Eyeworld

EW NEWS & OPINION 34 October 2016 by Ellen Stodola EyeWorld Senior Staff Writer, and Liz Hillman EyeWorld Staff Writer look at the influence of CTRs on the rotational stability of an IOL. This was a clinical study with two groups—one group with an IOL without a CTR and one group with an IOL with a CTR. Each group had 100 patients. The IOL axis was documented at the end of surgery, at 1 hour postop, at 1 week postop, and at 6 months postop. The study results found that a CTR reduced the rotation within the first hour, but there was no benefit after 6 months. Without a CTR, there was major IOL rotation found within the first hour, low rotation within the first week, and it was stable after that. Meanwhile, with a CTR, there was low IOL rotation within the first hour and major rotation later be- tween 1 week and 6 months postop. The study concluded that there was no significant difference in rotation- al stability after 6 months, and there is a questionable benefit of using a CTR with toric IOLs. Another poster discussed in this session highlighted a study from the U.K. on "Fingerprick autologous blood: a novel treatment for dry eye syndrome and persistent epithelial defects." Some indications for autologous serum include for dry eye syndrome, persistent epithelial defects, limbal stem cell deficiency, post-LASIK dry eye, recurrent erosion syndrome, diabetic/neurotrophic keratopathy, and graft vs. host disease. However, autologous serum is quite expen- sive, with an initial cost of £1,900 and then approximately £450 per month, according to the paper authors. There is also a delay in obtaining funding for treatment on the U.K.'s National Health Service, a delay in the production of drops, contraindications to blood dona- tion, and a requirement for refriger- ation. The study, conducted in the U.K., provides a potential alternative with fingerprick autologous blood practiced in a wet lab setting before taking it to the operating room. Ehud Assia, MD, Tel-Aviv, Israel, said that he has asked other surgeons who have used this tech- nique about their experience with it. They've said it works well, but "it's not a simple technique. You do need some experience doing this proce- dure," Dr. Assia reported. Other videos that were high- lighted in this session included one on the CAPSULaser (Los Gatos, Cal- ifornia), IOL surface modification, research on the effect of trypan blue on the capsule, and new insight on cavitation and hydroxyl radicals. Top posters and papers One of the best posters presented —"Impact of a capsular tension ring on the rotational stability of a single-piece hydrophilic acrylic intraocular lens"—fell in the cataract category. A capsular tension ring (CTR) can be used for zonular weak- ness, stabilization of the capsular bag, and for reduction of anterior capsular phimosis, and the study sought to The wounds where the needle is in- serted and where the IOL is inserted should be separated by 90 degrees to make it easier to insert the leading haptic into the inner cavity of a 30-gauge needle. With the leading haptic inserted about 3 mm inside a 30-gauge needle at this position, it makes insertion of the trailing hap- tic into a second 30-gauge needle, placed 180 degrees opposite, easier. The direction of these needles when they are inserted should be the same as that of the IOL's haptics, having an angle of 20 degrees with respect to the limbus and 5 degrees with respect to the iris surface. Ophthalmic cautery is used to create a flange—the same diameter as the needle—of the haptics, which are then fixed inside the sclera. Boris Malyugin, MD, Moscow, a chairperson for the session, said this video showed a new variation of an already established technique, but it appears easier and safer. While those on the panel praised the ele- gance of the technique, many noted its subtleties and advised that it be The ESCRS Congress concluded with a session on the best presentations throughout the meeting O n the final day of the XXXIV Congress of the European Society of Cataract and Refractive Surgeons (ESCRS) in Copenhagen, Denmark, a panel discussed several presentations that were deemed the best throughout the meeting. They highlighted top videos, posters, papers, and presen- tations from meeting symposia. Top videos The overall video winner in all categories was Shin Yamane, MD, Yokohama, Japan, who presented a video on scleral IOL fixation with a double needle technique. The video explained the technique and showed a case example. First, the positional relationship of the wounds must be considered. Highlights from ESCRS Best of the Best Presentation spotlight Dr. Spalton speaks at the Best of the Best session at the XXXIV Congress of the ESCRS in Copenhagen, Denmark. Source: ASCRS

• Cover