OCT 2012

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

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46 EW AAO PREVIEW October 2012 November 10-13, 2012 Innovations abound during AAO's cataract sessions by Michelle Dalton EyeWorld Contributing Writer Throughout this year's AAO meeting, paper sessions on cataract surgery will concentrate on newer techniques, avoiding complications, and innovative technologies VISIONBLUE capsule of the lens. Contraindications VisionBlueTM is contraindicated when a non-hydrated (dry state), hydrophilic acrylic intraocular lens (IOL) is planned to be inserted into the eye because the dye may be absorbed by the IOL and stain the IOL. Precautions General: It is recommended that after injection all excess VisionBlueTM the eye by thorough irrigation of the anterior chamber. be immediately removed from Carcinogenesis, mutagenesis, impairment of fertility: Trypan blue is carcinogenic in rats. Wister/Lewis rats developed lymphomas after receiving subcutaneous injections of 1% trypan blue dosed at 50 mg/kg every other week for 52 weeks (total dose approximately 1,250,000-fold the maximum recommended human dose of 0.06 mg per injection in a 60 kg person, assuming total absorption). Trypan blue was mutagenic in the Ames test and caused DNA strand breaks in vitro. Pregnancy: Teratogenic Effects: Pregnancy Category C: Trypan blue is teratogenic in rats, mice, rabbits, hamsters, dogs, guinea pigs, pigs, and chickens. The majority of teratogenicity studies performed involve intravenous, intraperitoneal, or subcutaneous administration in the rat. The teratogenic dose is 50 mg/ kg as a single dose or 25 mg/kg/day during embryogenesis in the rat. These doses are approximately 50,000- and 25,000-fold the maximum recommended human dose of 0.06 mg per injection based in a 60 kg person, assuming that the whole dose is completely absorbed. Characteristic anomalies included neural tube, cardiovascular, vertebral, tail, and eye defects. Trypan blue also caused an increase in post-implantation mortality, and decreased fetal weight. In the monkey, trypan blue caused abortions with single or two daily doses of 50 mg/kg between 20th to 25th days of pregnancy, but no apparent increase in birth defects (approximately 50,000-fold maximum recommended human dose of 0.06 mg per injection, assuming total absorption). There are no adequate and well-controlled studies in pregnant women. Trypan blue should be given to a pregnant woman only if the potential benefit justifies the potential risk to the fetus. Nursing mothers: It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when trypan blue is administered to a nursing woman. Pediatric use: The safety and effectiveness of trypan blue have been established in pediatric patients. Use of trypan blue is supported by evidence from an adequate and well-controlled study in pediatric patients. Geriatric use: No overall differences in safety and effectiveness have been observed between elderly and younger patients. Adverse Reactions Adverse reactions reported following use of VisionBlueTM include discoloration of high water content hydrogen intraocular lenses (see Contraindications) and inadvertent staining of the posterior lens capsule and vitreous face. Staining of the posterior lens capsule or staining of the vitreous face is generally self limited, lasting up to one week. Rx ONLY Revised: July 2005 Manufactured by: © Dutch Ophthalmic Research Center International b.v. Scheijdelveweg 2, 3214 VN Zuidland The Netherlands Distributed in the United States by: Dutch Ophthalmic USA 10 Continental Drive, Bldg 1 Exeter, NH 03833, U.S.A. Phone: 800-75-DUTCH or 603-778-6929 U.S. PAT. 6,367,480; 6,720,314 Chicago fun fact The Willis Tower (formerly the Sears Tower) is the tallest building in the Western Hemisphere at 110 stories high Source: Explore Chicago TM (TRYPAN BLUE OPHTHALMIC SOLUTION) BRIEF SUMMARY OF PRESCRIBING INFORMATION Indications and Usage VisionBlueTM is indicated for use as an aid in ophthalmic surgery by staining the anterior A t this year's American Academy of Ophthal- mology (AAO) meeting in Chicago, cataract surgeons will almost be in overload from the number of sessions, courses, and videos available to them, said William Fishkind, M.D., Tucson, Ariz., cataract program co-chair. "There is a continued interest in femto phaco," he said. "AAO is a place where we can see papers that are scientific that will start to give us more insight into whether this is a passing phase or actually has scien- tific validity." There are two sessions during AAO "specifically dedicated to femto phaco," Dr. Fishkind said. "While these sessions are not purely femto phaco, they discuss how cer- tain aspects of cataract surgery relate to femto phaco and how aspects of it relate to cataract surgery. I think those are not-to-be-missed sessions." ASCRS President David F. Chang, M.D., San Francisco, will lead AAO's Spotlight on Cataract Symposium for the 11th consecutive year, with this year's theme concen- trating on cataract complications. In this session, attendees will see "seven different video case presenta- tions that will illustrate a variety of complications and complicated cases. Using electronic response pads, the audience will be asked to make clinical management deci- sions, followed by rapid-fire didactic presentations that are relevant to the case. The management will then be discussed by a rotating panel of experts," Dr. Chang said. Among the topics being discussed: management of refractive power surprise; the unhappy multifocal IOL patient; mature white, brunescent, and trau- matic cataracts; and capsulorhexis and posterior capsular tears. "This session is going to be a blockbuster," Dr. Fishkind said. "It's going to be incredibly dynamic. It's something I will participate in, but even if I weren't involved, I wouldn't want to miss it. It will be something I can use in my practice to improve the quality of care I deliver to my patients surgically. There will be pearl after pearl, important pieces of information after important pieces of informa- tion. And then, you've got Jack Holladay, M.D., delivering the Kelman Lecture on something that none of us really understand as well as we should. And we're going to hear it from the guy who has pro- pelled us to improve outcomes year

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