Eyeworld

SEP 2013

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

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September 2013 EW MEETING REPORTER 89 continued from page 87 capsulorhexis, while Dr. Chee said the Victus creates accurate capsulotomies and is easy to dock and plan for treatment, among other benefits. Rob Eno, vice president, global marketing and international sales of OptiMedica, spoke about the Catalys, while Robert P. Rivera, MD, U.S., said he first used an older version of the LenSx machine in 2011, but after having issues with it, switched to the Catalys machine in August 2012, and it has proven to be an excellent machine for both him and his staff. "It's time to say goodbye to phaco and hello to laser. This is a great innovation," Dr. Rivera said. Finally, Frieder Loesel, PhD, chief strategy officer, Technolas Perfect Vision (which has formed a joint venture with B+L to develop the machine), and Dr. Chee spoke about the Victus. Phaco tips for everyone The final session of the APACRS meeting in Singapore highlighted "Top Phaco Pearls" from a number of surgeons. They presented tips on different skills and how to handle certain situations in this video-based symposium. The session's panelists were Pannet Pangputhipong, MD, Thailand, Ronald Yeoh, MD, Singapore, Graham Barrett, MD, Australia, and Roger Steinert, MD, U.S. Presenters at the session included Amar Agarwal, MD, India, Michael Knorz, MD, Germany, Mohan Rajan, MD, India, Damien Gatinel, MD, France, Dr. Steinert, Chee Soon Phaik, MD, Singapore, Sri Ganesh, MD, India, Hungwon Tchah, MD, Korea, Dr. Pangputhipong, Hiroko Bissen-Miyajima, MD, Japan, Shamira Perera, MD, Singapore, Abhay Vasavada, MD, India, and Dr. Barrett. To kick off the session, Dr. Agarwal talked about the intraocular lens scaffold technique, which he uses to manage a sinking nucleus due to posterior capsular rupture. He said this technique can be helpful if you have fragments in the anterior chamber and are worried that they will fall down when you're perform- ing phacoemulsification. The technique is something that everyone can perform on their own in a clinic, he added. In addition to giving a presentation on a cataract complication with a small pupil, Dr. Steinert presented for David Hardten, MD, U.S., on the adjustment of a toric IOL. With the advance of the toric IOL, he said, surgeons are doing fewer astigmatic keratotomies. However, he noted that sometimes the toric IOL is not particularly helpful. "Sometimes the preop data misleads you," he said. This misleading information can come from keratometry, topography, and tomography. He said a helpful tool for trouble with a malpositioned lens is astigmatismfix.com, which can help suggest the optimum location to move the lens. You can typically be more accurate when you reposition these than in the initial surgery, Dr. Steinert said. Dr. Gatinel discussed whether or not it is necessary to remove a KAMRA inlay (AcuFocus, Irvine, Calif.) before doing cataract surgery. In his case, he successfully performed phaco with the inlay still in the eye. Dr. Pangputhipong presented on hydrodissection minimal rotation. He said with phaco technique, you do not have to depend too much on quality of the hydrodissection. Most nuclear disassembly techniques need hydrodissection because they require a good nuclear rotation, he said. To do this, you can either use a triangular crack or X pattern phaco technique. Dr. Bissen-Miyajima presented on what she said was a technique that people may already know about but that she wanted to highlight. When doing phaco you may not need a lot of hydrodissection. In cases with a femtosecond laser, hydrodissection should be carefully done if the gas bubble is behind the lens nucleus, she said. Removing the phaco tip and injecting the OVD to allow the lens material to float is another option, Dr. Bissen-Miyajima said. Dr. Perera focused on glaucoma and angle closure. He said you always need to "hope for the best, but prepare for the worst." "If you fail to prepare, prepare to fail," Dr. Perera said. He said to make sure to look out for folds in the anterior capsule and that loose lens syndrome can cause angle closure. If you have imaging, use that to your advantage, he said. The key is preparation. To finish the session, the audience voted on the best tip. Dr. Vasavada received the most votes for his tip on managing a rupture in the posterior capsule. Also receiving a high number of votes were Dr. Pangputhipong and Dr. Chee. EW Sh ar pe n yo ur LEADERSHIP Sharpen your LEADERSHIP sk ills and strengthen your skills and s t re ng t he n your NETWO K NETWORK with OWL! OR h OWL! ? ! Ophthalmic Women Leaders leadership l advancement l community JOIN Ophthalmic Women Leaders (OWL) for powerful programming and more events than ever before. Connect with women leaders across ophthalmology in a unique collegial environment. OWL membership includes: Ȉ Ȉ Ȉ Ȉ Ǥ Ǥ ǯ Ƥ for the professional development and advancement of women. "Being part of OWL has given me immense opportunity for pportunity for networking, being mentored and more. I cannot recommend OWL more to someone who is new to the industry, or looking to make industry, y deeper roots. The experiences are invaluable." Allison Potter, Manager of Professional Relations, Potter, M r Professional Pascale Communications

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