Cataract Surgery CE/CME ACCREDITED Watch Time: 32 mins

touchEXPERT OPINIONS Helping patients to see the maximum: Balancing the risks and benefits of intraocular lens options for cataract surgery

Stay abreast of the latest innovations in intraocular lens (IOL) technology and the key considerations influencing IOL selection and patient expectations.

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Video Chapters
What is the IOL of choice in a patient with healthy eyes?

Dr Rosa Braga-Mele discusses IOL selection in a patient who has healthy eyes with no other ocular diseases, problems, or history of surgery, and how to manage the patient’s expectations post-cataract surgery.

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What are the IOL options for patients with cataracts and irregular corneal astigmatism?

Dr Rosa Braga-Mele discusses the key factors to consider when selecting an IOL for a patient with irregular corneal astigmatism, and the importance of balancing patient expectations and needs.

view bio and disclosures 2/3 Next Interview
 
How does pre-existing retinal pathology impact IOL choice?

Dr Rosa Braga-Mele outlines the IOL options for a patient with age-related macular degeneration, and the considerations for post-surgical enhancements for patients undergoing cataract surgery.

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Overview & Learning Objectives
Overview

In this activity, an expert in cataract surgery, Dr Rosa Braga-Mele, discusses the range of IOL technologies available to address patients’ needs and expectations. The interviews focus on three different scenarios; a patient with healthy eyes, a patient with an irregular astigmatism and a patient with age-related macular degeneration.

This activity is jointly provided by USF Health and touchIME. read more

Target Audience

This activity has been designed to meet the educational needs of ophthalmologists, including cataract and refractive surgeons.

Disclosures

All individuals in a position to influence content have disclosed to USF Health any financial relationship with an ineligible organization. USF Health has reviewed and mitigated all relevant financial relationships related to the content of the activity. The relevant relationships are listed below. All individuals not listed have no relevant financial relationships.

Faculty

Dr Rosa Braga-Mele discloses: consultancy fees from Alcon, Johnson & Johnson, LensGen and Zeiss.

Content Reviewer

Christopher Donovan, MD has no financial interests/relationships or affiliations in relation to this activity.

Touch Medical Director

Alison Scott has no financial interests/relationships or affiliations in relation to this activity.

USF Health Office of Continuing Professional Development and touchIME staff have no financial interests/relationships or affiliations in relation to this activity.

Requirements for Successful Completion

In order to receive credit for this activity, participants must review the content and complete the post-test and evaluation form. Statements of credit are awarded upon successful completion of the post-test and evaluation form.

If you have any questions regarding credit please contact cpdsupport@usf.edu

Accreditations
Physician

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through a joint providership of USF Health and touchIME. USF Health is accredited by the ACCME to provide continuing medical education for physicians.

USF Health designates this enduring material for a maximum of 0.75 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The European Union of Medical Specialists (UEMS) – European Accreditation Council for Continuing Medical Education (EACCME) has an agreement of mutual recognition of continuing medical education (CME) credit with the American Medical Association (AMA). European physicians interested in converting AMA PRA Category 1 CreditTM into European CME credit (ECMEC) should contact the UEMS (www.uems.eu)

Advanced Practice Providers

Physician Assistants may claim a maximum of 0.75 Category 1 credits for completing this activity. NCCPA accepts AMA PRA Category 1 CreditTM from organizations accredited by ACCME or a recognized state medical society.

The AANPCP accepts certificates of participation for educational activities approved for AMA PRA Category 1 CreditTM by ACCME-accredited providers. APRNs who participate will receive a certificate of completion commensurate with the extent of their participation.

Date of original release: 25 November 2021. Date credits expire: 25 November 2023.

If you have any questions regarding credit please contact cpdsupport@usf.edu

Learning Objectives

After watching this activity, participants should be better able to:

  • Explain how novel IOL technologies address patients’ visual needs and expectations
  • Outline the key factors that influence IOL selection in patients undergoing cataract surgery
  • Formulate strategies to manage patient expectations post-cataract surgery
Faculty & Disclosures
Dr Rosa Braga-Mele

University of Toronto, Toronto, Canada

Rosa Braga-Mele, MD, is a Professor of Ophthalmology in the Faculty of Medicine at the University of Toronto, Canada. read more

Dr Braga-Mele is a cataract specialist and educator who speaks at national and international level on advanced surgical techniques and innovations in the area of phacoemulsification surgery, complicated cataract cases and intraocular lens (IOL) development. She has published over 150 abstracts and papers.

Dr Braga-Mele served as the Chair of the Education Clinical Committee (2015–2018) and Chair of Cataract Clinical Committee (2010–2015) for the American Society of Cataract and Refractive Surgery (ASCRS), and was a member of the Governing Board for ASCRS. She is Cataract Section Editor for EyeWorld (an ASCRS publication), and is on the Editorial Board of other ophthalmic publications.

She was the inaugural Research Director at the Kensington Eye Institute (KEI) in Toronto from 2007–2012. She was Cataract Director at the KEI during May 2013 to December 2019.

She has won multiple teaching awards, including the Silver Needle award at the University of Toronto, as well as the American Academy of Ophthalmology (AAO) Senior Achievement Award and the AAO Secretariat Award. Recently, she was awarded the University of Ottawa Alumni Association 2019 Meritas Tabaret Award.

Dr Rosa Braga-Mele discloses: consultancy fees from Alcon, Johnson & Johnson, LensGen and Zeiss.

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This Activity Is Funded By:

An independent medical education grant from Alcon Laboratories Inc.
This activity is provided by USF Health and touchIME.

The information provided by this CE activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

USF is an Equal Opportunity / Affirmative Action / Equal Access Institution.

USF Health is accredited by the Accreditation Council for Continuing Medical Education, the American Nurses Credentialing Center and the Accreditation Council for Pharmacy Education to provide continuing education to healthcare professionals. As an accredited provider, USF Health is required to disclose personal information to relevant accredited bodies that certify CE to process credits/contact hours, comply with reporting requirements, and for internal recordkeeping and regulatory purposes. USF Health does not share or sell any individual’s contact information or unique identifiers to any commercial supporter, advertiser, or third party without the specific permission of the individual.

Unapproved products or unapproved uses of approved products may be discussed by the faculty; these situations may reflect the approval status in one or more jurisdictions. The presenting faculty have been advised by touchIME and USF Health to ensure that they disclose any such references made to unlabelled or unapproved use. No endorsement by touchIME or USF Health of any unapproved products or unapproved uses is either made or implied by mention of these products or uses in touchIME or USF Health activities. touchIME and USF Health accept no responsibility for errors or omissions.

This content is intended for healthcare professionals.

Date of original release: 25 November 2021. Date credits expire: 25 November 2023.

This content is intended for healthcare professionals only. Please confirm that you are a healthcare professional.

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Question 1/5
What type of available IOL technologies can provide visual acuity at near, intermediate and far ranges?

EDOF, extended depth of focus; IOL, intraocular lens.
 Correct

Trifocal and EDOF IOLs can improve vision at near, intermediate and far ranges. Trifocal IOLs have three focus points, while EDOF IOLs provide a continuous range of vision across near, intermediate and far ranges.1,2

Abbreviations
EDOF, extended depth of focus; IOL, intraocular lens.

References

  1. Werner L. Ophthalmology.2021;128:e74–93.
  2. Breyer DRH, et al. Asia Pac J Ophthalmol (Phila). 2017;6:339–49.
Question 2/5
Which of the following post-surgical enhancements should not be used in a patient with dry eye?

IOL, intraocular lens.
 Correct

Laser keratorefractive surgery, i.e., LASIK or PRK, can be used in the treatment of residual refractive error after IOL surgery. However, dry eye can pose a significant risk for decreased best-corrected visual acuity following these procedures.

Abbreviations
IOL, intraocular lens; LASIK, laser-assisted in situ keratomileusis; PRK, photorefractive keratectomy.

Reference
Packer M. Curr Ophthalmol Rep. 2014;2:34–40.

Question 3/5
After discussions with your patient with cataracts, you have agreed that a trifocal IOL is most suitable. How do you counsel them on halos?

IOL, intraocular lens.
 Correct

The presence of halos around point sources of light is a known risk with trifocal IOLs. These optical aberrations can permanently affect a patient’s vision but will likely improve over time through a process of neuroadaptation.

Abbreviations
IOL, intraocular lens.

Reference
Braga-Mele et al. J Cataract Refract Surg. 2014;40:313–22.

Question 4/5
Your patient with cataracts also has advanced neovascular AMD. What treatment should you carry out prior to cataract surgery?

AMD, age-related macular degeneration; VEGF, vascular endothelial growth factor.
 Correct

It is recommended that patients with neovascular AMD be treated with intravitreal anti-VEGF therapy prior to undergoing cataract surgery. Real-world data suggest that 6 months’ of treatment prior to surgery leads to optimum long-term outcomes.

Abbreviations
AMD, age-related macular degeneration; VEGF, vascular endothelial growth factor.

Reference
Mehta H. J Clin Med. 2021;10:2538.

Question 5/5
You and your patient with cataracts and astigmatism have agreed on an IOL to implant. Prior to surgery, what is your strategy for managing their expectations?

IOL, intraocular lens.
 Correct

Preoperative counselling is key to the success of IOL surgery. Patients should be made aware of potential visual aberrations following surgery. While neuroadaptation may improve these aberrations, this could take several months.

Abbreviations
IOL, intraocular lens.

Reference
Braga-Mele R, et al. J Cataract Refract Surg. 2014;40:313–22.

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