Eyeworld

Contact information Name: Name: ATARACT C 72 | EYEWORLD | APRIL 2019 of residency programs have residents performing FLACS before graduation. 1 That said, "In terms of training, the great thing about FLACS is that the learning curve is flat. Thus, I think FLACS can be adopted by anyone, from those just out of residency to people well into their careers." Dr. Schallhorn said it's important to learn about the laser, how it works, its benefits and limitations, and how it could fit into your practice. Attending a FLACS course at a national meet- ing is helpful, she said. Then, schedule a wet lab with one of the laser manufacturers, practicing as many times as you need to get comfortable. Once you're ready, take the leap to patients, Dr. Schall- horn said. "Schedule a full day (10 cases or more) of FLACS patients so you can really get the hang of it," Dr. Schallhorn advised. "Make sure to tell patients that you are using a new technique with a laser and that you will be discussing their case with someone in the room. Verbally walk your pa- tients through the procedure so they know what to expect and are comfortable talking and asking questions during the procedure. After that, try dif- ferent incision construction and fragmentation/ capsulorhexis patterns as you gain experience until you find the settings that work for you." According to Dr. Schallhorn, the biggest challenge for FLACS adoption is breaking out of your comfort zone. "With any new procedure, I think about the potential it has to offer my patients compared with what I am doing," she said. ACRYSOF ® IQ TORIC IOL IMPORTANT PRODUCT INFORMATION CAUTION: Federal (USA) law restricts this device to the sale by or on the order of a physician. INDICATIONS: The AcrySof ® IQ Toric posterior chamber intraocular lenses are intended for primary implantation in the capsular bag of the eye for visual correction of aphakia and pre- existing corneal astigmatism secondary to removal of a cataractous lens in adult patients with or without presbyopia, who desire improved uncorrected distance vision, reduction of residual refractive cylinder and increased spectacle independence for distance vision. WARNING/PRECAUTION: Careful preoperative evaluation and sound clinical judgment should be used by the surgeon to decide the risk/benefit ratio before implanting a lens in a patient with any of the conditions described in the Directions for Use labeling. Toric IOLs should not be implanted if the posterior capsule is ruptured, if the zonules are damaged, or if a primary posterior capsulotomy is planned. Rotation can reduce astigmatic correction; if necessary lens repositioning should occur as early as possible prior to lens encapsulation. All viscoelastics should be removed from both the anterior and posterior sides of the lens; residual viscoelastics may allow the lens to rotate. Optical theory suggests that high astigmatic patients (i.e. > 2.5 D) may experience spatial distortions. Possible toric IOL related factors may include residual cylindrical error or axis misalignments. Prior to surgery, physicians should provide prospective patients with a copy of the Patient Information Brochure available from Alcon for this product informing them of possible risks and benefits associated with the AcrySof ® IQ Toric Cylinder Power IOLs. Studies have shown that color vision discrimination is not adversely affected in individuals with the AcrySof ® Natural IOL and normal color vision. The effect on vision of the AcrySof ® Natural IOL in subjects with hereditary color vision defects and acquired color vision defects secondary to ocular disease (e.g., glaucoma, diabetic retinopathy, chronic uveitis, and other retinal or optic nerve diseases) has not been studied. Do not resterilize; do not store over 45° C; use only sterile irrigating solutions such as BSS ® or BSS PLUS ® Sterile Intraocular Irrigating Solutions. ATTENTION: Reference the Directions for Use labeling for a complete listing of indications, warnings and precautions. © 2018 Novartis 7/18 US-TOR-18-E-1605 Jose de la Cruz, MD The University of Illinois has been using the fem- tosecond laser in cataract surgery since 2011. "There are so many things we found that are beneficial not just to the outcomes of the patient, the predictability, but also in the advancement of training, the exposure," Dr. de la Cruz said. Here ophthalmology residents are introduced to femto from an imaging standpoint early in their first year and laser setup and docking later that first year, with wet lab and simulation training throughout the whole of their training. In their second year, residents are exposed to the parts of the surgery and how the laser can assist. "With all these years of using the laser, we've found different ways in which it can help the res- ident, not only in the surgery itself but also their learning," Dr. de la Cruz said. One advantage of the laser, he continued, is its imaging capabilities. The OCT image on the machine can show tilt or lens dislocation, for example, which allows the surgeon to prepare for the possibility of related complications. Dr. de la Cruz said the laser can assist trainees in surgical steps that they're not yet comfortable with, allowing them to focus on improving those skills in the wet lab while still performing the steps they are comfortable with in the OR. "You can use it as a tool to advance and make surgery more efficient in the OR, working parallel in a wet lab environment to bring skills up," he said. continued from page 70 Reference 1. Yen AJ, Ramanathan S. Advanced cataract learning experience in United States oph- thalmology residency programs. J Cataract Refract Surg. 2017;43:1350–1355. Financial interests Caspar: None de la Cruz: None Schallhorn: None

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