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LIVE from Hawaiian Eye 2013: Hightlights from the Tuesday Seminars

Lots of great information shared in Kona. Highlights from yesterday’s meeting courses:

Alan E. Reider, JD, MPH warned attendees against written co-management agreements, between providers, that is.

“The Office of Inspector General (OIG) has stated publicly and in regulations that an agreement to refer a patient back in exchange for a referral raises serious risk of violating the Anti-Kickback Statute. When you have a contract for co-management, you have eliminated the patient from the equation. The patient is the decision maker in co-management. Patient choice is critical.”

Of course a written consent agreement between the patient and provider prior to comanagement is essential. See OMIC’s Coordinating Care with Optometrists and Comanagement Consent Form.

John A. Hovanesian, M.D. discussed conventional cataract surgery results as compared to the femtosecond-assisted procedure. The seminar made a convincing case for traditional surgery attaining comparable results.

He identified three steps for surgeons to improve and possibly meet this accuracy:

1. Mark the astigmatic axis in advance using a marking pen while the patient is upright.
“I like to mark both the horizontal and vertical axis,” Dr. Hovanesian said. “This can be done by a well-trained nurse who understands how to get the patient fixated and upright.”

2. Mark the capsulotomy for size and shape.
“You can follow the line. I find that by doing this, I tend to pay more attention to the mark on the cornea and less attention to landmarks like the iris,” Dr. Hovanesian said. “When we follow the iris, we tend to stray off from the intended path and intended size of our capsulotomy. Here, we’re much more consistent.”

3. Meticulously clean the lens epithelial cells using a capsule polisher.
“No matter how carefully you’ve done your irrigation and aspiration, I’m always amazed at how many lens epithelial cells remain.”

See OMIC’s resources for Femtosecond and Cataract Surgery.