Eyeworld

EW CATARACT May 2014 33 IOL cutters continued from page 30 "Show it to everyone. See who's interested. There are no proprietary rights in instruments. No one's going to patent it," he said. Snyder/Osher IOL Explantation Set Working through smaller incisions successfully was the driving force behind the Snyder/Osher IOL Ex- plantation Set (Geuder, Heidelberg, Germany), said co-designer Robert H. Osher, MD, in practice at Cincinnati Eye Institute. "We wanted a set of scissors and forceps that would serve multiple purposes," he said. "Our design allows for the scissors to cut at right angles, at 45 degrees, straightaway, and backward." The scissors have interchange- able handles and can be switched from vertical to horizontal rotation to cut, he added. Michael E. Snyder, MD, in practice at the Cincinnati Eye Institute, added: "We wanted to make sure that we could work through a 2.2 mm incision, so we wanted the jaws of the scissors to be long enough that we could make some reasonable progress across the lens per cut. But they had to be short enough so when they were open inside the eye with the cross point of the scissors being in the wound, we had a margin of safety from the cornea and the capsule." He credits Dr. Osher with em- phasizing the length from the hinge point to the tip of the scissors as a key to be able to maximize the dis- tance per cut while minimizing the "wideness" of the jaw opening for the protection of the capsule and the corneal epithelium. "On older scissors, the distance from pivot point or hinge to the end of the scissors tip was much longer and that made it more awkward to work through the smaller channel," he said. Dr. Snyder prefers a "one size fits all" approach, so he wanted to ensure the scissors could cut easily through silicone, acrylic, or, rarely, collamer. The Snyder/Osher scissors incorporate a serrated edge to better grasp the slippery silicone and col- lamer lenses. They wanted to minimize the blade thickness because the thinner a blade, "the more it's going to slip past the trailing portion that's been cut and less likely to push that trail- ing portion up or down, so the less likely to contact either the endothelium or the capsule and the greater the therapeutic safety window," Dr. Snyder said. While serration is more impor- tant when explanting silicone lenses, an added benefit Dr. Snyder incorporated into the design was a rounded tip "so that the scissors wouldn't inadvertently catch or snag the capsule or the iris tissue." Dr. Osher said it's the one set that's "always on my tray." Both men recalled the time from concept to commercialization as being "a few months," and said it is much easier to bring an instru- ment to market than a device or drug. "There are other ideas out there," Dr. Osher said. "Just persevere if you believe in it." EW Editors' note: The physicians have no financial interests related to the products mentioned. Contact information Mackool: mackooleye@aol.com Osher: rhosher@cincinnatieye.com Packer: mark@markpackerconsulting.com Snyder: msnyder@cincinnatieye.com

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