Eyeworld

March 2011 New technology in cataract and lens-related surgery A panel of experts presented the latest innovations in cataract and lens-related surgery, including fem- tosecond cataract procedures, tissue adhesives, accommodating IOLs, astigmatism technologies, and non- longitudinal phaco/CMICS smaller incisions and disposable I/A tips. Rosa Braga-Mele, M.D., associ- ate professor, University of Toronto, and director, cataract unit and surgi- cal teaching, Mt. Sinai Hospital, Toronto, introduced the torsional mode of non-longitudinal phaco as a way to improve chamber stability and thermal profile as well as de- crease surgical time, energy output, and irrigation fluid. Clearer corneas and improved visual outcomes also result, she said. Dr. Braga-Mele will present a study on torsional Intelli- gent Phaco (IP) with the Infiniti OZil handpiece (Alcon, Fort Worth, Texas) at the ASCRS meeting in San Diego in March. Surgeons are mov- ing to disposable I/A tips because of increasing post-op infections, in- cluding toxic anterior segment syn- drome (TASS), Dr. Braga-Mele added. Kerry D. Solomon, M.D., Ar- turo and Holly Melosi Professor of Ophthalmology, Medical University of South Carolina, Charleston, gave an overview of the evolution of fem- tosecond cataract procedures, in- cluding how the technology might make sense from a business, access, and patient perspective. Conven- tional cataract surgery involves many challenges that femto might help obviate, including incision leakage, off-center capsulorhexis, and effective lens position, he said. "Refractive cataract surgery has room to improve," he said. "This is one of the areas that we believe fem- tosecond laser refractive cataract sur- gery has potential." Terry Kim, M.D., associate pro- fessor of ophthalmology, Duke Uni- versity School of Medicine, Durham, N.C., said newer types of adhesives that are in the pipeline are specifi- cally tailored for ophthalmic use for sealing wounds in anterior segment surgery. Currently, alkyl-cyanoacry- late glue can be difficult to apply, has immediate polymerization, low tolerance in the wound, stiff or abra- sive properties, and can be toxic to the lens or retina. Fibrin adhesive, known as Tisseel (Baxter Healthcare, Deerfield, Ill.), raises infection con- cerns and can be time-consuming and costly. Newer alternatives in- clude the ReSure Adherent Ocular Bandage (Ocular Therapeutix, Bedford, Mass.), which is made of a 100% synthetic and biocompatible polymer. The ReSure is applied as a liquid to the clear cornea incision continued from page 116 continued on page 122 SELF!DEFENSE Safety Doesn't Happen By Accident • Stab Introducing The Safety Knife Series * From Surgistar • Phaco Slit • MVR/Sideport • Crescent ^^^Z\YNPZ[HYJVT Call Customer Service for Your Evaluation Today! Distributor Inquiries Welcome Customer Service: Phone: +1.865.671.4300 Fax: +1.865.671.4302 Email: customerservice@surgistar.com *Patent Pending

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