MAR 2014

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

Issue link: https://digital.eyeworld.org/i/276058

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Page 170 of 210

After his talk, Dr. Mehta explained: "Like Count Dracula, who w as originally known as Vlad the Impaler, one can impale a lens utilizing a phaco tip," he said. "And once the lens is impaled on it, utilizing the microburst technology, which is available in virtually all phaco machines, you can split it into its component parts with com- parative ease." " It's a brilliant part of a phaco machine, which is something you really should use," he said of the burst mode. Presenting about the technology at the "Basics of phaco machines, dynamics, & how recent technology is used" session, Dr. Mehta joined a host of other Indian experts on the t opic of phaco machines, including their use and possibilities, led by Lahane Tatyarao Pundlikrao, MD, Mumbai. Dr. Mehta's talk was "Burst mode in phaco in supra hard cataracts." Dr. Mehta talked about how with this technology, once the nu- clear tip has become embedded in a hard lens, "the tip does not generate any ultrasound energy, which is a waste," he said. "It just stays within the confines of the lens." "The big advantage of it is that the cornea the next day remains pristine," he said. He said that this mode of phaco could be incredibly useful, even though it remains an unexplored aspect of the phaco machine for many. "Utilizing this sort of technol- ogy, the microburst, which so often is ignored by most people who tend t o simply use pulse and think that pulse phaco is the end-all and be-all of phaco surgery, enables you to do the hardest cataracts with the great- est of ease," Dr. Mehta said. The fact that this mode is avail- able on nearly all phaco machines makes it useful as a possibility for different scenarios, he said. For in- s tance, he discussed another method using the microburst technology, wherein the surgeon can core out the middle of a hard lens. The microburst technology can "core out the hard lens utilizing minimum aspiration. Just set it on 80, which is enough to keep the full core available, keep the tip open, a nd you remove the central core." "By doing that, you convert the hard lens into a donut—when you split it, there's really nothing left in the middle. If you can remove the middle of a hard lens, a hard lens is a hard lens no more," he said. No cataract too complicated Despite advances in phacoemulsifi- cation techniques and technologies, complications continue to occur in modern cataract practices. A session at the meeting tapped into expert opinion demonstrating techniques to handle these difficult and varied cases. In the case of a patient with cataract and high myopia, Arup Chakrabarti, MD, Kerala, was able to perform a routine, uncomplicated View it now ... EWrePlay.org Lalit Verma, MD, gave an overview on intravitreal injections from a book that he and colleagues recently wrote. 164-169 MR AIOC_EW March 2014-DL2_Layout 1 3/6/14 4:30 PM Page 168

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