APR 2013

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

Issue link: https://digital.eyeworld.org/i/119916

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Page 32 of 82

April 2013 INFINITI® Vision System 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. Caution: Federal (USA) 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. 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 1/13 INT12890JADUS-PI Microbulldog continued from page 28 Figure 7: MSA is now securely on tip of haptic. Figure 8: Even pulling on the IOL will not cause slippage of the haptic through the MSA. It is very secure. Source (all): Steven G. Safran, MD Figures 4, 5, 6: Microbulldog silicone assistant is guided onto the haptic by inserting the haptic into the tip of the needle and sliding the MSA down over the haptic. trailing haptic. While this trailing haptic is placed in the eye and passed to a microforceps to externalize it through a sclerotomy, the surgeon needn't worry about the first leading haptic slipping back into the eye. The focus can be maintained on the task at hand. After the second trailing haptic is externalized the silicone assistant can be easily slid off the haptic and the surgery completed. This is a simple, inexpensive method that can be used by any surgeon with access to a butterfly cannula, a scissor, and a 25-g needle. It takes very little skill and even less time to perform and should reduce some of the anxiety associated with performing the scleral fixated haptic or "glued in IOL" procedure. George Beiko, FRCSC, has advocated taking the silicone sleeve from an MST (Redmond, Wash.) or Mackool capsule retractor and sliding it over the lead haptic to hold it in place during surgery. These retractors can be quite expensive however, and manipulating the silicone sleeve over the haptic can be a bit delicate. The homemade microbulldog silicone assistant method suggested here offers the ad- vantage of being very inexpensive to fashion and very easy to apply to the IOL haptic during surgery as it is "pre" loaded onto a 25-g needle, which serves to guide it over the haptic very gently when needed in order to give a hand to the surgeon born with only two arms. EW Editors' note: Dr. Safran is in private practice in Lawrenceville, N.J. He has no financial interests related to this article. Contact information Safran: safran12@comcast.net

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