Eyeworld

85 June 2015 EW MEETING REPORTER Editors' note: The live surgery sessions were sponsored by Alcon and Bausch + Lomb. East to West "Do you know how big Asia is?" Audrey Chia, MD, Singapore, asked at the SNEC-Duke Symposium. This thought, she said, was her first upon rent was not along the intended axis of the IOL. He turned the Verion overlay on to show the desired lens axis; sure enough, the rent was offset by several degrees from the IOL axis. Inserting the IOL using the In- trepid AutoSert IOL injector (Alcon), Dr. Ramamurthy paused once or twice to reorient the injector to al- low the IOL to unfold into position without touching the rent. Robert Ang, MD, Philippines, speaking from the panel, said the gentle unfolding of AcrySof platform IOLs is an advantage in cases like this. Dr. Kim agreed, adding that Dr. Ramamurthy's successful maneuver- ing was a testament to the control that the AutoSert allows the surgeon during invention—as well as the surgeon's skill. "You embody 'grace under pressure,'" Dr. Kim said. He wondered when the rent had occurred as it was difficult to see in real time. He guessed that Dr. Ramamurthy's tip had caught on the rhexis during I/A. Dr. Ramamurthy thought it more likely that he had accidentally cut the anterior capsule during prechop. In any case, calmly deciding that the capsule integrity remained in spite of the rent, Dr. Ramamurthy completed the operation without further mishap. Chee Soon Phaik, MD, Sin- gapore, also encountered some difficulty in one of her live surgery demonstrations—which is not all that surprising. Dr. Chee, said Ronald Yeoh, MD, Singapore, from the panel, tends to choose the most difficult cases for the audience's education—and entertainment. Operating on a 64-year-old high myope (an eye with an axial length of 26.70 mm) with a posterior polar cataract proved even more compli- cated than Dr. Chee expected, sim- ply because there was no way to be sure of the density of the posterior polar cataract, and she had expected a softer cataract. Nonetheless, Dr. Chee demon- strated characteristic skill as she slowly worked her way through the cataract. In this case, Dr. Chee used the Victus femtosecond laser platform (Bausch + Lomb), presectioning the cataract using the spider pattern. After completing the rhexis, she pro- ceeded with viscodissection, inject- ing dispersive viscoelastic under the anterior capsule up to the equator and proceeding with peripheral chop, first debulking the cortical material, leaving the central portion for last. At the same live surgery sym- posium, Mohan Rajan, MD, India, used the Stellaris PC platform (Bausch + Lomb) to operate on a cataract, nuclear sclerosis 3+ in a 69-year-old patient. It was difficult to tell which he was most excited about: the Stellaris (a "fantastic machine," he said), the "amazing" enVista IOL (Bausch + Lomb) he implanted, the fact that he was oper- ating in SNEC for the first time— praising the facilities and staff—or that it was his 100th live surgery. In any case, Dr. Rajan's delight was infectious. "Of all the live sur- geries I've done, I will keep this for posterity," he said. continued on page 86

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