MAY 2013

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

Issue link: https://digital.eyeworld.org/i/129516

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Page 28 of 86

26 EW International May 2013 ISBCS continued from page 25 ISBCS 2009" at www.isbcs.org. I believe that doctors make decisions for individual patients based on their judgement of what is best for that patient, but that this is sometimes influenced by other factors, which include cost and reimbursement. I do not believe that ethical doctors will do "anything for money," but I do believe that giving them a financial disincentive may not be in patients' best interests. EW References 1. Arshinoff SA. Same-day cataract surgery should be the standard of care for patients with bilateral visually significant cataract. Survey Ophthalmol, 2012; 57: 574-579. 2. Henderson, BA, Schneider, J. Same-day cataract surgery should not be the standard of care for patients with bilateral visually significant cataract. Survey Ophthalmol, 2012; 57: 580-5583. 3. Arshinoff, SA, Strube, YNJ, Yagev, R. Simultaneous bilateral cataract surgery. J Cataract Refract Surg, 2003; 29: 12811291. 4. Arshinoff SA. IOL Power prediction. Ophthalmology, 2012; 119: 2646-2647. 5. Olsen, T. Use of fellow eye data in the calculation of intraocular lens power for the INFINITI® VISION SYSTEM CAUTION: Federal 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. 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. 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. second eye. Ophthalmology, 2011; 118: 17101715. 6. Nassiri et al. Immediate vs. delayed sequential cataract surgery: a comparative study. Eye 2009: 23; 89-95. 7. Lundström M, Albrecht S, Nilsson M, Aström B. Benefit to patients of bilateral same-day cataract extraction: Randomized clinical study. J Cataract Refract Surg. 2006; 32: 826-30. 8. Arshinoff, SA. Bilateral endophthalmitis after simultaneous bilateral cataract surgery. J Cataract Refract Surg, 2008; 34: 20072008. 9. Arshinoff, SA, Bastianelli, PA. Incidence of endophthalmitis after immediate sequential bilateral cataract surgery. J Cataract Refract Surg, 2011; 37: 2105-2114. 10. Castells X et al. Factors associated with second eye cataract surgery. Br J Ophthalmol. 2000; 84: 9-12. 11. Leivo T, et al. Simultaneous bilateral cataract surgery: economic analysis. Helsinki Simultaneous Bilateral Cataract Surgery Study report 2. J Cataract Refract Surg. 2011; 37: 1003-1008. 12. Lundström M, Albrecht S, Roos P. Immediate versus delayed sequential bilateral cataract surgery: an analysis of costs and patient value. Acta Ophthalmol. 2009; 87:33-38. 13. O'Brien JJ, et al. Immediately sequential bilateral cataract surgery versus delayed sequential cataract surgery: potential hospital cost savings. Can J Ophthalmol. 2010; 45: 596-601. Editors' note: Dr. Claoué is secretarytreasurer, International Society of Bilateral Cataract Surgeons, and senior consultant ophthalmic surgeon, Queen's Hospital, BHR University Hospitals NHS Trust, London. Dr. Claoué has no financial interests related to this article. Contact information Claoué: eyes@dbcg.co.uk EyeWorld factoid Around the world, an adult goes blind every five seconds and a child goes blind every minute. Source: National Institutes of Health © 2013 Novartis 3/13 INT13016JADUS

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