Eyeworld

149 October 2016 EW MEETING REPORTER Given some of the limitations to topical mydriatic options, she said, "Mydrane represents a new and simplified alternative to cataract sur- gery in adults," possibly allowing for better surgical scheduling and more operations each day. Uwe Pleyer, MD, Berlin, Germa- ny, presented a study that compared the use of intracameral mydriatics in Sweden to other European countries. The survey included more than 480 to be an effective, predictable, and safe procedure, Dr. Güell said. The incidence of significant complica- tions appears acceptable, with an endothelial cell loss around 2% per year, he added. Comparison of results with sclera-fixated IOLs is difficult, but most available data favors Artisan because of the surgical time and the severity of the complications. Addi- tionally, Dr. Güell noted the need for prospective, long-term, multicenter studies for evaluating anterior vs. posterior fixation and iris-fixated vs. sclera-fixated IOLs. Dr. Güell also discussed the "phakic" models of these lenses, or the Artisan/Artiflex IOLs used to correct a range of refractive errors on phakic eyes. In summary, he said that these are part of the standard surgical options for the correction of primary and secondary refractive er- rors. Despite some implantation dif- ficulties, many of which are surgeon dependent, the Artisan/Artiflex are Dr. Güell's favorite phakic IOLs, and he expects that in the near future these could improve outcomes. Insights on pharmacologic pupil expansion Mydriasis is an important step in cataract surgery to ensure the iris is large enough to allow for the opera- tion and IOL implantation. Topical mydriatic agents have their limitations. These include slow penetration, unstable pupil dilation, potential cardiovascular side effects, and possible ocular surface damage. Angela Panico, MD, Verona, It- aly, described a study that compared Mydrane (0.02% tropicamide, 0.31% phenylephrine, 1% lidocaine, Thea Pharmaceuticals, Clermont-Ferrand, France), an intracameral mydriat- ic drug, to the topical alternative. Seventy total patients—half receiv- ing Mydrane and half receiving eye drops—had pupils measured before surgery, at several points during surgery, and after surgery. The mydriasis obtained with Mydrane was lower than that with eye drops, Dr. Panico said, but there was no relevant difference in terms of safety between the two groups, and mydriasis was stable in all parts of surgery in both groups. surgeons and more than 250,000 cataract surgeries. The use of intracameral mydriat- ics was significantly higher among Swedish surgeons (62%) compared to other European countries (17%). Data collected also revealed fewer surgical delays due to pupil dilation in Sweden compared to other Euro- pean countries. Astigmatism management A symposium focused on astig- matism management in cataract surgery, with presentations on measuring astigmatism, calculating astigmatic correction, intraoperative aberrometry, managing irregular astigmatism, marking the axis, and correcting misaligned IOLs and astigmatic surprises. continued on page 150

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