NEW ORLEANS ACADEMY OF OPHTHALMOLOGY 61st ANNUAL SYMPOSIUM

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2 NEW ORLEANS ACADEMY OF OPHTHALMOLOGY 61st ANNUAL SYMPOSIUM February 10 12, 2012 SHERATON NEW ORLEANS HOTEL Program Committee Chairs O. Jay LaCour III, M.D. and D. Anthony Mazzulla, M.D. Needs Assessment Retinal vascular diseases are responsible for many cases of blindness throughout the world. Recent studies have been published that have the potential to change the standard of care for Age-Related Macular Degeneration. Over the last few years, new surgical techniques have expanded the physician s armamentarium for treating vitreoretinal disease. Orbital trauma that is not cared for correctly and expediently is a serious threat to vision. Devastating endophthalmitis is a potential side effect, and recent research has shown an increasing resistance to conventional antibiotics. As the population ages, the incidence of cataract also increases. New techniques in IOL fixation techniques are changing the standard of care for cataracts and intraocular lenses. Comprehensive ophthalmologists and subspecialists need to be updated on the recent clinical trials, new techniques and treatments that impact the standard of care in retinal diseases, ocular trauma and anterior segment disorders. 2

3 Purpose The focus of this meeting will be to update the general ophthalmologist as well as the specialist on the latest in diagnosis, medical management, surgical techniques and clinical outcomes in the fields of retina, oculoplastics and anterior segment, as well as research on future developments in these disciplines. Educational Objectives Upon completion of this program, participants should be able to: Integrate anti-vegf agents into the pre-existing treatment paradigms for diabetic retinopathy. Compare and contrast existing therapies in the management of cystoid macular edema secondary to venous occlusive disease. Interpret the results of the CATT study and its application to practice. Integrate prior and current treatment modalities to provide optimal treatment for patients with ARMD. Evaluate the role of evisceration/enucleation, as well as alternative therapies, like immunosuppressive therapy, in preventing sympathetic ophthalmia. Review current techniques of IOL fixation and determine the most appropriate technique for the patient. Evaluate current therapies for endophthalmitis. Critique surgical approaches to posterior segment trauma. Apply current information to avoid and/or manage complications during and after cataract surgery Appraise current office procedures for corneal complications - perforations, recurrent erosions and epithelial defects Recognize current concepts in thyroid eye disease - risk factors, severity, as well as medical and surgical therapy for each phase. Summarize the most useful techniques for repairing orbital fractures. Compare and contrast various therapeutic and surgical options for facial rejuvenation as botulism toxin, soft tissue fillers, blepharoplasty and rhytidectomy. Accreditation The New Orleans Academy of Ophthalmology is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Designation The New Orleans Academy of Ophthalmology designates this educational activity for a maximum of AMA PRA Category 1 Credits. Physicians should only claim credits commensurate with the extent of their participation in the activity. 3

4 Faculty Gary W. Abrams, M.D. Professor of Ophthalmology Kresge Eye Institute Detroit, MI Anita Agarwal, M.D. Associate Professor of Ophthalmology and Visual Sciences Vanderbilt Eye Institute Nashville, TN Riva Lee Asbell AB, CO Clinical Assistant Professor of Surgery UMDNJ- Robert Wood Johnson Medical School New Brunswick, NJ Neil M. Bressler, M.D. The James P. Gills Professor of Ophthalmology Wilmer Eye Institute, Johns Hopkins University School of Medicine Baltimore, MD Jeffrey Daigrepont, EFMP Senior Vice President, Coker Group Alpharetta, GA Jonathan Dutton, M.D., PhD Professor of Ophthalmology University of North Carolina Chapel Hill, NC Richard S. Hoffman, MD Clinical Associate Professor Oregon Health & Science University Eugene, OR David E. Holck, MD Private Practice San Antonio, TX David G. Hwang, MD, FACS Professor of Ophthalmology, Co-Director Cornea Service, and Director, Refractive Surgery Service Department of Ophthalmology University of California, San Francisco San Francisco, CA William F. Mieler, MD Professor and Vice-Chairman Department of Ophthalmology & Visual Sciences University of Illinois at Chicago Chicago, IL Jeffrey Nerad, MD Professor of Ophthalmology, University of Cincinnati School of Medicine Private Practice, Cincinnati Eye Institute Cincinnati, OH The New Orleans Academy of Ophthalmology relies upon invited speakers at all sponsored continuing medical education activities to provide information objectively and free from bias or conflict of interest. In accordance with ACCME and institutional guidelines pertaining to potential conflicts of interest, the faculty for this continuing medical education activity have been asked to complete faculty disclosure forms. In the event that some invited speakers indicate that they have a relationship which, in the context of the subject of their invited presentation, could be perceived as a potential conflict of interest, they have agreed to disclose such a relationship, but do not consider that it will influence their presentation. The intention is to provide full disclosure of any potential conflict-of-interest, real or perceived, which is related to a specific event. 4

5 Friday, February 10, :00-7:45 AM Registration and Continental Breakfast 7:55-8:00 AM President s Remarks Jonathan D. Nussdorf, M.D. Session I Macular Disease 8:00-8:15 AM Legacy of Don Gass Anita Agarwal, MD 8:15-8:40 AM Common Questions Regarding Dietary Supplements and Age-related Macular Degeneration Neil Bressler, MD 8:40-8:55 AM Clinical Implications of CATT Results on Treatment of Neovascular Age-related Macular Degeneration Neil Bressler, MD 8:55-9:10 AM NSAIDs-The Current Role in the Management of Postoperative Inflammation and CME William Mieler, MD 9:10-9:25 AM Commonly Misdiagnosed Macular Conditions Anita Agarwal, MD 9:25-9:55 AM Roundtable: AMD: VEGF Agents; Preferences, Cost Considerations, PDT, IVTA Moderator: Gary Abrams, MD Panel: Drs. Anita Agarwal, Neil Bressler, William Mieler 9:55-10:05 AM Q & A 10:05-10:40 AM break and Visit the Exhibits Session II Endophthalmitis & Uveitis 10:40-10:55 AM Countering the Rising Threat of MRSA and Fluoroquinolone Resistance: What Every Ophthalmologist Needs to Know David Hwang, MD 5

6 10:55-11:15 AM Current Management of Endophthalmitis 2012 William Mieler, MD 11:15-11:35 AM Ocular Parasites Anita Agarwal, MD 11:35-11:55 AM Panuveitis-Approach to Diagnosis Anita Agarwal, MD 11:55-12:05 PM Q & A 12:05-1:30 PM Lunch and Visit the Exhibits Session III Orbit 1:30-2:00 PM Thyroid Eye Disease Jonathan Dutton, MD 2:00-2:15 PM Eyelid Lesions Made Easy Jeffrey Nerad, MD 2:15-2:30 PM Update on Orbital Fracture Repair David Holck, MD 2:30-2:45 PM Orbital Foreign Bodies Jonathan Dutton, MD 2:45-3:00 PM Pearls in Blepharoptosis Repair Jeffrey Nerad, MD 3:00-3:10 PM Q & A 3:10-3:40 PM break and Visit the Exhibits Session IV Anterior Segment 3:40-3:55 PM Phaco Crush: A Technique to Reduce Ultrasound-Related Corneal Complications after Cataract Surgery David Hwang, MD 3:55-4:10 PM P.K.P. R.I.P.? Have New Selective Keratoplasty Procedures Made Penetrating Keratoplasty (PKP) Obsolete? David Hwang, MD 6

7 4:10-4:30 PM Management of Decentered IOLs Richard Hoffman, MD 4:30-4:45 PM Pseudoexfoliation Challenges & Options Richard Hoffman, MD 4:45-5:00 PM Will New Medical Therapies Render Endothelial Keratoplasty (EK) obsolete? Investigative Approaches to the Prevention and Management of Corneal Edema David Hwang, MD 5:00-5:10 PM Q & A 5:15-6:15 PM Workshop Pitfalls in EMR Chart Documentation Riva Lee Asbell Workshop Ethics: ACO s/physicians as Employees the Good and the Bad Dennis Agliano, MD 5:30-8:00 PM President s Wine and Cheese Reception Open to all attendees and their guests Saturday, February 11, :15-7:50 AM Registration and Continental Breakfast 7:50-8:00 AM President s Remarks Session V Orbit 8:00-8:15 AM A Ten Year Review of Orbital Fracture Complications David Holck, MD 8:15-8:30 AM An Update on Lacrimal Intubation Techniques Jeffrey Nerad, MD 8:30-8:45 AM Changing Concepts in Orbital Implants Jonathan Dutton, MD 7

8 8:45-9:00 AM When do I Use External Approach vs. Endoscopic Approach in Medial Wall Orbital Decompression David Holck, MD 9:00-9:30 AM Principles of Eyelid Reconstruction Jeffrey Nerad, MD 9:30-9:50 AM Facial Rhytidectomy Advanced Oculoplastic Surgery David Holck, MD 9:50-10:00 AM Q & A 10:00-10:30 AM Break and Visit the Exhibits Session VI 10:30-10:45 AM Posterior Segment Manifestations of Closed-Globe Ocular Injuries William Mieler, MD 10:45-11:00 AM Traumatic Retinal Detachment Gary Abrams, MD 11:00-11:15 AM Management of Retained IOFBs William Mieler, MD 11:15-11:30 AM What s New in PVR? Gary Abrams, MD 11:30-11:45 AM Management of Choroidal Hemorrhage Gary Abrams, MD 11:45-12:10 PM Roundtable: Differing Surgical Approaches to Trauma: Lensectomy, Pars Plana or Limbus, Timing of Repair (Case discussion) Moderator: Anita Agarwal, MD Panel: Drs. Abrams, Bressler and Mieler 12:10-12:20 PM Q & A 12:20-1:20 PM Lunch Presentation: Secrets of the Eye Codes Riva Lee Asbell Visit the Exhibits 8

9 Session VII 1:20-1:40 PM Principles of Upper & Lower Blepharoplasty Jeffrey Nerad, MD 1:40-1:55 PM Aesthetic Brow Lifting- Is There an Ideal Approach? David Holck, MD 1:55-2:25 PM blepharospasm and Hemifacial Spasm Jonathan Dutton, MD 2:25-2:40 PM An Introduction to Cosmetic Toxins & Facial Fillers Jeffrey Nerad, MD 2:40-2:55 PM Facial Palsy Management- Are There Better Ways? David Holck, MD 2:55-3:20 PM Roundtable: Evisceration, Yes or No Moderator: Jonathan Dutton, MD *FOR Dr. Dutton *AGAINST Dr. Agarwal Discussion - Drs. Agarwal, Dutton, Holck and Nerad 3:20-3:30 PM Q & A 3:30-4:00 PM break and Visit the Exhibits Session VIII 4:00-4:15 PM Office-Based Corneal Procedures for the Comprehensive Ophthalmologist I: New Ideas for Management of Corneal Perforations and Recurrent Erosions David Hwang, MD 4:15-4:30 PM Scleral Fixation without Conjunctival Dissection Richard Hoffman, MD 4:30-4:45 PM Office-Based Corneal Procedures for the Comprehensive Ophthalmologist II: Management of Persistent Corneal Epithelial Defects David Hwang, MD 4:45-5:00 PM Minimally Invasive ExPress Shunt Implantation without Conjunctival Dissection Richard Hoffman, MD 9

10 5:00-5:10 PM Q&A 5:15-6:15 PM Workshop DSEK for Beginners: Techniques and Tips David Hwang, MD Workshop EHR: Where Have We Been and Where Are We Going Jeffery Daigrepont Sunday, February 12, :00-7:25 AM Registration and Continental Breakfast 7:25-7:30 AM President s Remarks 7:30-8:30 AM Workshop: Early Morning Eye Opener Session IX Retinal Vascular Disease 8:30-8:45 AM Treatment of Macular Edema from Retinal Vein Occlusions: How Do We Choose Which Treatment Among So Many Choices Neil Bressler, MD 8:45-9:00 AM Update Regarding Management of Venous Occlusive Disease William Mieler, MD 9:00-9:15 AM branch Retinal Artery Occlusion in the Young Anita Agarwal, MD 9:15-9:30 AM Retinal Angiomatous Proliferation (RAP) Gary Abrams, MD 9:30-10:00 AM Roundtable: When to Poke, When to Burn (BRVOs, CRVOs in the VEGf Era) Moderator: Neil Bressler Panel: Drs. Abrams, Agarwal and Mieler 10:00-10:10 AM Q & A 10:10-10:25 AM Break 10

11 Session X 10:25-10:50 AM Update on Treatment of Diabetic Macular Edema Neil Bressler, MD 10:50-11:05 AM Update Regarding Medical and Surgical Management of Diabetic CME William Mieler, MD 11:05-11:20 AM Diabetic Vitrectomy/TRD Repair Gary Abrams, MD 11:20-11:50 PM Roundtable: Role of Anti-VEGF in Proliferative Disease Moderator: William Mieler, MD Panel: Drs. Abrams, Agarwal and Bressler 11:50-12:00 PM Q & A 12:00-12:10 PM Closing Every effort has been made to present the program as accurately as possible from information available at the time of printing. The New Orleans Academy of Ophthalmology reserves the right to make changes to the program. 11

12 Hotel Accommodations Sheraton New Orleans Hotel 500 Canal Street New Orleans, LA (504) (888) A block of rooms have been reserved for registrants at the special rate of $ To make your hotel reservations, call the Sheraton and mention the New Orleans Academy of Ophthalmology. The Sheraton may charge an early departure fee if your scheduled length of stay changes, so please inform the hotel prior to arrival on any change in departure date. After January 9, 2012, reservations will be on a space available basis. Please make your hotel reservations in advance. Registration information ** All New Orleans Academy of Ophthalmology members should register in advance for the meeting. Please register online at or send in the registration form.** The registration fee of $ includes all course materials and refreshments. The deadline for the early registration fee is January 9, After January 9, the fee is $ The registration fee of $ ($295 after January 9) is for the allied health professional whose physician is not a NOAO member. The registration fee of $25.00 is for allied health professionals whose physician is a NOAO member. These fees include entrance to the Symposium, all course materials and refreshments. There is no charge for residents if letter from chief of service accompanies the reservation form. New this year 1st Annual Technicians Conference, Friday February 10, Please see for registration and pricing details. If you do not receive a confirmation of registration or you have any questions regarding this conference, please contact the Academy office at

13 Cancellation policy Cancellation requests must be made in writing via , facsimile or by mail. A cancellation fee of $50.00 will be assessed if request is postmarked by January 9, After January 9, the cancellation fee is $ Please enclose a copy of your confirmation slip with your notice of cancellation. Note: No refunds will be made once the meeting begins. Workshop Registration Information The following workshops are available at no charge to attendees of the 2012 Annual Meeting: Pitfalls in EMR Chart Documentation Instructor: Riva Lee Asbell, AB, CO Friday, February 10, 5:15 6:15 PM This course reviews chart documentation problems found in electronic medical records (EMR) and gives a step-by-step critique on how to identify and then correct them. Suggestions for formatting your EMR as well as problems encountered in audits and under review by the OIG will be discussed. Ethics: ACOs and Physicians as Employees The Good and the Bad Instructor: Dennis Agliano, M.D., Member, Council on Ethical and Judicial Affairs, AMA Friday, February 10, 5:15 6:15 PM According to the Centers for Medicare and Medicaid Services (CMS), an ACO is an organization of health care providers that agrees to be accountable for the quality, cost, and overall care of Medicare beneficiaries who are enrolled in the traditional fee-for-service program who are assigned to it. Proponents believe that ACOs will improve quality and slow spending growth. Skeptics are concerned that ACOs will focus narrowly on their bottom line and either stint on needed care or... demand unreasonable prices from payers. This course will describe the evolution of the ACOs and provide a better understanding of what s to come in the very near future. EHR: Where We Are and Where Are We Going Saturday, February 11, 5:15 6:15 PM This workshop gives a detailed view into the recent trends in the EHR industry and marketplace. Attendees will better understand the current government actions, vendor and software trends and its use in practice. DSEK for Beginners: Techniques and Tips Saturday, February 11, 5:15 6:15 PM This workshop will provide attendees with the latest surgical tips and techniques for DSEK. Emphasis will be placed techniques that minimize complications and maximize donor endothelial survival. Donor tissue prep, insertion, unfolding and positioning will also be discussed. Please register in advance for EMR Chart Documentation, Ethics, EHR, and DSEK. There are limited seats. 13

14 New Orleans & Activity Information All of the Big Easy s spectacular sights are still available and open to the public. Now s the time to re-acquaint yourselves with the city you fell in love with. New to the city? Then check out some of the sights listed below. The French Quarter: This 12-block area, also called the Vieux Carré (Old Square), is the heart of the city and borders the Mississippi River. The narrow streets of two-and three-story French and Spanish inspired buildings have a unique look. If historic sites interest you, see the Gallier House Museum ( the Hermann- Grima House ( the Old Ursuline Convent, and the Beauregard-Keyes House ( ). You ll find everything from fabulous jazz and five-star restaurants to strip clubs on world-famous Bourbon Street. pristine post-civil War Van Benthuysen-Elms Mansion and Gardens ( , www. elmsmansion.com). The Longue Vue House ( , in Old Metairie is a spectacular 45-room mansion designed in a Classical Revival style. By Land or by River: For a different view of the Mardi Gras City, take a riverboat cruise on the Mississippi River. Sightsee by day or go on a dinner jazz cruise. The Cajun Queen Riverboat ( , com), the Steamboat Natchez ( , and the John James Audubon Riverboat ( , www. aquariumzoocruise.com) all accept passengers. For landlubbers, the Riverfront streetcars are a great and economical way to sightsee. Cities of the Dead: A high water table and an elevation below sea level resulted in the practice of building aboveground tombs. There are 42 cemeteries in the metropolitan New Orleans area. Metairie, the most beautiful, and St. Louis Number One, the oldest, are worth a visit. Tour companies such as Save Our Cemeteries ( ) and Haunted History Tours ( ) offer guided tours. Plantations and Historic Homes: The Garden District, minutes from the French Quarter, features many stately mansions, including the For Families: The Crescent City boasts one of the top 5 Aquariums and Zoos in the in the United States. The Audubon Aquarium of the Americas ( , www. auduboninstitute.org) features the largest collection of sharks and jellyfish and a rare white alligator. Located next to the French Quarter and beautiful Woldenberg Park, the Aquarium is sure to please young and old alike. The Audubon Zoo ( , www. auduboninstitute.org) has more than 2,000 animals in their natural habitat settings, including the Louisiana Swamp. 14

15 Registration Form Name (please print) Address City/State/Zip/Country 61ST ANNUAL SYMPOSIUM ROUND THE GLOBE JOURNEYS IN RETINA, ORBIT AND ANTERIOR SEGMENT February 10 12, 2012 Sheraton New Orleans Hotel Degree Telephone Fax Are there any conference-related topics that would better assist you in practice that you would add? Please list: Registration Fees (please check one): Postmarked after Postmarked by 1/9/12 1/9/12 - onsite NOAO member o No charge if dues are paid by 1/9/12 o $ Physician o $ o $ Allied Health Professional o $ (NEW: $25 if employed by NOAO member, with letter) o $ Resident/Fellow o No charge with letter from chief of service * Workshop Registration (check only one per day) o EMR Chart Documentation Friday, Feb. 11, 5:15 6:15 pm o Ethics: ACO s/physicians as Employees Friday, Feb. 11, 5:15 6:15pm o DSEK for Beginners Saturday, Feb. 12, 5:15 6:15 pm o EHR: Where are We Going Saturday, Feb. 12, 5:15 6:15 pm Payment Information o Personal Check o Visa o MasterCard o Discover Card Number Exp. Date CVC $ Total Amount Enclosed Please detach and mail this form with payment to: New Orleans Academy of Ophthalmology 7733 Maple Street, New Orleans, LA fax ~or~ register on-line at

16 Non-Profit Org. US Postage PAID New Orleans, LA Permit No JOURNEYS IN RETINA, ORBIT AND ANTERIOR SEGMENT ROUND THE GLOBE New Orleans Academy of Ophthalmology 7733 Maple Street New Orleans, LA February 10 12, 2012 Sheraton New Orleans Hotel This activity has been approved for AMA PRA Category 1 credit Special Thanks to our Supporters: ASCRS/Eyeworld, Ophthalmology Management, Refractive Eyecare from Ethis Communications, Review of Ophthalmology