Wednesday, April 23, 2008

EuroTimes Practice Management Resource Centre - Developing a vision for your practice

Great ophthalmologists do not necessarily make great business experts.

That is why EuroTimes has decided to invite business and management experts to address the EuroTimes Practice Management Resource Centre workshops at the XXVI Congress of the ESCRS in Berlin from Saturday September 13 to Monday September 15.

These workshops will be run every year and will be an integral part of the EuroTimes Practice Management Resource Centre service which aims to help ophthalmologists develop a vision for their practices.

At these workshops we will look at the challenges that ophthalmologists face and the opportunities that are available to them.

The knowledge they acquire at these workshops will assist them in delivering the highest level of services to their patients

For many ophthalmologists, the prospect of establishing and managing a practice can be daunting. These workshops will explain the nuts and bolts of running a successful practice and will also offer ophthalmologists and their practice staff the opportunity to discuss their personal experiences in practice development with their colleagues.

Further information about these workshops will be available on this weblog, in the May issue of EuroTimes and also on our website at

Tuesday, April 22, 2008

EuroTimes Podcasts with Dr Thomas Kohnen, Dr Emanuel Rosen and Dr Joseph Colin

One of the most exciting innovations on the EuroTimes website ( has been the launch of a podcasting facility.

We did our first podcast in September 2007 with an interview at the XXV ESCRS Congress in Stockholm where we talked to Dr Thomas Kohnen about Phakic IOls. We have now revisited the subject with an interview with Dr Joseph Colin.

EuroTimes editor Sean Henahan has also interviewed Dr Emanuel Rosen about the promising results from the solid-state laser system known as the Pulzar Z1 from CustomVis.

In the coming weeks we will be posting more podcasts on our website, so watch this space.

Monday, April 7, 2008

A maverick ‘doesn’t stab you in the back – he stabs you in the FOREHEAD’

By Howard Larkin

The “maverick” in question is, of course, Arizona Senator John McCain, the presumptive standard-bearer of the Republican Party in the November US presidential election.

The characterisation comes courtesy of Tony Snow, erstwhile chief flack for the current US President, George W Bush.

Tony graphically amplified his opinion of how Senator McCain has treated his fellow Republicans with a gesture involving a fist and a forearm. He’s still pretty sore about stuff like McCain supporting political campaign financing reform, and opposing tax cuts for the rich and torturing prisoners of war.

Your humble blog-o-spondent can only apologise for not having camera at the ready. Maybe you can download the tape from the American Society of Cataract and Refractive Surgery’s new EyeSpaceMD (Note: link to )? Hard for me to say without a password, but it appears to be there.

Tony was the featured speaker at the ASCRS Government Relations Committee’s general session at the society’s annual meeting in Chicago. You might more expect this kind of gesture along the docks in the Windy City’s Calumet Sag than on a tony stage in McCormick Place, one of the largest and highest priced convention centres in America, if not the world. Well, maybe not the world these days. Y’all come down to America, now, it’s gittin’ cheap. Well, cheaper, anyway.

Tony admits that the US economy isn’t looking so good at this instant. How could he when just two days ago the US Bureau of Labor Statistics reported a 3/10ths per cent increase in unemployment to 5.1 per cent in March alone?

But Tony points out that more people made more money in the US under George W Bush than in any period in history – an unprecedented 52 months of uninterrupted economic expansion and job growth, in fact.

Never mind that for most of those months jobs added fell well below the estimated 150,000 needed to keep up with population growth. Or that peak median household income during the current economic expansion didn’t exceed the peak during the previous business cycle for the first time since such statistics have been kept. Or that the US government only considers you “unemployed” if you have no job income at all and have actively looked for a job during the past month.

In other words, if you make $100 a month babysitting or have just given up looking for work after months of no luck, you’re not unemployed you’re just lazy, I guess. Add in the 4.9 million who are working part-time for “economic” reasons, a figure that has jumped more than 629,000 in the past year, and the 400,000 who are “discouraged,” meaning they are not looking for work because they don’t think jobs are available, and the unemployment rate jumps to a not-so-impressive 8.5 per cent.

Tony also failed to mention that for the most part, unemployed Americans also have no health insurance coverage. About 20,000 of the 47 million uninsured in the US die every year because they cannot get adequate care without coverage, according to studies by the Institute of Medicine and other researchers.

Still, Tony believes that the US remains the engine of economic development in the world. We are still the country where people come to make their fortunes, he says. And even though 81 per cent of Americans believe the country is on the wrong track, he says that about the same percentage say they themselves are doing just fine. As I go online, I’m having no trouble verifying the 81 per cent on the wrong course figure, but so far have yet to find the other data Tony vaguely refers to. But I’m sure it’s out there.

Anyway, if it seems a bit indecorous for a guy who fronted for the top Republican to bash the heir apparent like Tony does, just consider what he has to say about the Democrats.

Hillary Clinton: “When [Bill Clinton] walks into the room he is the focal point of everyone’s attention. When [Hillary Clinton] walks into the room, you ask ‘who turned up the air conditioner?’”

Bill Clinton: “I love to watch Bill Clinton for the same reason I watch the Indianapolis 500. I want to see what happens when he hits the wall at 200 miles per hour.”

Barack Obama: “Obama has Bill Clinton’s gift for telling people what they want to hear. …Hope and change? Raise your hand out there, who’s against hope?”

Tony even thumps his ex-boss George W: “He speaks English and Spanish in the same way – they’re both second languages.”

Very funny stuff. Standing ovation stuff.

Tony believes the real problem in America is that the political establishment, in the words of George W, “misunderestimates” the American people. The entire political establishment, on both sides, lacks a “governing ideology.”

Tony doesn’t say what that ideology should be beyond suggesting that it should reflect the spirit of freedom that America embodies. Apparently, it has something to do with standing together and shouting “USA, USA, USA,” like several thousand American citizens of all national origins did at Ground Zero in New York City several weeks after the 9/11 terrorist attacks. More substantively, it should promote technology and business growth somehow. I think.

Tony says he doesn’t think that any of the three prospective presidents has the oomph to break through the poisonous partisanship that has paralysed Washington. He thinks that this time around, Obama and McCain will slug it out, McCain will win the presidency, the Democrats will take large majorities in both houses of the US Congress, and the stalemate will continue. A “transcendent political leader” will be needed to break the gridlock and that might happen in the 2012 election cycle, if we’re lucky, says Tony.

Tony also notes that everyone expected Hillary Clinton to have the nomination in hand by now, and no one expected McCain to get the Republican nomination. Barack Obama, with his perfect political pitch, came out of nowhere, Tony says. With a superbly organised national campaign, I might add.

Democracy broke out, Tony says. And for once, he’s right. Maybe we won’t need to wait for 2012 to get away from personal attacks and obscene gestures as part of our political discourse. Though somehow, I doubt it.

Sunday, April 6, 2008

Dr Peter Barry answers critics of ESCRS Endophthalmitis Study

Dr Peter Barry offered a spirited defence of the European Society of Cataract and Refractive Surgeons(ESCRS)Endophthalmitis study at an ASCRS Symposium today.

Dr Barry, who was part of the ESCRS team that took part in The Around The World in 90minutes symposium, was discussing antibiotic prophylaxis with a number of colleagues from the American Society of Cataract and Refractive Surgery(ASCRS) the Asian Pacific Association of Cataract and Refractive Surgeons (APACRS) and the Latin American Society of Cataract and Refractive Surgery (ALACSA/LASCRS).

From the results of the ESCRS study, Dr Barry and his co-investigators recommended that intracameral cefuroxime should be adopted worldwide. They said its use could save many thousands of eyes from potential blindness due to postoperative bacterial endophthalmitis following cataract surgery with IOL implantation.

The study enrolled 15,971 subjects from 23 clinics in nine European countries. The study found that the rate of endophthalmitis ranged from 0.05 per cent to 0.35 per cent

Dr Barry referred to criticism of the study in the American literature and particularly by the editor of Ophthalmology who had stated that this rate was "extraordinarily high".

"I would challenge that comment, " said Dr Barry, "because in Sweden where the standard practice is intracameral cefuroxime and no antibiotics, in their intracameral cefuroxime group their endophthalmitis rate is almost identical to our intracameral rate."

Dr Barry said the March 2007 editorial in Ophthalmology was titled Making The Most of the Evidence. "I would say to the editor of Ophthalmology that he is not making the most of the evidence, " said Dr Barry.

The other members of the ESCRS team who presented at the meeting were Dr Jose Guell (astigmatism) Dr Thomas Kohnen (IOL optics), Dr Simonetta Morselli (phaco fluidics), Dr Richard Packard (coaxial versus biaxial phacoemulsification) and Dr Paul Rosen (multifocal versus monovision).


* A report on the ESCRS Endophthalmitis study will be featured in the May edition of EuroTimes. We are also preparing a podcast on the subject at featuring an interview with Dr Peter Barry

Saturday, April 5, 2008

Rolling Stones Start Up Binkhorst Lecture

They weren't there in the flesh but The Rolling Stones got the Binkhorst Lecture off to a lively start when their classic track "Start Me Up" pumped out from the audio system to introduce Dr Edward Holland on stage.

Dr Holland explained that he hoped his choice of music would help keep the audience awake but there was no danger of anyone dozing off as he delivered an absorbing address on Innovations in Corneal Surgery:Beyond Penetrating Keratoplasty.

The past few years have brought tremendous innovations in corneal surgery as new surgical procedures target the specific layer of pathology rather than replacing the entire cornea for all disorders. Endothelial disease is no longer managed by penetrating keratoplasty but rather the more precise techniques of endothelial keratoplasty. Anterior corneal disorders can be treated with the newer deep anterior lamellar keratoplasty techniques.

Dr Holland explained how patients requiring penetrating keratoplasty have better refractive outcomes because of laser vision correction surgery in the grafts as well as femtosecond assisted keratoplasty surgery. These techniques have resulted in much improved uncorrected as well as best corrected visual acuity.

The most challenging corneal patients, he said, are those with limbal stem cell failure. These patients benefit from the ever improving ocular surface transplant procedures as well as new advances in keratoprosthetic devices.

These new procedures have resulted in our ability to treat more corneal patients than ever before with a more rapid recovery and better visual outcomes.

A full report on Dr Holland's address will be published in a forthcoming issue of EuroTimes

Glaucoma experts accentuate the positive

Keep hope alive.

That was the message from Reay H Brown, MD, at the ASCRS Glaucoma Day held yesterday.

Dr Brown, addressing a session on The Business of Glaucoma, said the biggest challenge for doctors treating glaucoma patients was staying positive.

"Patients fear they are going blind," said Dr Brown. "Let us break the fear cycle and replace it with a hope cycle."

Dr Brown told delegates that most of the news on glaucoma outcomes was positive. Treatment is successful, most patients maintain vision and doctors can make a huge difference, he said.

He called on doctors to enjoy glaucoma care by recognising the challenges.
"Doctors fear they are not doing enough," he said. "We don't pay enough attention to patient fears and our own fears."

The key to breaking the fear cycle, he said, was for doctors to control the conversations with their patients. They should emphasise the success of glaucoma therapy, he said, and stay positive when talking to patients.

"If we feel optimism and hope," he said, "patients will too."

Dr Brown concluded his presentation by encouraging doctors to leave the patients with hope.

"Create a hope cycle," he said. "Giving hope to patients will give you hope too."

EuroTimes brings the sun to Chicago

The Windy City can be very pretty but it can also be very cold and wet.

The EuroTimes team flew into Chicago from Dublin late Thursday evening for the 2008 ASCRS/ASOA symposium and congress where we were greeted with the incessant rain that has been a depressing feature of the Irish and European landscape over the last few months.

Happily, the sun is now shining and Chicago is looking forward to its hottest weekend in three months, according to the weather forecasters.

That should cheer up the delegates at the conference in the McCormick Centre who are looking forward to hearing presentations on the cutting edge of innovation and excellence in ophthalmic surgery and practice.

The highlights of the debates will be published in EuroTimes in our June and July issues but you can get a snapshot of what is going on in this weblog every day.

As always, we welcome your comments and opinions so watch this space.