SEP 2013

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

Issue link: https://digital.eyeworld.org/i/176967

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Page 89 of 98

September 2013 Luis Izquierdo Jr., MD, Peru, discussed how to avoid posterior capsule rupture (PCR). He said in the discussion of this problem, the two main causes for capsule rupture are the lens and you. That's the simple point, he said. There are a number of risk factors surrounding the lens and PCR, including the age of the patient, the age of the lens, the history, and previous surgeries. Dr. Izquierdo said it is very important to try to avoid these ruptures. However, there is a learning curve, so with time and experience a surgeon can expect to have less risk of PCR. In addition to Dr. Izquierdo's talk about preserving the posterior capsule, Peter Barry, MD, Ireland, discussed what to do if you do tear the capsule. He said one important point is when this happens, stay inside the eye and don't take your instrument out because this could turn a small tear into a big tear. Dr. Barry offered several tips for when the capsule tear occurs after phaco and during I/A. He would choose a two-port limbal vitrectomy in this case. He said to dissociate infusion/cutter, lower infusion to preserve the anterior chamber, increase the cutting rate to the max, remove the vitreous to the plane behind the torn posterior capsule, use triamcinolone staining, and make sure to preserve the capsule remnants. Dr. Barry said to make sure to never pull the cutter when the vitreous is engaged and never use cellulose sponge vitrectomy. Physicians, industry face off on femtophaco Ophthalmologists discussed femtophaco machines in a heated debate questioning each technology offering in the "Femtophaco Face-Off" symposium. The symposium was chaired by Graham Barrett, MD, Australia, Bonnie An Henderson, MD, U.S., Zoltan Nagy, MD, Hungary, and Ronald Yeoh, MD, Singapore. The companies with femtosecond laserassisted phacoemulsification ma- chines on the market—LENSAR (Orlando, Fla.), LenSx (Alcon, Fort Worth, Texas), Catalys Precision Laser (OptiMedica, Sunnyvale, Calif.), and Victus (Bausch + Lomb, Rochester, N.Y.)—had one presentation each by a physician using the technology and an industry representative from the respective company. Nick Curtis, CEO of LENSAR, spoke about that machine, while Harvey Uy, MD, Philippines, discussed his experience using it as a clinical investigator. "I think this technology is here to stay because it's going to give us better results and because it's going to make life easier for cataract surgeons," said Dr. Uy. "I love the LENSAR machine because it's ergonomic and easy to use. It's been optimized for all aspects of refractive cataract surgery." Brian Huss, director of global marketing for LenSx lasers, discussed the LenSx machine, while Michael Knorz, MD, Germany, discussed being an early adopter of the technology, first using it in 2011. Dr. Knorz said that personally, he does not like pitting the four systems against each other as all four offer reproducible cataract surgery. "I do believe all the other laser systems are very reliable and work well. You'll hear about OptiMedica soon, we heard about LENSAR, you'll hear about the Victus. I do like competition. Competition for me as a customer guarantees faster evolution," he said. Physicians presenting and the chairs debating emphasized that each system has unique benefits and negative aspects. Dr. Henderson asked each physician to name the main critique of the machines that they use, and each had a different answer—for instance, Dr. Knorz said the LenSx machine is still "very expensive" in his opinion, while Soon Phaik Chee, MD, Singapore, who spoke about the Victus machine, said that she has been waiting for more options to be introduced into the market for it. For the benefits, Dr. Knorz said the LenSx machine creates a perfect continued on page 89

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