Eyeworld

113 EW INTERNATIONAL October 2016 Dr. Malyugin: Over the last few years we have heard a lot of criticism related to the femto laser-created cataract incisions. Some of this criticism was due to the partial loss of the self-seal- ing properties of the main and sideport incisions. However, this particular paper impressed me by showing clear benefits of the specific pattern of the primary incision created with the femtosecond laser that demonstrated perfect wound stability and by rising the safety margin of FLACS over conventional surgery utilizing manual blade incisions. EW Editors' note: Dr. Malyugin is deputy director general, S.N. Fyodorov Eye Microsurgery Complex, Moscow. He has no financial interests related to his comments. Contact information Malyugin: boris.malyugin@gmail.com (Group B); multi-plane corneal inci- sion created manually with a metal blade (Group C). The stability of the incisions was evaluated at the time of surgery without pressure, at 1 day and 2 weeks postop with and with- out incision pressure for incision leakage. Results: Fifteen eyes in Group A had incision leakage at a mean IOP of 28.2. Fifteen eyes in Group B had incision leakage at a mean IOP of 15.1. Fifteen eyes in Group C had in- cision leakage at a mean IOP of 9.9. Incision leakage IOP was significant between Group A and Group B, and Group A and Group C. Conclusion: The 110-degree reverse side cut primary incision created with a femtosecond laser provides the most effective seal for potential wound leakage, especially compared to manual incisions. Dr. Malyugin: This lens is called "bio- analogic" because it mimics the shape of the natural lens with the flat anterior surface and prolate posterior surface. The authors claim several mechanisms of actions of these lens: truly accommo- dative lens displacement and arching of the lens surface due to the ciliary body and vitreous displacement and optics polyfocality. The first mechanisms are dependent on the preservation of the clarity and elasticity of the capsule postoperatively, while the latter increas- es the depth of focus, specifically if that is combined with mini-monovision. As a result of the surgery two-thirds of patients did not use spectacle correction for near tasks. I am looking forward to having the longterm data with special attention to PCO and how it will affect the functional outcomes achieved. Primary phacoemulsification incision with a femtosecond laser 110-degree reverse side cut, 70-degree forward side cut, and a keratome Eric Donnenfeld, MD, Eric Rosenberg, DO, Alanna Nattis, DO, Henry Boozan Purpose: To compare the phacoemulsification primary inci- sion self-sealing efficacy of a fem- tosecond laser 110-degree reverse and 70-degree forward side cut with a manual keratome incision in pa- tients undergoing cataract surgery. Methods: In a randomized prospec- tive trial, 45 patients undergoing cataract surgery were randomly assigned to one of three treatment groups for their primary corneal incision: 110-degree Catalys femto- second laser (Abbott Medical Optics, Abbott Park, Illinois) reverse side cut (Group A); 70-degree Catalys femtosecond laser forward side cut mediate, and near following implan- tation of the WIOL-CF bioanalogic polyfocal intraocular lens. The lens optics are designed to extend the depth of focus (EDOF). Methods: Retrospective analysis of data collected on 10 consecutive pa- tients (19 eyes) undergoing bilateral implantation of the bioanalogic, polyfocal WIOL-CF lens implant following femtosecond laser and implantation through a 2.6 mm incision. Visual data (UDVA, CDVA, UNVA and uncorrected intermediate vision at 60 and 80 cm), refractive outcomes were collected at 1 month and 3 months following surgery. Contrast sensitivity data and defocus evaluation was performed on all sub- jects at 3 months following surgery. Results: Mean age at surgery was 71 years (61 to 84). Three months after implantation, binocular UDVA, UIVA at 60 cm and UIVA at 80 cm were 20/25 or better in 85% of patients. Binocular UNVA (40 cm) was better than 20/25 in 53% of patients, and better than 20/32 in 69% of patients. Preoperative spherical equivalent was reduced at 3 months from –0.72 D±3.91 D to –0.09 D±0.75 D. Mean absolute error, calculated as the difference of the postoperative manifest refrac- tion and the predicted postoperative target refraction, shows that the percentage of eyes within ±0.50 and ±1.00 D was 57% and 100%, respectively. Conclusion: The WIOL-CF IOL bioanalogic polyfocal lens is an ex- tended depth of focus implant that reliably and predictably provides good functional vision at distance, intermediate, and near and a good option for presbyopia correction. International For more from Dr. Malyugin, view his presentation at clinical.ewreplay.org.

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