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ASCRS Journal Club

December 2020

Discussion with Faculty

The Q&A commenting for this ASCRS Journal Club has closed.

Richard Tipperman December 8, 2020 at 9:29 PM ET

Dr. Masket's paper in the ASCRS journal on ND is a treasure trove of information in managing these patients

Richard Tipperman December 8, 2020 at 9:28 PM ET

Reverse optic capture and or plano piggyback IOl both can alleviate ND. Would do planned ROC in the 2nd eye.

Ronald Wise December 8, 2020 at 9:27 PM ET

ND in patient with Fuchs Dystrophy and 20/25 uncorrected vision post op. I am reluctant to perform IOLX. Suggested treatment for first eye? What would you do differently on second eye?

Samuel Masket December 8, 2020 at 9:33 PM ET

Please look at our 2018 JCRS paper on ND (Jan 2018 Masket et al: Surgical Management of Negative Dysphotopsia).. IOL exchange is often not the best option for a symptomatic eye. Reverse optic capture is highly successful for ND, but not PD. Reverse optic capture can be done primarily or secondarily. ND is largely position of the optic relative to the anterior capsule. This is not true for PD where optic position seems to be immaterial.

Steven Siepser December 8, 2020 at 9:18 PM ET

Richard, I was pleased to hear that you are now a proponent of late exchanges, excellent thought. Steven Siepser, MD Great Job!

Leela Raju December 8, 2020 at 9:18 PM ET

Would this data change when you would proceed with a lens exchange? Sooner than later?

Samuel Masket December 8, 2020 at 9:25 PM ET

We do discuss the status of the capsule and urge them not to have a capsulotomy if they are symptomatic with PD. While we are comfortable with IOL exchange with open capsules, the options for IOL fixation are reduced. SM

Leela Raju December 8, 2020 at 9:06 PM ET

Welcome everyone- please feel free to submit your questions at any time and our panelists/discussants will respond as they come in.

Natalie Afshari December 8, 2020 at 9:02 PM ET

Welcome to everyone!

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