JUN 2013

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

Issue link: https://digital.eyeworld.org/i/137624

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22 EW CATARACT June 2013 Tools & techniques The Singer Fixator by Richard S. Hoffman, MD T his column was created with the thought that most surgeons would benefit from an in-depth step-bystep approach to learning useful techniques. Adding new procedures to our armamentarium, in my view, is the responsibility that each one of us takes on to make us better surgeons and offer our patients the best possible surgical outcomes. Learning a useful new technique and applying it in the operating room is one of the most satisfying aspects of our profession. The ability to constantly improve our skills and develop as surgeons is what ultimately distinguishes us from a "technical chimp." Although techniques have their allure, sometimes it is the simple new tool that brings us the most joy. Microincision forceps and scissors, a pupil expansion ring, a suture snare—these are the Legos, Hot Wheels, and Erector Sets for grown-up ophthalmologists. In this month's column, I briefly review some of the benefits of my latest toy. How long I use it before it breaks … time will tell. A lthough I routinely use a Fine-Thornton ring for creation of bimanual microincisions and the main temporal IOL incision, I have mostly abandoned its use for IOL insertion. I have found that better traction can be achieved for inserting an IOL cartridge into the main incision when a blunt cyclo- Figure 1: The device has a thin metal prong emanating from a block with dull fixation tines underneath. dialysis spatula or similar device is placed in the side-port incision and used as countertraction while the cartridge tip is inserted into the eye. This maneuver aids in IOL injection Figure 2: The metal tines function as a mini-fixation device to aid in placement of the side-port incision. Richard Hoffman, MD, Tools & techniques editor Placing the prong into the side-port, with the metal tines pressed against the underlying globe, a second microincision (biaxial phaco) (Figure 3 on left) or a larger temporal incision (coaxial phaco) (Figure 4, right) can be safely created. Figure 5: The device can function as a countertraction spatula with additional traction supplied by the metal tines. Source (all): Richard Hoffman, MD

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