Eyeworld

JUN 2012

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

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June 2012 Howcan you hit amoving target? Eyesmove. Eyes rotate. Pupils shift. Shouldn't your LASIK treatment keep up? Advanced Control Eye Tracker (ACE) for the TECHNOLAS 217z100 Excimer Laser Platform is the most comprehensive eye tracker available in the US. Complete compensation of rotational errors, both static and dynamic, from diagnostics to the very end of the ablation. Instantaneous adjustment of the ablation profile as the eye rotates. Figure 4. During bimanual cortical I/A, the floppy capsular bag is repeatedly refilled with dispersive OVD to block the pliant posterior capsule from trampolining toward the aspirating tip. The absence of the coaxial infusion sleeve permits the aspirating instrument to reach across to the opposite equatorial regions of the capsular bag a dispersive OVD is an excellent strategy for removing cortex from a floppy bag as well. Placing both the anterior and posterior capsule on stretch prevents a pliant posterior capsule from trampolining toward the aspiration port. In this situation, cortical aspiration can be performed either with or without irrigation (dry technique). Dispersive agents are preferable to cohesive viscoelastics because they better resist aspiration (Figure 4). Finally, stripping the cortex tangentially rather than radi- ally helps to distribute the tractional force across as large an area of zonules as possible. Bimanual I/A instrumentation provides several advantages in the presence of weak zonules. The abil- ity to alternate between two aspirat- Using continued from page 23 4. Masket S, Belani S. Proper wound construc- tion to prevent short-term ocular hypotony after clear corneal incision cataract surgery. J Cataract Refract Surg. 2007;33:383-386. 5. McDonnell PJ, Taban M, Sarayba M, et al. Dynamic morphology of clear corneal cataract incisions. Ophthalmology. 2003;110:2342- 2348. 6. Chawdhary S, Anand A. Early post-pha- coemulsification hypotony as a risk factor for intraocular contamination: in vivo model. J Cataract Refract Surg. 2006;32:609-613. 7. Shingleton B, Wadhwani R, O'Donoghue M, et al. Evaluation of intraocular pressure in the immediate period after phacoemulsification. J Cataract Refract Surg. 2001;27:524-527. 8. Realini T. Wound construction key to avoid- ing endophthalmitis. EyeWorld. 2007; February:64-66. Editors' note: Dr. Wong is clinical instructor, Robert Wood Johnson Medical School, New Brunswick, N.J., and medical director, Wills Eye Laser Vision, Princeton, N.J. He has no financial interests related to this article. Contact information Wong: 609-921-9437, mwong2020@hotmail.com Figure 5. In the setting of weak zonules, capsule retractors do not trap the cortex in the equator of the capsular bag, unlike a CTR. Bimanual cortical I/A instrumen- tation facilitates sub-incisional cortical aspiration and dissociates the irrigation and aspiration fluid currents Source (all): David F. Chang, M.D. ing ports improves access to the sub- incisional cortex, which can be par- ticularly challenging to remove if the capsulorhexis diameter is small and the posterior capsule is lax (Figure 5). A dual incision system also means that the aspirating port never needs to turn toward the cap- sular fornix. It can be kept facing the cornea and away from the posterior capsule virtually at all times. With- out a constraining infusion sleeve, the surgeon is better able to reach across to the opposite equatorial quadrants where the aspirating port can be safely buried within fluffs of cortex before vacuum builds (Figure 4). This further lessens the risk of aspirating the pliant peripheral or posterior capsule. Finally, in the presence of a zonular dialysis, the continued on page 27 Increased precision through iris recognition for all treatments –wavefront-guided, cylinder, or sphere only. Peace of mind for you and your patients. ACE has you covered. Some of the products and/or specific features aswell as the procedures featured in this document may not be approved in your country and thus may not be available there. Design and specifications are subject to change without prior notice as a result of ongoing technical development. Please contact our regional representative regarding individual availability in your respective market. The trademarks (™and ®) and logos used in this document are the property of Technolas PerfectVision GmbH or the respective owner. kbcomunicacion. Ref.TPV-008/02-2012 ©2012Technolas PerfectVision GmbH. All rights reserved. Technolas PerfectVision Inc 3365 Tree Court Industrial Blvd. St. LouisMo. 63122 Customer Service 1-888 704 3601- Domestic Customer Service 636-226 3600 - International Technolas PerfectVisionGmbH Messerschmittstr. 1 + 3 80992München, Germany www.technolasPV.com

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