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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September 2011 while limiting potential corneal epithelial or conjunctival trauma from the tines of the Fine-Thornton ring if adequate purchase of the globe is not achieved. I have recently been evaluating the Singer Fixator (Mastel Precision, Rapid City, S.D.), a handy instrument designed by the late Jack Singer, MD, that offers many of the benefits of the Fine-Thornton ring and a side-port fixation spatula. The device has a thin metal prong emanating from a block with dull fixation tines underneath (Figure 1). Placing the device 180 degrees from the location of the side-port or left-handed microincision, the metal tines function as a mini-fixation device in order to aid in placement of the side-port incision (Figure 2). Placing the prong into the side-port, with the metal tines pressed against the underlying globe, a second microincision (biaxial phaco) (Figure 3) or a larger temporal incision (coaxial phaco) (Figure 4) can be safely created. The device can be especially helpful during creation of the capsulorhexis in an uncooperative patient undergoing surgery with topical anesthesia. The eye can be fixated and maneuvered into the most ideal position to ensure a complete rhexis is done without any sudden contributions from the patient. By using the prong and fixation block, rather than a fixation ring or forceps, the patient is usually more comfortable during the maneuver and there is less likelihood for tearing the conjunctiva or the corneal epithelium. Finally, the device can be placed in the side-port incision during insertion of the IOL cartridge injector and function as a countertraction spatula with additional traction supplied by the metal tines (Figure 5). In an extremely uncooperative patient, the potential for seriously detrimental eye movement exists with the Singer Fixator and it is probably best to utilize a FineThornton ring. However, in most routine cases, the Singer Fixator offers the advantage of fixation and countertraction with one practical instrument. EW Editors' note: Dr. Hoffman is clinical associate professor of ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Ore. Contact information Hoffman: rshoffman@finemd.com EW CATARACT If you would like to contribute an 800-1,000 word article on a helpful tool or technique you use in practice, contact EyeWorld Editor Jena Passut at jena@eyeworld.org or (703) 383-5705. We're Changing The Game with our new Model M4 valve. Model M4 Porous Plate www.ahmedvalve.com 800.832.5327 23

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