O
TO COME
NSITE
Nicole Fram, MD, Los Angeles, offered her top five pearls for
managing poorly healing epithelial defects:
• Determine etiology; take a thorough history
• Look at the medications; change topical medications to preserva-
tive free
• Use amniotic membrane early in refractory disease
• Evaluate and treat abnormal eyelid anatomy and disease
• Know when a tarsorrhaphy is necessary and act quickly to avoid
corneal thinning
Takeaways for corneal wound burn management from Sumit "Sam"
Garg, MD, Irvine, California, included: (1) recognize occurrence
early; (2) consider a new wound to complete the case; (3) consider
induced cylinder; and (4) be patient.
According to Keith Warren, MD, Overland, Park, Kansas, indica-
tions for anterior segment surgeons to perform vitrectomy include
capsule rupture during phaco, vitreous prolapse, pediatric or traumat-
ic cataract, and posterior vitreous pressure.
Tips for using the miLOOP (Carl Zeiss Meditec) from Mitchell
Weikert, MD, Houston:
• Stain the capsule and size the capsulorhexis appropriately
• Understand the mechanics of snare expansion/contraction
• Carefully pass the snare under the stained capsule
• Monitor instrument angle
• Maintain black ring at incision
• Use a second instrument to prevent lens tilt
• Anticipate delay of the snare with rotation and go beyond the mid-
line
• Carefully break the nuclear bridge
• Rotate with a second instrument and fracture a second time
continued from page 28
Nicole Fram, MD
Sumit "Sam" Garg, MD
Keith Warren, MD
Mitchell Weikert, MD
30 | EYEWORLD | OCTOBER 2019
