OCT 2012

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

Issue link: https://digital.eyeworld.org/i/87458

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Page 69 of 168

October 2012 Challenging cataract cases negative side effects on the retina or macula," he said. "If a patient can't sit for a YAG Careful placement of three-piece IOL in the bag laser or be cooperative, a posterior capsulorhexis with an optic capture is appropriate," said Howard V. Gimbel, M.D., chair, Department of Ophthalmology, Loma Linda University, Loma Linda, Calif. Dr. Gimbel noted that he prefers the use of Healon 5 (AMO) over Healon GV as he said it is more cohesive. However, he will also use trypan blue under the Healon product. When performing an optic capture, surgeons should aim for a tight seal with no communication between the vitreous and aqueous, Dr. Gimbel said. The surgeons commenting on Pressing 90 degrees away from optic haptic junction to capture into Berger's space Dr. Arbisser's case also agreed that a near correction is the best way to go for mentally challenged patients. Dr. Arshinoff will sometimes do mono- vision in lieu of a near correction. Marie-Jose Tassignon, M.D., ophthalmology department, Antwerp University Hospital, and faculty of medicine, Antwerp University, Belgium, reminds surgeons to use Berger's space to help position an implant when necessary. Dr. Tassignon invented the bag-in-the-lens IOL (Morcher, Stuttgart, Germany), which aims to help prevent PCO. Dr. Tassignon believes the Properly buttonholed IOL Source (all): Lisa Arbisser, M.D. gery is routine in my standard adult cataract surgery and is specifically indicated with this patient." (Dr. Arbisser pointed out that U.S.-based surgeons are not fully paid for two surgeries when they do bilateral same-day cases, which leads to fewer same-day surgeries in the U.S.) Dr. Menapace has published a number of studies about the button- hole procedure that Dr. Arbisser described, and Dr. Arbisser has watched Dr. Menapace perform that technique before. Dr. Menapace said that a poste- rior capsulorhexis requires great attention to detail but can be effective and safe. "It totally excludes central PCO and has no discussion of a case like the one presented here calls attention to the importance of visual defects in those who are mentally challenged or very elderly. Sometimes, their behavior might change, leading caregivers to think there's a change in their mental condition. In reality, they might need their vision checked, she explained. EW Editors' note: Dr. Tassignon is the developer of the IOL she mentioned in the article and receives royalties. The other physicians have no financial interests related to this article. Contact information Arbisser: 309-793-2020, larbisser@eyesurgeonspc.com Arshinoff: 416-745-6969, ifix2is@sympatico.ca Gimbel: hvgimbel@gimbel.com Menapace: 43 1 40400/7931, rupert.menapace@meduniwien.ac.at Tassignon: +32 3 821 33 77, marie-jose.tassignon@uza.be

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