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Clinical Committee Articles and Guidelines

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The ASCRS Clinical Committees were created to serve as a source to disseminate important, timely information on topics relating to each of their subspecialties. On this portion of our website, you will find clinical updates, journal articles, white papers, position papers, and guidelines created by our Clinical Committees and Task Forces on a variety of topics.

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Clinical Committee Articles and Guidelines
ASCRS Consensus Statement on VUITY | ASCRS Task Force
Leads: Douglas Rhee, MD, Cathleen McCabe, MD, Leon Herndon, MD, Rajesh Rao, MD

On August 16, 2022, the Prescribing Information for VUITY (pilocarpine hydrochloride ophthalmic solution) 1.25% was updated following a voluntary submission by Allergan, an AbbVie company, to the U.S. Food and Drug Administration (FDA). New information has now been included in the Warnings and Precautions, Postmarketing Experience, and Patient Counseling Information sections. This ASCRS Task Force was convened to develop an understanding of the data and a preliminary consensus on appropriate counseling of patients regarding risks associated with the use of VUITY.

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Clinical Alert: ASCRS Clinical Advisory on Intracameral Moxifloxacin Injection for Infection Prophylaxis
OCTOBER 24, 2022 | ASCRS Cataract Clinical Committee

Moxifloxacin solution is frequently injected at the conclusion of cataract surgery for endophthalmitis prophylaxis. Two different concentrations are commonly available in the United States (U.S.) for intracameral (IC) use: 0.5% [5 mg/mL] and 0.1% [1 mg/mL]. The recommended volume to be injected is different for the two concentrations, and incorrect dosing can increase the risk of toxic anterior segment syndrome (TASS) or endophthalmitis.

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Prevention and management of refractive prediction errors following cataract surgery
AUGUST 1, 2020   |   ASCRS Refractive Cataract Surgery Subcommittee

Refractive prediction errors remain a cause of patient dissatisfaction after cataract surgery. Successful management of residual refractive errors requires preoperative prevention but also an understanding of its management postoperatively.

Corneal crosslinking: Current protocols and clinical approach
NOVEMBER 22, 2019   |   ASCRS Cornea Clinical Committee

A review of the current literature on the corneal crosslinking (CXL) procedure for treating ectasia. Cornea Clinical Committee members explored the data on the techniques currently in use and under investigation, including their advantages, safety profiles, risks, and cost analyses, compared with data on corneal transplantation.

An algorithm for the preoperative diagnosis and treatment of ocular surface disorders
JUNE 6, 2019   |   ASCRS Cornea Clinical Committee

The ASCRS Cornea Clinical Committee developed a new consensus-based practical diag-nostic OSD algorithm to aid surgeons in efficiently diagnosingand treating visually significant OSD before any form of refractivesurgery is performed. By treating OSD preoperatively, postoper-ative visual outcomes and patient satisfaction can be signifi-cantly improved.

Phacoemulsification of posterior polar cataracts
FEBRUARY 1, 2019   |   ASCRS Cornea Clinical Committee

Posterior polar cataracts present a unique challenge for the cataract surgeon. Proper preoperative examination and diagnostics and specific techniques for each stage of the procedure are described, all with the aim of protecting the posterior capsule and preserving intraocular lens (IOL) fixation options.

Medical and surgical management of the small pupil during cataract surgery
JULY 6, 2018   |   ASCRS Refractive Cataract Surgery Subcommittee

As cataract surgery continues to evolve, the intraoperative small pupil continues to pose challenges to even the most experienced cataract surgeon. Several steps can be taken preoperatively to decrease the chance of intraoperative miosis. Even so, the problem of miosis during cataract surgery remains a relatively common occurrence.

Phacoemulsification of the rock-hard dense nuclear cataract: Options and recommendations
JULY 6, 2018   |   ASCRS Cataract Clinical Committee, Challenging and Complex Cataract Surgery Subcommittee

We describe the essential steps in the successful phacoemulsification of the rock-hard, dense cataract. Appropriate and directed preoperative history, physical examination, and diagnostics allow the surgeon to select the best incision, anesthesia, and intended surgical technique for a given dense nuclear challenge.

Guidelines for the cleaning and sterilization of intraocular surgical instruments
JULY 6, 2018   |   Ophthalmic Instrument Cleaning and Sterilization Task Force

These Guidelines for the Cleaning and Sterilization of Intraocular Surgical Instruments were written by the Ophthalmic Instrument Cleaning and Sterilization (OICS) Task Force, comprised of representatives of the American Society of Cataract and Refractive Surgery, the American Academy of Ophthalmology, and the Outpatient Ophthalmic Surgery Society.

Perioperative assessment for refractive cataract surgery
MAY 6, 2018   |   ASCRS Refractive–Cataract Surgery Subcommittee

As cataract surgery has evolved into lens-based refractive surgery, expectations for refractive outcomes continue to increase. During the past decade, advancements in technology have provided new ways to measure the cornea in preparation for cataract surgery.

CLINICAL ALERT: Intraocular Use of Epinephrine to Maintain Mydriasis during Cataract Surgery
DECEMBER 13, 2017   |   ASCRS Cataract Clinical Committee

A recent alteration in the formulation of epinephrine from one of the more common sources of preservativeā€free epinephrine has contributed to a shortage or impending shortage of this product for ophthalmologists.

Surgical techniques and adjuvants for the management of primary and recurrent pterygia
MARCH 1, 2017   |   ASCRS Cornea Clinical Committee

The removal and rate of recurrence of pterygium have been discussed for years. The disorder is highly associated with environmental factors, and recurrence rates can be unacceptably high and cannot be successfully predicted.

Clinical Alert: Ocular Complications of Cosmetic Anterior Chamber Iris Implants (2016)

Unregulated cosmetic iris implants being inserted outside the United States and European Union are causing severe ocular complications in many patients.

Cataract surgery and nonsteroidal antiinflammatory drugs
SEPTEMBER 30, 2016   |   ASCRS Cataract Clinical Committee and the American Glaucoma Society

Nonsteroidal antiinflammatory drugs (NSAIDs) have become an important adjunctive tool for surgeons performing routine and complicated cataract surgery. These medications have been found to reduce pain, prevent intraoperative miosis, modulate postoperative inflammation, and reduce the incidence of cystoid macular edema (CME). 

Report for Antibiotic Eyedrop Regimen for Cataract Surgical Patients Survey (2016)
AUGUST 1, 2016   |   ASCRS Member Survey

2016 Survey of ASCRS members helps to define how ophthalmologists are using antibiotics prophylactically for cataract surgical patients.

Clinical Alert: HORV Association with Intraocular Vancomycin (2016)
JULY 20, 2016   |   ASCRS and ASRS

Following the first published series of hemorrhagic occlusive retinal vasculitis (HORV) the American Society of Cataract and Refractive Surgery and the American Society of Retina Specialists formed a joint task force to further analyze the prevalence, potential etiology, treatment, and outcomes of this complication associated with intraocular surgery.

ASCRS Releases Position Statement on Two Established Ophthalmic Practices
AUGUST 15, 2015   |   ASCRS Cataract Clinical Committee

ASCRS has released an official position statement opposing directives that restrict the use of diluted povidone-iodine solution for topical infection prophylaxis and the use of multidose topical eye drops on multiple patients.

Cataract surgery in the small eye
MAY 28, 2015   |   ASCRS Cataract Clinical Committee, Challenging/Complicated Cataract Surgery Subcommittee

One of the more challenging surgeries for the anterior segment surgeon is cataract extraction and intraocular lens (IOL) implantation in the small eye. This begs the question of what constitutes a “small eye.”

Antibiotic prophylaxis of postoperative endophthalmitis after cataract surgery: Results of the 2014 ASCRS member survey
JANUARY 26, 2015   |   ASCRS Cataract Clinical Committee

A 2014 online survey of the American Society of Cataract and Refractive Surgery members indicated increasing use of intracameral antibiotic injection prophylaxis compared with a comparable survey from 2007.

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