Eyeworld

EW NEWS & OPINION 13 At the ASCRS•ASOA Symposium & Congress, the best paper of session is selected by the moderator and panel for each free paper symposium. In the next several issues of EyeWorld, the medical editors will be highlighting some of these best papers by inviting the authors to submit a brief summary or abstract David F. Chang, M.D., chief medical editor Modifying monovision with spherical aberration to improve through-focus visual performance in presbyopia Scott MacRae, Len Zheleznyak, Ramkumar Sabesan, Je-Sun Oh, Geunyoung Yoon In traditional monovision, the dom- inant eye is corrected for distance and the non-dominant eye for near. However, the significant interocular difference in blur can reduce binocu- lar visual performance (binocular summation) and limits the range of clear vision of the two eyes. To over- come these limitations of traditional monovision, we "modified monovi- sion" by making the optical quality of the two eyes less disparate while maintaining 1.5 D of anisometropia. This was accomplished by inducing spherical aberration (+/–0.2 mm in 4 mm pupil) in the non-dominant eye. A custom-made binocular adap- tive-optics visual simulator, which can manipulate a patient's optical quality in both eyes independently (aberration correction and induc- tion), was used to measure through- focus visual performance in traditional and modified monovi- sion paradigms. We found that in- ducing both positive and negative spherical aberration extends binocu- lar depth-of-focus (through-focus vi- sual acuity better than 20/30) and improves binocular summation when compared to traditional monovision. Such strategies may im- prove spectacle independence. Comparison of precision, circular- ity, diameter, and centration of capsules removed by femtosecond laser and capsules removed by manual technique Juan F. Batlle, M.D., William W. Culbertson IV, M.D., Rafael Feliz, M.D. The trial with the Catalys Precision Laser System (OptiMedica, Santa Clara, Calif.) for cataract surgery was performed at Centro Laser between July 2009 and September 2010. This was a prospective, randomized trial of 29 eyes that received laser capsu- lotomy in one eye and conventional manual capsulorhexis in the fellow eye. We compared centration, circu- larity, and diameter of the capsules obtained. Laser disc diameter devi- ated from intended by 27±25 mi- crometers, and the circularity index was 0.942±0.040 (where 1.00 is per- fect). The findings were statistically significant for both endpoints (p<0.001). Centration for the laser capsulotomy was within 86±51 mi- crometers of intended. In compari- son to manual technique, the measured diameter following fem- tosecond laser capsulotomy was a more accurate order of magnitude. These were exciting findings because we were able to show the extreme precision and predictability of this technology, which we think will change the future of cataract sur- gery. Novel surgical technique and in- strumentation: Fixation of an IOL using a 30 g injectable shape memory alloy clip in a porcine eye Jeffrey L. Olson, M.D., Michael Erlanger, M.D. Our presentation introduced a novel surgical technique and novel surgi- cal instrumentation using a 30 gauge injectable shape memory alloy clip to fixate a posterior in- traocular lens to the iris in a simu- lated surgical setting. The device is designed to replace the complex su- turing procedures currently used to fixate dislocated IOLs. The biocom- patible nitinol clip has super-elastic, shape memory properties. The pre- loaded, straightened 30 gauge clips fit onto an injector device that de- ploys the clips like a conventional syringe. Deployed clips return to their circular configuration. The Best papers of session continued on page 16 June 2011 technique requires two corneal paracentesis and a micro-forceps to stabilize the IOL haptic beneath the mid-peripheral iris. The 30 gauge needle punctures the iris adjacent to the haptic, and the shape memory alloy clip is deployed to fixate the IOL to the iris. The procedure can be

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