EnVision Summit 2023: A collective insight into the talk

Multiple attendees of this year's EnVision Summit sat down with MJH Life Sciences' Peg Achenbach, OD, FAAO, Executive Director/Global Ambassador Strategies, Ophthalmology and Optometry, to share insights into their presentations at the EnVision Summit.

Editor's note - This transcript has been edited for clarity:

Himani Goyal, MD:

Yeah, so today I spoke about the refractive changes after DMEK. And, you know, traditionally, we've been taught that there's a hyperopic shift within like this .75/+.75 range, plus or minus a little bit. And I really wanted to talk about my personal cases with DMEK, and how they don't fit that trend at all. And really just sort of get everyone to think about how we could do better. And maybe even changing our practice pattern of when we do DMEK, how we do pre-op calculations when we do those pre-op calculations. And also to think that, hey, maybe there isn't really a systematic way for us to predict what's going to happen. And so I presented, actually, a case where there was a myopic result, a case where there was an emmetropic result. And then where there was a hyperopic shift of way more than that, +.75 like in the range of +1.5, to 2.5.

You know, there's so many things that we could maybe even stare at this typography and see if there's a way we can predict. But what I proposed is that maybe we should be doing DMEK and cataract surgery as a stage procedure more often, with DMEK being first, versus cataract surgery being first. And what that allows us to do is really take advantage of getting a clearer cornea, getting better measurements, and then having that predictive result that we're so good at with cataract surgery in our patients who have normal anatomy.

And the second thing that I recommended is, besides, you know, doing this stage DMEK first procedures that maybe there should be a trend for us to now do baseline biometry, and typography in our adult patients who don't have any pathology at all. And it sort of brought me back to like now being part of an academic institution where we're collaborating with our retina colleagues and all of our other colleagues, you know, sometimes we'll see a young patient, myopic, or otherwise, that has trauma or comes in with a spontaneous retinal detachment.

You go into the surgery with – end up doing oil and all these kinds of things and get a premature cataract in one eye. And now we don't have any measurements. And we're doing what second best, is taking the other eye and using that for calculations. And eventually we're going to revert this pathology back into as normal as possible. But maybe if we had gotten those measurements beforehand, we would be better prepared.

So it's really food for thought to get everyone to also open up about hey, you know, maybe your results and our results are not this classic hyperopic shift and where they can go. And so there was a lot of great discussion. You know, some people even brought up hey, these could be great pieces for a light adjustable lens, which is amazing, an amazing thought. And really just, there's so many different options, not just 1, but it was to sort of talk, start the discussion on, maybe we need to think about changing our practice patterns.

Maja Kostic, MD, MPH, PhD:

So the title of my lecture today was like "Finally Answered," so that is, like, very interesting topic about some very rare mutation. It's like, [inaudible] mutation. And they're just 25 families worldwide described about this mutation. So we have been fortunate that we have 3 patients in last 6 years at Bascom Palmer Eye Institute, all of that started when I was a fellow there. And we just had like this third patient. So I talk about, you know, how we solve the problem for those patients, and then how we can move forward and help them in understanding their disease and also having the prognosis for their disease.

Jessica Randolph, MD:

I spoke today on transitioning from private practice to academics in retina. And so I talked about things to consider before you leave or before you decide to leave. And then once you've decided how to find a good fit, and then once you get to your new place, sort of how to lean into the academic way of life and all the things to be on the lookout for and questions to ask and look for. So I think it was, I think it was great, and I really enjoyed giving it. I love this conference. It's a wonderful time to spend with others in a beautiful location.

Hong-Uyen Hua, MD:

Yes, my poster was a retrospective observational case series of 10 patients who receive scleral windows and we use intraoperative OCT guidance in order to figure out the appropriate depth for the scleral windows. And our project is the first of its kind using intraoperative OCT for these windows and showed excellent post operative outcomes. All of these patients showed better subretinal fluid, almost resolution of subretinal fluid and 7 out of 10 of these patients had complete resolution of their subretinal fluid and the majority of these patients showed improvement in their visual acuity afterwards