Eyeworld

UPDATE 19 foundation's Operation Sight net- work of volunteer surgeons have provided more than 880 free cata- ract surgeries for needy American patients living in their own commu- nities. Nearly 250 ASCRS members have generously volunteered their time and expertise. Visit the ASCRS Foundation booth to learn more about Operation Sight and to sign up for a free webinar on becoming a member of our growing network. EW Contact information Desai: desaivision@hotmail.com Zundel: nzundel@ascrs.org ny), and Johnson & Johnson (New Brunswick, New Jersey)—the foun- dation will also host an interactive Phaco 50th timeline wall, where each physician can add their photo and personal message. Be sure to also visit the foundation booth to add your number of phaco proce- dures performed to the member- ship's master tally—with the total number done by those in attendance to be announced at the close of the meeting. Become an Operation Sight volunteer Since its beginning in 2014, the In the journal Collagen crosslinking with conventional and accelerated ultraviolet-A irradiation using riboflavin with hydroxypropyl methylcellulose Anne Marie Hagem, MD, Andreas Thorsrud, MD, Gunhild Falleth Sandvik, MPhil, Marianne Råen, MPhil, Liv Drolsum, MD, PhD In this prospective randomized case series, investigators considered how accelerated crosslinking compared to the conventional technique. The 40 eyes included here either underwent conventional crosslinking with 3 mW/cm2 UVA irradiation, for 30 minutes in what was dubbed the CXL30 group, or were randomized to the CXL10 group, which underwent accelerated crosslinking using 9 mW/cm2 UVA irradiation for 10 minutes. Investigators used the same riboflavin 0.1% solution with hydroxypropyl methylcellu- lose 1.1% in both groups. One month after performing the crosslinking, using in vivo confocal microscopy, investigators determined that at the 100-micrometer depth there were no keratocytes in any of the eyes. However, investigators found that for those in the CXL30 group at the 300-micrometer level fibroblasts were at 83.3% versus just 31.3% for those in the CXL10 group. Likewise, at 400 micrometers, keratocyte levels for those in the conventional group were at 42.1% versus just 5.9% for those in the accelerated group. In the CXL30 group, there was a difference in endothelial cell density of 64.7% versus just 20% for those in the CXL10 group. After 12 months, investigators did not see any statistically significant differences in either maximum keratometry or in visual acuity. Investigators concluded that there was an absence of keratocytes with both techniques and also deep structural changes were noticeable particularly in the CXL30 group. They theorize that these deep changes, which could result in long-term safety implications, may be explained by use of methylcellulose-riboflavin. Clinical outcomes of immediate small-incision lenticule extraction after suction loss: Comparison with uneventful small-incision lenticule extraction Jin Hyoung Park, MD, PhD, Hyung Jin Koo, MD, PhD Investigators in this retrospective case series set out to evaluate how suction loss occurring during otherwise straightforward small-incision lenticule extraction (SMILE) surgery for myopia or myopic astigmatism effected the safety and predictability of the procedure. Patients here were placed in one of two groups: the 23 eyes that underwent the procedure using immediate reapplied suction were placed in one group, while 48 others that underwent uneventful SMILE were placed in another group. Investigators here found that for 96% of those who underwent the procedure with reapplied suction, corrected distance visual acuity remain unchanged or was improved. Investigators determined that manifest refraction defocus equivalent was at a mean of within 1.25 D of attempted correction for the group that underwent immediate suction reapplica- tion versus 0.35 D for those who underwent uneventful SMILE. They concluded that for those who underwent uneventful surgery there was a slightly higher correlation between the achieved and attempted spherical refraction. The conclusion reached was that while using reapplied suction was safe and predictable in terms of long-term results it was slightly lower than for those who underwent the SMILE procedure completely uneventfully. Robot-assisted simulated cataract surgery Tristan Bourcier, MD, PhD, Jimmy Chammas, MD, Pierre-Henri Becmeur, MD, Arnaud Sauer, MD, PhD, David Gaucher, MD, PhD, Philippe Liverneaux, MD, PhD, Jacques Marescaux, MD, PhD, Didier Mutter, MD, PhD Could a robot perform cataract surgery? Investigators here considered the feasibility of robot-assisted simulated cataract surgery. Cataract procedures here were done on 25 lens nuclei using either the Da Vinci Xi robotic surgical system or the Whitestar Signature system for phacoemulsification. In all cases, the surgery was able to be successfully performed. Investigators found that the Da Vinci Xi system allowed for the automatic performance of phacoemulsification steps including corneal incisions, capsulorhexis, grooving, cracking, and quadrant removal of OVD using irrigation/aspiration. The only steps that were done manually included the injection of OVD, balanced salt solution, and finally the intraocular lens. With this approach, the procedure required a mean of 26.44 minutes. While the lens nucleus was successfully removed in all cases, in two of these the main corneal incision was unintentionally enlarged by the phaco hand piece. Investigators concluded that with the new Da Vinci Xi Robotic Surgical System together with phaco technology, it was possible to perform robot-assisted cataract surgery. April 2017 Distribution of free surgery provided by the ASCRS Foundation in 2016. Each icon represents approximately eight cataract surgeries. Source: ASCRS

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