Eyeworld

173 April 2016 EW MEETING REPORTER nucleus to a good level, staining the anterior capsule, making sure that a large anterior CCC is performed, and performing a vitrectomy if vitreous is present. Dr. Chee argued that she thinks performing the vitrectomy if vitreous is present may be the most important (which 14% of audience responders chose). Arup Chakrabarti, MD, Kerala, India, spoke about mature and white cataracts. He showed videos of both of these challenges and indicated that with a white cataract, the focus should be on the capsulorhexis, as he thinks this is the most important step. Meanwhile, when considering a hard cataract, nucleus manage- ment becomes very important. For a white cataract, Dr. Chakrabarti said that trypan blue staining is a must, and the anterior capsule should be stained on a rou- tine basis with this. He added that his OVD strategy is to use Healon 5 (Abbott Medical Optics). "In regard to hard cataracts, try to use torsional phaco," Dr. Chakrabarti said. If this is not possi- ble, longitudinal will also work. George Beiko, MD, St. Catha- rines, Canada, gave his top 5 pearls for dealing with posterior capsular tears. First, he said to try to convert the posterior capsular rent into a continuous curvilinear capsulorhex- is. His next pearl was if large nuclear "We have opportunities, but we need to overcome certain challenges with appropriate strategies and plan- ning," Dr. Hossain said. Editors' note: Dr. Hossain has no related financial interests. Video-based complications A session featured presentations on a number of different cataract and IOL complications, with Soon-Phaik Chee, MD, Singapore, Marie-Jose Tassignon, MD, Antwerp, Belgium, and Dennis Lam, MD, Hong Kong, serving as chairs. Topics included weak zonules; mature, hard, and white cataracts; ruptured PC; com- bined cataract/DMEK; IOL exchange; and infant cataract surgery. Dr. Chee offered her top 5 pearls for weak zonules. First, she said to remove the vitreous as it presents. The second pearl was to provide counterforce during the capsuloto- my. Dr. Chee also said to support the equator of the bag and support the capsular bag during phaco. Her final pearl was to focus on centering the IOL. When polled, audience respond- ers indicated that they think the first step in managing a subluxated cataract should be to perform a capsulotomy with the aid of hooks, with 45% of respondents indicating this choice over other choices of injecting viscoelastics to bring the continued on page 174 View videos from APAO 2016: EWrePlay.org Hugh Taylor, MD, discusses the prevalence of worldwide blindness and approaches to improving detection and treatment.

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