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EW CATARACT 47 September 2015 the first one's done, or go into a second room down the hall. So the delay is no more than 20 minutes. EW Editors' note: Dr. Cionni has financial interests with Alcon. Dr. Talamo has financial interests with Abbott Medical Optics (Abbott Park, Ill.). Dr. Nagy has no financial interests related to this article. Contact information Cionni: 801-266-2283 Nagy: nz@szem1.sote.hu Talamo: Jonathan_Talamo@meei.harvard.edu Beaver-Visitec International, Inc. | 411 Waverley Oaks Road Waltham, MA 02452 USA | BVI, BVI Logo and all other trademarks (unless noted otherwise) are property of a Beaver-Visitec International ("BVI") company © 2015 BVI For more information, call 1-866-906-8080 or visit us at www.beaver-visitec.com Pairing your procedure with Endoscopic CycloPhotocoagulation (ECP) helps your patients who suffer from glaucoma. * Francis, B., Berke, S., Dustin, L. and Noecker, R. (2014). Endoscopic cyclophotocoagulation combined with phacoemulsifi cation versus phacoemulsifi cation alone in medically controlled glaucoma. Journal of Cataract & Refractive Surgery, 40(8), pp.1313—1321. Pairing your procedure CycloPhotocoagulation patients who suffer * Francis, B., Berke, S., Dustin, L. and Noecker, R. (2014). Endoscopic cyclophotocoagulation combined with phacoemulsifi cation versus phacoemulsifi cation alone in medically controlled glaucoma. Journal of Cataract & Refractive Surgery, 40(8), pp.1313—1321. ECP added to cataract extraction resulted in greater reduction in IOP and glaucoma medications than cataract extraction alone over a 3 year period.* Performing Cataract Surgeries? View the new Endoscopy Retinal Surgery tutorial at: www.eyetube.net/series/endo-optiks/. from glaucoma. AAO Booth 1221 Utrata forceps, to remove the cap- sule; I will push down on the middle of the capsular disc to identify any tension striae where there may be adhesions. Once I'm certain that there are no adhesions, I'll proceed with removal of the capsular disc. I tend not to inflate the anteri- or chamber as much as I otherwise would because when I go to hydro- dissect, I want room for gas bubbles to come forward around the lens. If it seems that the gas generation from treating the lens has remained trapped in the capsular bag and the capsular bag is under tension, I enter the eye with my phaco probe and a second instrument and carefully push apart the cut segments of the lens to allow the gas bubbles to come forward and decompress the bag before I do further manipulation to free the nucleus. Instead of requiring hydrodis- section with balanced salt solution, sometimes there's either no or very little hydrodissection required. I will assess this situation before I proceed with the full hydrodissection by rocking the lens back and forth and seeing if it rotates freely. When it comes to removing cortex, you don't have strands of cortex sticking out beyond the edge of the capsule because they've been cut with the laser. I use a curved I/A tip that lets me comfortably put the aspiration port right up under the capsule, and then tangentially (diagonally) engage until I have cortex and strip it in a circumferen- tial manner. I prefer bimanual I/A for this but an angled/curved coaxial I/A tip also works well. It is clear that you can perform a laser treatment and then wait a little while before you take a patient into the operating room. But if you treat a patient with the laser and you leave them waiting for an hour or 2, cytokines and inflammatory mediators can be released into the eye and the pupil can constrict, and that can be more difficult to keep dilated during the procedure. So that is a challenge—to make sure that the timing of the laser pretreatment and the completion of the surgery are appropriately sequenced. What I'll typically do is I'll start my day by treating 2 patients. One will immediately go into surgery and the other will wait and go in when

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