OMDI as an Alternative to Prostaglandin Analogues in Low or Nonresponders

Joseph F. Panarelli, MD; and Neda Shamie, MD

Eyetube

Joseph F. Panarelli, MD, sits down with Neda Shamie, MD, to discuss a phase 3, nonrandomized, two-phase, open-label, multicenter study that evaluated the IOP-lowering efficacy and safety of omidenepag isopropyl (OMDI) in patients with primary open-angle glaucoma or ocular hypertension who did not respond or responded poorly to latanoprost. What were the results? To access the full review, please visit the link here: https://pubmed.ncbi.nlm.nih.gov/37853676/

Combining Vitreoretinal Surgery With EDOF IOL Implantation

The lens technology’s potential to reduce patients’ trips to the OR and loss of accommodation.

Peter Stalmans, MD, PhD

Cataract and Refractive Surgery Today

Cataract surgery is often thought of as an age-related procedure. In numerous European countries, however, including Belgium, where I practice, many patients receiving a vitrectomy undergo concurrent cataract surgery if they are older than 50 years of age to minimize the number of surgical procedures they will require and maximize their UCVA. IOL selection in this situation is challenging because these individuals are typically active members of the workforce who require crisp intermediate and near visual acuity. My colleagues and I therefore conducted a study to evaluate patient satisfaction when vitrectomy was combined with the implantation of an extended depth of focus (EDOF) IOL (AT LARA, Carl Zeiss Meditec).1 WHY AN EDOF IOL? Traditional multifocal IOLs are designed to provide better near visual acuity and greater spectacle independence than monofocal IOLs.2 Patients who receive multifocal IOLs, however, are more likely to experience glare, halos,2,3 and reduced contrast sensitivity.3 An EDOF lens was selected for our study because it can provide good intermediate visual acuity with fewer unwanted visual effects.4 Participants with more than mild corneal astigmatism received a toric model. Earlier research demonstrated high patient satisfaction with EDOF lenses.5,6 Our study is the first to gauge patient satisfaction with an EDOF IOL implanted following a vitrectomy. The study also explored whether unilateral or bilateral IOL status had an impact on quality of life. METHODOLOGY Patients who underwent a vitrectomy at the University Hospitals Leuven in Belgium from January 2019 to January 2022 were invited to participate in our study. In addition to patients with vision-threatening conditions such as retinal detachment (RD) and epiretinal membrane, the study enrolled a small number of individuals who elected to undergo a vitrectomy to remove floaters. Among patients with an RD, only those with macula-on detachments at the time of the procedure or those with macula-off detachment of less than 24 hours’ duration were included.

Determining When to Use Modifiers -58 and -78

Both are used in association with the original surgery, but ultimately serve different purposes.

Joy Woodke, COE, OCS, OCSR

Retina Today

When retina procedures are performed during the global period of a surgery, an appropriate modifier must be appended to the CPT code for reimbursement. When an unrelated procedure is performed postoperatively in the fellow eye, for example, modifier -79 is used. However, when the surgery is related to the original procedure, either modifier -58 or -78 should be considered. DEFINITIONS When considering which modifier is appropriate for a related procedure, clinicians should carefully review the definitions of modifiers -58 and -78. Modifier -58 is defined as a staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period and has three definitions for use: 1. Planned or anticipated (staged) 2. More extensive than the original procedure 3. Therapy following a surgical procedure Modifier -78 is used for a related but unanticipated return to the OR or office procedure room by the same physician or other qualified health care professional during the postoperative period of the initial procedure. Reporting modifier -58 will initiate a new global period for the CPT code reported. Modifier -78, on the other hand, does not prompt a new postoperative period, and the original global period remains.