SEP 2012

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

Issue link: https://digital.eyeworld.org/i/82503

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Page 85 of 103

AAO Booth #2641 September 2012 There's continued from page 85 Atkinson Tip Retrobulbar Anterior Chamber Cannula (Mendez) Nucleus Hydrodissection Cannula Irrigating Cystotomes tute for human eyes, and the tissues—particularly the capsule and the lens—often behave differently from those of adult human eyes. Porcine capsules, for example, have tensile properties much more like a pediatric human capsule. Cadaveric human eyes are expensive (roughly $200 each) and are rarely an option. Some programs now have access to virtual cataract surgical simulators such as the EyeSi (VRMagic, Mannheim, Germany), but cost remains a significant impediment, and virtual reality systems, while potentially very useful, lack the sort of kinesthetic feedback that is essen- tial for residents to experience. Consequently, many programs in the U.S. and abroad now use syn- thetic eyes. While not usually considered a Double Bevel Sideport Knives Stab Knives MVR Knives Crescent Knives "synthetic eye," cherry tomatoes (boiled and then chilled) and grapes can be useful models for practicing a capsulorhexis. The Red Globe variety of grape may be up to 1 inch in diameter, suitably large for practice with Utrata forceps, and the skin has a mechanical tension similar to that of the aging lens capsule.1 Several synthetic models are available at reasonable prices that provide fairly realistic kinesthetic feedback. The first is from Kitaro. The dry lab component has different materials for manually practicing capsulorhexis, nuclear dividing techniques, wound construction, IOL insertion, and even simulated eye movements using a unique magnet attachment. The wet lab comprises an artificial cornea and lens with distinct capsular, cortical, and nuclear components for use with a phaco machine. The lenses come in different densities. Gulden Ophthalmics (Elkins Park, Pa.) makes an ergonomic simulator eye for practicing the basic steps of phaco surgery, i.e., capsulorhexis, sculpting and four- quadrant grooving, bimanual crack- ing into four quadrants, chopping, and emulsification of the nucleus. Replacement lenses are available at $5 each. Phillips Studio in the U.K. makes a life-sized synthetic eye in which the hardness of the nucleus can be adjusted, allowing residents to practice different phaco tech- niques as well as capsulorhexis. Replacement eyes are $20 each. While no comparative studies of the utility of these different models have been published, many program directors find them extremely help- ful. Above all, residents should re- member that ANY surgical practice can be beneficial if a well-planned surgical curriculum is available that includes proper use of the options described above. EW Reference Figueira EC et al. The grape: An appropriate model for continuous curvilinear capsu- lorhexis. J Cataract Refract Surg 2008, 34:1610-1. Contact information Dunn: jpdunn@jhmi.edu Khalifa: yousuf_khalifa@urmc.rochester.edu Park: lisa.park@nyumc.org Getting hip to cataract surgery U 10201-A Trademark Street, Rancho Cucamonga, CA 91730 Phone: 909.481.0011 or 800.782.6534 FAX 909.481.4481 email: goeagle@eaglelabs.com www.eaglelabs.com Yes! Please Send: Ye Cat alog Brochures for Refractive Products, Cannulae, Blades & Kniv es Samples of t he Following: Name Dept. Address City St Phone# ate Zip Please Return to Eagle, Attention: Cust omer Relat ions FM 71198 ndergoing cataract surgery may do more than restore vision. New study results published in a recent issue of JAMA suggest that it may also help lower the chance of hip fracture in older patients. Results of this retrospective study, conducted in Medicare patients 65 years and older, showed a 16% decrease in hip fractures in those who underwent cataract surgery 1 year after the procedure. The study, led by Victoria L. Tseng, M.D., Warren Alpert Medical School of Brown University, Providence, R.I., looked at a 5% random sample of the 1,113,640 Medicare Part B beneficiaries in the U.S. who were determined to have cataracts during the period from 2002-2009. Investigators determined that the chance of experiencing a hip fracture for those with cataracts was reduced by cataract removal. This was particu- larly true for those with severe cataracts, where there was a 23% reduction in the odds of hip fracture for those who had their cataracts taken out. Investi- gators noted that postural instability has been linked to changes in vision caused by cataracts. They concluded that a reduction in hip fractures for older patients was one potentially unheralded benefit of undergoing cataract surgery. © Eagle Labratories 2012

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