Eyeworld

OCT 2013

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

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INFINITI® VISION SYSTEM CAUTION: Federal law restricts this device to sale by, or on the order of, a physician. As part of a properly maintained surgical environment, it is recommended that a backup IOL Injector be made available in the event the AutoSert® IOL Injector Handpiece does not perform as expected. INDICATION:The INFINITI® Vision System is indicated for emulsifcation, separation, and removal of cataracts, the removal of residual cortical material and lens epithelial cells, vitreous aspiration and cutting associated with anterior vitrectomy, bipolar coagulation, and intra-ocular lens injection. The INTREPID® AutoSert® IOL Injector Handpiece is intended to deliver qualifed AcrySof® intraocular lenses into the eye following cataract removal. The following system modalities additionally support the described indications: -Ultrasound with UltraChopper® Tip achieves the functionality of cataract separation. -AquaLase® Liquefracture Device achieves the functionality for removal of residual cortical material and lens epithelial cells. -The INTREPID® AutoSert® IOL Injector Handpiece achieves the functionality of injection of intraocular lenses. The INTREPID® AutoSert® IOL Injector Handpiece is indicated for use with AcrySof® lenses SN60WF, SN6AD1, SN6AT3 through SN6AT9, as well as approved AcrySof® lenses that are specifcally indicated for use with this inserter, as indicated in the approved labeling of those lenses. WARNINGS: Appropriate use of INFINITI® Vision System parameters and accessories is important for successful procedures. Use of low vacuum limits, low fow rates, low bottle heights, high power settings, extended power usage, power usage during occlusion conditions (beeping tones), failure to sufciently aspirate viscoelastic prior to using power, excessively tight incisions, and combinations of the above actions may result in signifcant temperature increases at incision site and inside the eye, and lead to severe thermal eye tissue damage. Adjusting aspiration rates or vacuum limits above the preset values, or lowering the IV pole below the preset values, may cause chamber shallowing or collapse which may result in patient injury. When flling handpiece test chamber, if stream of fuid is weak or absent, good fuidics response will be jeopardized. Good clinical practice dictates the testing for adequate irrigation and aspiration fow prior to entering the eye. Ensure that tubings are not occluded or pinched during any phase of operation. The consumables used in conjunction with ALCON® instrument products constitute a complete surgical system. Use of consumables and handpieces other than those manufactured by Alcon may afect system performance and create potential hazards. AES/COMPLICATIONS: Use of the NeoSoniX®, OZil® torsional, U/S, or AquaLase® handpieces in the absence of irrigation fow and/or in the presence of reduced or lost aspiration fow can cause excessive heating and potential thermal injury to adjacent eye tissues. ATTENTION: Refer to the directions for use for a complete listing of indications, warnings and precautions. © 2013 Novartis 4/13 INT13016JADUS October 2013 ASCRS continued from page 24 small pupils, and traumatic cataracts. Although I am inexperienced with M-SICS, I quickly became convinced of the greater speed, efficiency, and safety of this technique compared to phaco for such advanced and intimidating cases that we would rarely encounter in the U.S. Factoring the expense of staffing the operating rooms and the patient screening done at rural satellite locations, it costs approximately $50 per patient to conduct such a large scale outreach effort. Dr. Kiros, Dr. Assefa, Dr. Tabin, Dr. Daniel Getaneh, Dr. Chang, and Dr. Almaz Kefeg at Quiha Zonal Hospital. Preoperative patients lined up outside the OR. Source (all): David F. Chang, MD Collaboration with Himalayan Cataract Project (HCP) Himalayan Cataract Project has been one of the most active and effective ophthalmology INGOs in East and West Africa. As faculty members at the University of Utah's Moran Eye Center, Dr. Tabin, Alan Crandall, MD, and Randy Olson, MD, have created a cooperative academic model where their residents, fellows, and staff can work in Africa, and collaborating African ophthalmologists can come to Utah for specialty training. HCP has been working in Ethiopia since 2007 to support high volume cataract surgical interventions, outreach, and training. Under the leadership of Dr. Tabin and Matt Oliva, MD, HCP has helped to train and better equip key Ethiopian ophthalmologists on an ongoing basis. This year, the ASCRS Foundation has launched a new initiative in collaboration with HCP to expand and improve cataract surgical training in Ethiopia. With HCP's extensive experience and country-wide partnerships, our mutual goal is to further advance and support the three Ethiopian training centers— Gondar, Mekele, and Jima—located in the underserved Amhara, Tigray, and Oromia regions, respectively. ASCRS support would be in the form of financial donations, equipment from industry donors, and volunteer ASCRS visiting faculty members. The Foundation would like to thank Carl Zeiss Meditec (Jena, Germany), Alcon (Fort Worth, Texas), and Optronics (Goleta, Calif.) for generously donating operating microscopes and surgical video cameras to these training programs. In addition, the Foundation will help fund charity outreach surgical programs in conjunction with HCP. These high volume "camps" restore sight to hundreds of blind cataract patients, while providing intensive surgical training to Ethiopian ophthalmologists. Last month, I joined Dr. Tabin, University of Utah fellow Ben Thomas, MD, and Dr. Kiros and his staff for our first joint HCPASCRS outreach program at Quiha Eye Hospital in Mekele. During the course of five long days, our team performed 750 M-SICS cataract operations using PMMA IOLs from Aravind's Aurolab. Three out of every four cataracts that we did were white, but the real challenge was the high prevalence of trachomatous corneal scarring, pseudoexfoliation, Complimentary role of Sinskey Eye Institute (SEI) The ASCRS Foundation Board has long advocated for increasing the number of proficient cataract surgeons in Ethiopia. Being located in different geographic areas, these three regional teaching centers supported by our new initiative will nicely compliment the Foundation's eight-year history of training surgeons and treating underserved patients through its Robert Sinskey Eye Institute (SEI) in the capital city of Addis Ababa. Funded by the ASCRS Foundation, the SEI's brand new two story clinical building was completed and inaugurated this past August. The much-needed expansion of clinical and surgical space should significantly increase the volume of patients treated by the two SEI ophthalmologists, Allehone Ayalew, MD, and Zerihun Mekonnen Hailu, MD. EW References 1. Venkatesh R, Chang DF, Muralikrishnanp R, et al. Manual Small Incision Cataract Surgery: A Review. Asia-Pacific J Ophthalmol 2012; 1: 113-119. 2. Haripriya A, Chang DF, Reena M, Shekhar M. Analysis of complication rates of phacoemulsification and manual small-incision cataract surgery at Aravind Eye Hospital. J Cataract Refract Surg 2012; 38:1360-1369. Contact information Chang: dceye@earthlink.net The ASCRS Foundation has been providing humanitarian eyecare in Ethiopia since 2005. Through its partnership with the Himalayan Cataract Project, the Foundation is working to improve EthiopiaÕs residency training programs and to sponsor high volume cataract surgery outreach efforts. To support the ASCRS Foundation/HCP initiative, please consider making a tax-deductible donation to the ASCRS Foundation at www.ascrsfoundation.org.

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