EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/76185
July 2012 EW MEETING REPORTER 55 Singapore, and Ke Yao, M.D., Hangzhou, China, offered sugges- tions on how to select patients for the procedure, as well as how to manage those patients pre-op. Finally, Donald Tan, M.D., Singapore, Jodhbir S. Mehta, M.D., Singapore, and Yan Wang, M.D., Tianjin, China, discussed different surgical techniques used in the all- in-one femtosecond laser refractive procedure, including SMILE (small incision lenticule extraction) and pseudo-SMILE. Opening ceremony stresses collaboration, knowledge transfer The APACRS meeting opened May 31 in Shanghai in conjunction with the 14th Congress of the Chinese Cataract Society. The meeting provides a unique opportunity for scientific communication and exchange among the world's leading ophthalmologists, said Ke Yao, M.D., president, Chinese Cataract Society, in his welcoming remarks during the Opening General Session. "Cataract has always been a major cause of blindness in China and the whole world," said Dr. Yao. "Chinese ophthalmologists are fac- ing an unprecedented change; 1.4 million cataract surgeries were done last year, but there are still 8 million [patients] on the waiting list. The waiting list is becoming longer and longer. Under this huge pressure, our Chinese ophthalmologists are eager to communicate with the world's experts." Graham Barrett, M.D., Perth, Australia, president, APACRS, and chief medical editor, EyeWorld Asia- Pacific, noted that the magazine has fundamentally altered the exchange of ophthalmic knowledge in the region, particularly in China. "I can think of no better description for this meeting than the sophisticated surgeon," he said. Left to right: Keiki R. Metha, India, Ronald Yeoh, Singapore, John Chang, Hong Kong, Y C Lee, Malaysia, and Michael Knorz, Germany "The program this year will educate us on state-of-the-art cataract and refractive surgery. We're going to explore the very best way to practice our profession and reflect the principles of elegance, efficiency, and excellence as exemplified by Shanghai." Dr. Assia honored with 2012 LIM Lecture For more than 20 years, the APACRS LIM Lecture has remained the high- est award of the Society, honoring exceptional ophthalmologists who have made extraordinary contribu- tions to the advancement of cataract and refractive surgery. This year's honoree was Ehud I. Assia, M.D., Kfar Saba, Israel. Dr. Assia called the award a "great honor," which he was "grate- ful" to be a part of. His talk was on surgical options in subluxated lenses, an uncommon but serious condition that may affect vision. Subluxation may occur in crystalline or intraocular lenses, he said. Subluxation of crystalline lenses usually occurs in young patients and is often associated with some systemic syndromes or follow- ing trauma. Intraocular lens subluxa- tion, on the other hand, happens in older patients with pseudoexfolia- tion or myopia, or following cataract surgery. "It almost always requires surgical intervention, and it is al- ways challenging," Dr. Assia said. Surgical options for crystalline lens subluxation are intracapsular cataract extraction (ICCE) or lensec- tomy and implanting an alternative lens, or to preserve the lens capsule using a stabilizing device. Dr. Assia recommended preserving the cap- sule because it maintains the barrier between the anterior and posterior segments and utilizes the remaining zonules. It also helps prevent lens decentration and tilt, and there's no contact with the IOL material and ocular tissue, preventing chafing. There are two kinds of capsule stabilizing devices: equatorial sup- port and anterior capsular support. One disadvantage of the equatorial ring is that it takes up the entire lens equator and requires a great deal of manipulation and may jeopardize the zonules. The other option is capsular support, done with a capsular anchor. Dr. Assia designed this device, which anchors the anterior capsule to the scleral wall. Surgical options for intraocular lens subluxation are the same as the crys- talline lens: either removing it entirely and replacing an alternative or attempting to preserve it. Dr. Assia's preferred solution is to reposition the IOL. "Some excellent results can be achieved if you refixate the lens," he said. "If the IOL is out of the bag, it's better to fixate it to the iris. If it's in the bag, it's better to fixate it to the sclera." continued on page 56