EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/115557
September 2011 donating time to mission work "especially in areas where cost is going to be a big concern, they need to learn the procedure. For a dense cataract and areas where you can't spend $500 on just equipment for the cataract, surgeons need to learn small incision ECCE." Unfortunately, Dr. Pettey said there just isn't the volume of cases that justify doing small incision ECCE to train residents well enough to have them perform on their own; "they really need to get their experience overseas. I think this is the only avenue to truly learn how to do this type of surgery flawlessly." Dr. Oetting cited Bonnie Henderson, M.D.'s recent paper outlining the current state of teaching ECCE techniques in training programs.2 Ayman Naseri, M.D., University of California, San Francisco, in a recent study found no difference in complications when residents started surgical training with extracap instead of phaco.3 cation vs. manual sutureless small-incision extracapsular cataract surgery in Nepal. Am J Ophthalmol. 2007;143:32-8. 2. Henderson BA, Oetting TA, Yang EB, Rankin JK, Aaron MM, Yang Z, Broocker G, Blomquist PH. Teaching manual cataract ex- traction. Ophthalmology. 2012;119(10):2191. 3. De Niro J, Biebesheimer J, Porco TC, Naseri A. Early resident-performed cataract surgery, Ophthalmology. 201;118(6):1215. EW CATARACT 57 Editors' note: The physicians have no financial interests related to this article. Contact information Oetting: Thomas-oeting@uiowa.edu Pettey: jeff.pettey@hsc.utah.edu Donnen Donnenfeld Donnenfeld nfeld side view K3-2440 Better than phaco? Some situations may be better handled with an extracap technique, Dr. Pettey said. "It's arguable in the patient with a very dense cataract, severe or even advanced Fuchs' dystrophy, cases of loose zonules— all those may be better served with small incision cataract surgery," he said. "Or even certain white cataracts—there's a good argument that in expert hands, small incision can be a better surgery." Dr. Oetting said the small incision extracap is "so inexpensive and so popular with the rest of the world" its value cannot be underestimated. "In the right hands it seems to be a superior procedure to phaco for very dense lenses," he said. Further, the techniques learned in extracap procedures are transferrable to corneal procedures such as Descemet's stripping endothelial keratoplasty, Dr. Oetting said. "It's not as black and white as this procedure is valuable and that procedure is not," he said. "Surgeons should know all three techniques." EW This new spatula is designed to open femtosecond created cataract incisions. Its 1mm long, fattened, "spear-shaped" tip top view wound with a sweeping motion. This instrument easily opens incisions which cannot be opened with traditional femto spatulas. K3-2450 for use in right hand K3-2451 for use in left hand This splitter is designed specially to compliment modern cataract femtosecond ablation techniques. The paracentral cur ve in the shaft exactly matches the shape of a laser created central nuclear bowl providing optimal surface contact for effciently splitting the lens out to the peripher y and down to the posterior plate. The Donnenfeld Femto Splitter improves nuclear Femto chopping with minimal manipulation. References 1. Ruit S, Tabin G, Chang D, et al. A prospective randomized clinical trial of phacoemulsifi- Designed by Eric D. Donnenfeld, MD of Rockville Centre, NY ® 973-989-1600 U 800-225-1195 U www.katena.com -1600