Eyeworld

JULY 2023 | EYEWORLD | 33 Contact Canabrava: sergiocanabrava@hotmail.com Ellis: Jim@JelliSee.com Lewis: rlewis@saceye.com Link: bill@williamjlink.com Lobanoff: mlobanoff@gmail.com Yeu: eyeulin@gmail.com accommodating IOL would need to have and research that shows that most accommodation occurs on the anterior surface of the crystalline lens. The flatter the surface, the greater the dioptric power change with diameter change, he said. He described the JelliSee Accommodating IOL (JelliSee Ophthalmics), which is an ac- commodated IOL that disaccommodates. It has elasticity built in and does not rely on retained capsular elasticity. He said this fluid-filled lens has a flexible but firm anterior surface. Actua- tors along the circumference of the IOL apply radial outward force to the anterior surface, mimicking zonule forces, and a relatively flat anterior surface mimics non-linear dioptric power change. In primates, Dr. Ellis said 7 D of accommo- dation has been demonstrated with the lens at 1 year postop. An in-human study is currently being conducted. A human patient who has re- ceived the lens could see 20/16 at distance and 20/25 at ultra-near (20 cm) at 1 day postop, and another could see 20/25 uncorrected at distance, near, and ultra-near 6 months postop, Dr. Ellis said. The last presenter ahead of the Innovator's Lecture was Elizabeth Yeu, MD, speaking about a "paradigm shift in lens extraction and cataract surgery." She described the MiCOR 700 (Carl Zeiss Meditec), which uses a no thermal energy, no ultrasound, and no cavitation approach to lens removal. According to Dr. Yeu's slides, this handheld, disposable device takes scrub nurses less time to set up. She said it maintains cham- ber stability with minimal fluid through the eye, and it uses agitation not emulsification to dissolve the cataract. In addition to its small footprint and time savings that could be attractive for domestic ORs, Dr. Yeu said this system is "primed to be taken out for global outreach." When asked by the panel about the effect on endothelial cells, Dr. Yeu said studies are being done to compare the performance and outcomes of cataract surgeries with the MiCOR 700 and traditional advanced phaco technologies now. When topography-guided LASIK was first approved, Dr. Lobanoff said the trials showed 88% of eyes could see 20/20 or better and 59% 20/15 or better. Surgeons were told to treat based off of the patient's manifest refraction, but eventually they started finding out that their results were not as good as the FDA stud- ies. Why? Dr. Lobanoff said the FDA trial was primarily for safety and only included "nearly perfect" corneas. When topographic elevations are that small, it is the same as the measured anterior corneal astigmatism, he said. When elevations are higher, the manifest astigmatism is not equal to the cornea. Working with geographic imaging software, Dr. Lobanoff described the work that was done to create Phorcides, which is software designed to assist with calculations for Contoura LASIK (Alcon) treatments. According to Dr. Lobanoff, with Phorcides, 100% of eyes saw 20/20 or better postop, with equal efficacy seen in low and high myopic treatments. Another study he described shared that binocularly 100% of eyes could see 20/15 or better. Richard Lewis, MD, spoke about an innova- tion that will improve visualization of the angle. Imaging the angle, Dr. Lewis said, has been a challenge for MIGS. He described the ViaLuxe Laser System (ViaLase) as a new approach to gonioscopic imaging and femtosecond path- ways. The gonioscope views the trabecular meshwork at the same angle as the system's femtosecond laser, for high-resolution goniosco- py with 12 microns of clarity and OCT imaging with 2 microns of cross-sectional precision, he said. Dr. Lewis said the system performs FLigHT (femtosecond laser image-guided high-preci- sion trabeculotomy) procedures. The durability of the treatment at 24 months shows that the sclerostomy is patent, and OCT confirms it hasn't regrown or scarred down, he said. In the study, there were no serious adverse events, and the mean IOP reduction was 34.5% with a more than 80% responder rate. While the system cur- rently uses a femtosecond laser for trabeculoto- mies, Dr. Lewis said he thinks there are a variety of different ways the imaging could be used. In his presentation, Forrest Ellis, MD, described the range of features that a truly

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