on the ASCRS Glaucoma Clinical Committee before eventually leading that committee.
Addressing what he hopes to accomplish during his presidency, Dr. Rhee joked, “Hopefully, my career in glaucoma will prepare me to ‘lower the pressure’ of the ASCRS presidency.”
He said that he has several initiatives planned. He’s working to assemble a consortium of organizations and individuals to initiate the TIME (topical vs. intracameral moxifloxacin to prevent endophthalmitis) study looking at intracameral moxifloxacin. He also mentioned the Ophthalmic Instrument Cleaning and Sterilization task force, led by David F. Chang, MD, and Cathleen McCabe, MD, which is endeavoring to reduce OR waste.
Dr. Rhee said that ASCRS is a progressive society, but there’s more work to be done. “We want ASCRS to be even more inclusive,” he said, encouraging everyone to volunteer. “You can make a difference with and through ASCRS,” he said.
Mitchell Weikert, MD, the recipient of this year’s ASCRS Educator Award, was also recognized. Dr. Weikert thanked ASCRS for the honor. “Receiving this recognition from an organization that has done so much for me personally and for our profession is an honor,” he said.
The session featured a talk from Chris Wallace, and he also joined a panel with Zaina Al-Mohtaseb, MD, Parag Parekh, MD, and Leela Raju, MD.
Mr. Wallace spoke about a variety of current topics, including Vladimir Putin, former President Barack Obama returning to the White House, Ketanji Brown Jackson being confirmed to the Supreme Court, and the pandemic.
Then he focused on President Joe Biden’s approval rating, noting that disapproval ratings are rising, particularly because of the perception that he’s soft on immigration, crime, and inflation. This disapproval, Mr. Wallace said, will likely have an impact on the midterm elections. He noted that since World War II, in the first midterm of a new president, the president’s party loses an average of 1 Senate seat and 23 seats in the House of Representatives. If Republicans make those average midterm gains, they will take back control, he said.
During the panel discussion, Dr. Parekh asked how ASCRS can cut through the noise to capture the attention of members of Congress and the administration more effectively to have the organization’s voice heard.
Mr. Wallace noted that the two things he thinks make the biggest impact are money and numbers. However, he said that merit makes a difference, too. “In a number of cases, particularly if you’re not up against powerful opposing lobbies, the opportunity to make a case on a subject of clear merit does make a difference,” he said.
Mr. Wallace also commented on the state of objective journalism and how many have seen a move toward more polarizing journalism. Mr. Wallace noted that he has gotten praise for being fair and even-handed recently and said he finds this “kind of depressing.” He began working in newspapers 53 years ago, starting out as a reporter at the Boston Globe. At that time, accuracy and fairness weren’t the subject of praise—it’s what stopped you from getting fired. But today, the fact that someone would be praised for being fair and down the middle is a “sad commentary” of the news business.
Mr. Wallace also commented on the lack of cooperation in Congress and if he thinks this is just “business as usual.” He discussed coming to Washington, D.C., in 1978, when his first job was covering the House of Representatives. What surprised him then was how many serious and thoughtful people there were who got things done. But now, he thinks there are many problems. Gerrymandering is a serious problem because there’s this situation where instead of the voters choosing the politicians, the politicians choose the voters. Mr. Wallace thinks there needs to be fundamental reform of how districts are set, and he thinks this would cause a lot of changes in representation.
The ASCRS Hall of Fame ceremony also took place during the session. This year, the late Roger Steinert, MD, and George Spaeth, MD, were inducted. Dr. Spaeth accepted his award, sharing a poem he wrote about what it means to truly see and expressed his gratitude for the honor. April Steinert, Dr. Steinert’s wife, accepted the award on his behalf. During the video presentation, she noted that he “wanted to share everything he learned with everyone because it benefited the patient.
Rosa Braga-Mele, MD, gives Binkhorst Lecture on her journey in ophthalmology
The Binkhorst Lecture wrapped up the ASCRS Opening General Session. This year, it was given by Rosa Braga-Mele, MD, and she spoke about her journey in ophthalmology, covering education, mentorship, and innovation.
Dr. Braga-Mele said that she was honored to receive the award. She noted that not only is she Canadian, but she’s the daughter of ethnic immigrant parents who strove for their children to do better than them, which pushed her to become a doctor.
She also spoke about previous Binkhorst Lecture awardees, mentioning Marguerite McDonald, MD, who won the award 20 years ago, and there has not been another woman since. It’s important to empower women to grow in positions in both medicine and leadership, she said.
A mentor is an experienced or trusted advisor, and Dr. Braga-Mele noted that she has had two significant mentors in her career. The first was Stephen Lane, MD, who she said has been a mentor with respect to many areas of education and working with industry. The second was I. Howard Fine, MD. “He probably started my speaking career in ophthalmology,” Dr. Braga-Mele said. She recounted meeting him on an escalator at an ASCRS Annual Meeting in San Diego many years ago and how that was the start of him supporting her career in ophthalmology.
Dr. Braga-Mele values being a mentor and teacher, saying that she’s “never not had a resident with me in the OR.”
“If I teach someone, you never know how many more people in the world that’s affecting,” she said. There’s a cascading influence.
She highlighted the “3 As of mentorship”: available, analytical, active listener.
The first rule of being a good teacher is being a good learner. She said she has always encouraged her residents to ask “why?” She’s done more papers with a resident or medical student on papers because of asking “why?”
Dr. Braga-Mele then spoke about innovation and technologies she has worked with. When we innovate, we make changes in something established, especially by introducing new methods, ideas, and products, she said. Innovation is not static; it’s dynamic.
She shared the research she’s worked on, including monitored anesthesia care provided by registered respiratory care practitioners during cataract surgery and bimanual sleeveless phaco. Though the sleeveless phaco didn’t come to fruition, one thing can blossom into others being developed by industry.
She also discussed several techniques, including the pocket chop, the Braga-Mele Chopper, and the Braga- Mele wiggle technique, as well as a study she did during the COVID-19 pandemic looking at concerns of the spread of respiratory droplets during cataract surgery.
Should we innovate with industry? Dr. Braga-Mele said this can also be helpful because sometimes you need funding support or a team to do new things. She mentioned her involvement in work on the Smaller-Incision New Generation Implantable Miniature Telescope (SING IMT) with Samsara Vision, the ELIOS system, and the Juvene lens from LensGen.
We wouldn’t be where we are without Charles Kelman, MD, and his innovative ideas, she added.
Another initiative that Dr. Braga- Mele said is close to her heart is the impact we’re leaving on the environment. She’s been working with Alcon to look at minimizing the carbon footprint companies have with the number of unnecessary ingredients in products.
Wrapping up her lecture, Dr. Braga-Mele discussed some things that help her balance her life. She is a certified Canadian basketball coach, and coaching is like mentorship, she said.
Balance is important because we forget about needing to keep ourselves in a position of a steady state. Dr. Braga-Mele shared some of the activities she likes to do to maintain balance in her life, including body building.
Editors’ note: Dr. Braga-Mele has financial interests with a variety of ophthalmic companies.
ASOA Opening General Session features recognitions and inspiring keynote
ASOA Executive Director Laureen Rowland, CAE, launched the ASOA Opening General Session, telling attendees to expect a “monumental experience” from the meeting.
She continued that “actually, we experienced that last night at the ASCRS ASOA Party for a Purpose. Thank you to all who donated to the ASCRS Foundation … Over $50,000 was raised and a special shoutout to ASOA’s ‘celebrity bartenders.’”
It’s been 9 months since the last Annual Meeting in Las Vegas, Nevada, and while that timeframe is short from a meeting planning standpoint, from ASOA’s perspective, that time has brought new programs, collaborations, and continued membership growth, Ms. Rowland said.
In the last year, ASOA launched its Growing as a Mid-Level Manager Certificate Program. It is also beginning a group mentorship program geared toward new administrators and launching a new virtual training program to augment in-person clinical training, Ms. Rowland said.
In the session, Deborah Davis, COE, was recognized as the outgoing ASOA president, and Thomas Brown, JD, COE, became president. Mr. Brown, an ASOA member since 1996, said that while his introduction by Ms. Rowland covered some of the highlights of his career, he wanted to share a story that is less than positive but serves as a life metaphor. He described going on a date with a woman in 1989, and as the evening ended, he completely missed the mark with a goodnight kiss, which landed on her nose. The next day, telling a female colleague at his work the story, Mr. Brown was advised to send flowers immediately. He took the colleague’s advice and later that day received a call from his date thanking him. The next week, he was visiting her house and meeting her parents when he saw the floral arrangement on the table. He said it was much more than what his money would have bought. He later asked his colleague about it. She grinned and said, “Everyone needs a little help sometimes.” The woman from the date is now his wife.
This is Mr. Brown’s message: “When you are helped, be sure to make the most of it, and when someone else needs help, be there for them.” Mr. Brown went on to describe how all of his jobs, successes, and failures have led to learning opportunities that have bettered him for the future.
“Remember … that normal people may never realize how amazing they can be, failure is another opportunity to begin again, and when someone else needs help, be there for them,” he said.
The 2022 AE Editor’s Choice Award, which recognizes the best member-authored article published in Administrative Eyecare magazine, was also given in this session. Dixon Davis, MBA, MHSA, received the award for his article “Rising Above – Strategic Leadership During a Crisis,” published in the January/February 2021 issue.
Bill Stainton, CSP, CPAE, served as the keynote speaker with “Connect the Dots: Breakthrough Thinking for Ophthalmic Professionals.”
Mr. Stainton is a 29-time Emmy Award-winning producer of the longest-running, highest-rated, and most award-winning regional comedy TV show in the U.S. (a Seattle-based show called Almost Live!). He began his talk asking if anyone likes to sit next to weird people. He ventured that most people would say no but challenged the audience to think of “weird” as just different.
“When we avoid people who are different, experiences that are different, ideas that are different, we’re missing out on the connections that are the building blocks of innovation. Your next breakthrough could be just one connection away, and if you miss it, it’s gone,” he said.
He gave an example. He was sitting on a flight from New York to Seattle, initially excited at the empty middle seat next to him, when at the last minute a woman, who he likened to the “crazy cat lady” in The Simpsons, boarded and claimed “his” middle seat. Mr. Stainton proceeded to put in headphones and listen to music up until the descent when she poked him, asking if Seattle was his home. Polite small talk continued, and he learned that she would be traveling on to Russia where she worked as a music teacher when she was younger. This got Mr. Stainton’s attention. He asked if she taught Russian music (“yes”) and enthusiastically told her that he was just listening to his favorite Stravinsky piece The Firebird. The woman then told him that she was with Stravinsky when he wrote it. Imagine Mr. Stainton’s surprised face. “Then the plane pulled up to the gate, and I never saw her again,” he said.
“I had completely written her off … because she was different,” he said, adding, “When we miss those connections, we’re missing those opportunities, opportunities to grow, to innovate.”
Innovation is the master key to facing challenges but most of us don’t use it, Mr. Stainton said. He said that while many think of innovation as a lightning bolt that only strikes a few, everyone has the ability to innovate, and innovations come in all shapes and sizes. The only difference that research has found separating creative thinkers and non-creative thinkers, Mr. Stainton said, is that creative people believe they’re creative.
Everyone (creatives and non-creatives) hits brick walls of all shapes and sizes. Innovative or creative thinkers, however, don’t just complain about it, they ask “How can this be better?”
“That’s what innovation is really about, looking at the situation, challenge, opportunity, problem and asking how can it be better,” Mr. Stainton said.
The answers come when you connect the dots, which are ideas, experiences, or an elderly woman in a middle seat.
“The more ideas you encounter, the more experiences you have, the more people you interact with, the more dots you can connect,” he said, later adding that “you never know which dot is going to be the one that leads to the breakthrough, which means we have to be open to new dots.”
This openness means removing blinders. Mr. Stainton gave an example of when he had blinders on. His show had booked Johnny Depp in late 1987, but at the last minute, Mr. Depp had to cancel. Now Mr. Stainton and his other writers were thinking of who they could invite as a guest at the last minute, and they kept hitting walls. One of the youngest, lowest paid writers piped up: “Maybe I could do something with liquid nitrogen,” Mr. Stainton recalled him saying. Mr. Stainton’s first reaction was “Bill, you’re scaring us,” but the host of the show lowered his blinders and wanted to learn more. The writer, Bill Nye, went on to describe what he could do on the show.
“He was the yellow dot, and I almost missed it,” Mr. Stainton said, explaining that the man who would later become known as Bill Nye, the Science Guy, changed the question when thinking about the problem and in doing so, changed the context, opening up a new possibility.
Mr. Stainton challenged attendees to find the yellow dot, the idea, the nugget, the next time they are in a situation that seems difficult.
“You never know which dot is going to be the one that leads to the breakthrough,” he said.
Editors’ note: The speakers have no financial interests related to their comments.
Good to Great Surgeon symposium
The Young Eye Surgeons (YES) Clinical Committee symposium Good to Great: Working Through Complications Video Symposium took attendees through topics like zonular loss/weakness, cataract under corneal scarring, use of an IOL scaffold in the setting of PCR, posterior polar cataract, small incision cataract surgery, and other complicated cases.
YES Clinical Committee Chair Zaina Al-Mohtaseb, MD, said that this has always been her favorite symposium. This year it was set up with members of the Clinical Committee presenting cases as well as residents.
Soroosh Behshad, MD, a YES Clinical Committee member, shared a video about how to handle zonular loss. His case involved a patient with Marfan syndrome. The lens looked stable on exam, and phacodonesis wasn’t as obvious as it was in the OR, he said.
Dr. Behshad said he knew he would need to suture the capsular bag to the sclera, and he was trying to preserve the capsular bag, which he said is an ideal situation in patients with Marfan syndrome. One pearl is to use a lot of viscoelastic with these patients, Dr. Behshad said. He added a capsular tension hook and began gentle hydrodissection to prevent trauma, and phacoed with a chopping technique to avoid further stress on the bag. He made sure to keep a second instrument under the phaco tip to prevent the bag from coming up, continuously injecting more viscoelastic.
Dr. Behshad went forward with careful cortical removal, placed a CTR to further stabilize, and at this point, he noticed something strange with the iris. He discovered a piece of nucleus underneath. After removing that, he was able to secure the capsular bag with an Ahmed segment. One pearl here, Dr. Behshad said, is to make sure you leave the suture ends long to confirm that you can bury the knot. He then placed a single-piece IOL because the bag was stable.
During the panel discussion Michael Greenwood, MD, said that the key with the rhexis in these cases is to make it big enough but not too big. He said this is a great case if you have access to femto as well.
Margaret Wang, MD, PGY-4, shared “Running with Scissors,” a case of a white cataract with capsular fibrosis that ended up with an anterior capsule rent. The patient was 40 years old and developed a white cataract 2 years after vitrectomy with a full silicone oil fill.
Dr. Wang began the case with trypan blue and placed iris hooks. She made the wound, took out the Healon (sodium hyaluronate, Johnson & Johnson Vision), and restained. Preoperatively, she said, the decision was made not to decompress, “and those were famous last words.” She started her rhexis with a cystotome, and an anterior rent occurred. The goal became preventing it from extending posteriorly. She used intraocular scissors to begin the flap within the rent. She said the rhexis was a little truncated because of the stickiness of the anterior capsule.
For phaco, she used a divide and conquer technique and was careful not to propagate the anterior rent. The cataract was easy to crack and no hydrodissection was needed. Once the first quadrant was removed, she said she felt more comfortable, and her hook was under the quadrants the entire time.
After cortex removal, Dr. Wang said the posterior capsule was intact, so she went forward inserting a single-piece IOL in the bag and removed the silicone oil. Six months after surgery, this patient’s IOL is still well centered in the bag. There is some nasal fibrosis.
Humberto Salazar III, MD, PGY-3, shared a case involving an IOL scaffold. It started with a 60-year-old man with a dense combined cataract in his left eye. The case was going well, with successful removal of the first two quadrants.
“Once I started to rotate the second half, there was posterior chamber rent I hadn’t noticed,” Dr. Salazar said, adding that this rent propagated, and the entire posterior capsule blew out.
He stayed calm, injected viscoelastic, brought the phaco tip out, and used viscoelastic to push the lens pieces in front of the iris. From there, he sutured his wound and through a paracentesis used a vitrector to try to break up the lens pieces. This was unsuccessful, so he pushed the pieces into the angle and performed a vitrectomy. Then he opened the main wound, placed more viscoelastic, and inserted a single-piece IOL within the sulcus, creating an IOL scaffold.
With this barrier between the vitreous cavity and anterior chamber, Dr. Salazar said he was able to phaco out the remaining pieces. Overall, the eye had a good outcome with this technique, he said.
Editors’ note: The speakers have no financial interests related to their comments.
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