Eyeworld

145 October 2015 EW MEETING REPORTER become much more difficult, and new phaco techniques were devel- oped to overcome these difficulties. There was then the question of making the CCC more precise, he said. Size and centration become im- portant in the capsulotomy because these are both needed when using multifocal and toric IOLs and for effective lens position. Dr. Packard discussed the introduction of the femtosecond laser and how it played a role in the that were successful and are being repeated this year. The "Best of the Best" review session will include a panel of experts discussing high- lights of the congress, and a new program this year, Presbyopia Day, will include a workshop and new symposium. "I believe the society stands out as a leader in high-quality, expert-led education for ophthal- mology of all levels of experience," Dr. Bellucci said. Exactly 30 years ago, Dr. Bellucci implanted his first IOL, and he has a deep feeling of affection and gratitude, the same feeling he has for this society that's continuing to further education in the field. Evolution of the capsulotomy In the opening ceremony, Richard Packard, MD, Windsor, U.K., pre- sented the Binkhorst Medal Lecture, "The evolution of the capsulotomy: from crude forceps to precision la- ser." Dr. Packard is a longtime ESCRS board and committee member and is at the forefront of research and teaching of minimally invasive cata- ract surgery. Dr. Packard chronicled the history of the capsulotomy. "We will see how the role of the capsular opening and the means of achiev- ing it have changed," he said. It has evolved from a roughly made tear to allow access to the nucleus for extraction to more regular open- ings and continuous circular tears to support intraocular lenses to finally reaching precision in size and location with the laser and other technologies. The modern era of cataract surgery begins with Jacques Daviel, he said, who pioneered the idea of removing the cataract from the eye in 1747 by opening the capsule and expressing the nucleus. Other pioneers in the field included Ignacio Barraquer, MD, Joaquin Barraquer, MD, Sir Harold Ridley, MD, Richard Kratz, MD, and Charles Kelman, MD, among many others. The continuous curvilinear capsulorhexis (CCC) was particu- larly influential in the field, and Dr. Packard said that Howard Gimbel, MD, Kimiya Shimizu, MD, and Thomas Neuhann, MD, all contrib- uted immensely to this. He noted that Calvin Fercho, MD, was likely the first surgeon to actually perform the CCC, although he's not known for popularizing the technique. The consequences of this new capsulot- omy, Dr. Packard said, were that the IOL could now be placed reliably and securely in the capsular bag, previous phaco techniques requiring the nucleus to be tilted would creation of the capsulotomy. Zoltan Nagy, MD, first used the laser in cat- aract surgery in 2008, he said. This was another fundamental change and helped to make the capsuloto- my a given size and position. With the femtosecond laser, capsuloto- mies were truly circular and lacked the variability seen in manual tech- niques. As with any new technology, however, there are some caveats. Come to booth 2918 to see floor plans and info on efficiency and productivity to learn how we can solve your problems. SPACE PLANNING: A GUIDE TO THE EFFECTIVE O P H T H A L M I C F A C I L I T Y 11/16/2015 @ 3:15 PM AAOE COURSE 502 BOOTH 2918 "We have made at least $5 for every dollar we spent on Practice Flow Solutions. Working with Practice Flow Solutions saved me from a really bad plan from the general architect. Your pre-design Assessment was very detailed and pointed out all the flow issues with the plan I had. Invaluable." Dr. Edward Meier Apex Eye Cincinnati, OH Practice Flow Solutions is a niche design firm uniquely focusing on helping medical practice efficiencies by identifying and solving problems in patient, staff and doctor flow. Larry Brooks, AIA and Tim Griffin, AIA, the founders of Practice Flow Solutions, have over 40+ years of experience designing and advising medical practices. www.PracticeFlowSolutions.com F L O W A S S E S S M E N T S S P A C E A S S E S S M E N T S O F F I C E D E S I G N + ONSITE EFFICIENCY STUDIES + IDENTIF Y THE PROPER AMOUNT OF SPACE + MA XIMIZE YOUR WORKFLOW AAO 2015 TIME WITHOUT A PATIENT TO SEE? PLANNING NEW PRACTICE SPACE? continued on page 146

• Cover