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2013 ASCRS•ASOA San Francisco Daily News Tuesday

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Learn more at Booth 1626 ASCRS•ASOA SYMPOSIUM SHOW DAILY CHICAGO 2012 EW & CONGRESS, 3 ASCRS News Today continued from page 1 Important Safety Information –TECNIS® Toric IOL Indications: The TECNIS® Toric 1-Piece posterior chamber lenses are indicated for the visual correction of aphakia and pre-existing corneal astigmatism of one diopter or greater in adult patients with or without presbyopia in whom a cataractous lens has been removed by phacoemulsification and who desire improved uncorrected distance vision, reduction in residual refractive cylinder, and increased spectacle independence for distance vision. The device is intended to be placed in the capsular bag. Warnings: Physicians considering lens implantation should weigh the potential risk/benefit ratio for any circumstances described in the TECNIS® Toric 1-Piece IOL Directions for Use that could increase complications or impact patient outcomes. The clinical study did not show evidence of effectiveness for the treatment of preoperative corneal astigmatism of less than one diopter. The TECNIS® Toric 1-Piece IOL should not be placed in the ciliary sulcus. Rotation of the TECNIS® Toric 1-Piece IOL away from its intended axis can reduce its astigmatic correction. Misalignment greater than 30° may increase postoperative refractive cylinder. Precautions: Accurate keratometry and biometry in addition to the use of the TECNIS Toric Calculator (www.TECNISToricCalc.com) are recommended to achieve optimal visual outcomes. The safety and effectiveness of the toric intraocular lens have not been substantiated in patients with certain preexisting ocular conditions and intraoperative complications. Refer to the TECNIS® Toric 1-Piece IOL Directions for Use for a complete description of the preexisting conditions and intraoperative complications. All preoperative surgical parameters are important when choosing a toric lens for implantation. Variability in any of the preoperative measurements can influence patient outcomes. All corneal incisions were placed temporally in the clinical study. Do not reuse, resterilize, or autoclave. Henry Klassen, MD, talked about cell-based applications and in particular, retinal progenitor cells in photoreceptor degeneration. The cell placement facilitates diffusion of trophic factors to the entire retina, Dr. Klassen said. In a rat study, treated animals had better sight than control rats. "We think this will benefit a wide range of retinal conditions, he said. Roger F. Steinert, MD, Irvine, Calif., described a technique using femtosecond laser micro bubbles for deep anterior lamellar dissection. "The issue is the difference in lamellar structure of the anterior and posterior cornea," he said. Using the 150 kHz laser, Dr. Steinert's group determined 10 x 10 micron spot spacing at 0.3 to 0.45 microjoules with eight passes provides the smoothest interface (in cadaver eyes). "Challenges are in getting these started to find the interface," Dr. Steinert said. The goal is to start on human trials by the summer. Douglas D. Koch, MD, Houston, evaluated the prediction errors in eyes with both forms of astigmatism and found each of the aberrometers overestimated the amount of astigmatism, with an average error of about 0.5 D error in with-the-rule eyes and 0.3 D in against-the-rule. For the final lecture of the session, Dr. Mackool praised Charles Kelman, MD, and brought up their friendship. He said Dr. Kelman was a visionary and was extremely coura- geous. "It's, therefore, a huge honor to deliver the Innovator's Lecture that bears his name," he said. Dr. Mackool discussed his family and his career, highlighting many of his accomplishments through the years and some of the ophthalmic challenges he tackled. "In order to flourish, innovation requires a bit of stargazing," he said. He attributed much of his happiness in life to his wife and his family. The leaking of fluid along the incision during phacoemulsification was a topic that Dr. Mackool discussed early on in his lecture. He said this could cause problems for the cornea and the iris during surgery. He described his approach and attempts to solve the problem, which started in 1980, and he continued to work on it through the years. Dr. Mackool highlighted the opening of his Mackool Eye Institute in 1983, which was the first ambulatory surgery center in New York. Other topics that Dr. Mackool talked about were addressing stromal hydration, being the first surgeon to put in acrylic IOLs, and writing textbooks. EW Editors' note: Dr. Klassen holds patents related to the technology he discussed. Dr. Steinert has financial interests with Abbott Medical Optics (Santa Ana, Calif.). Dr. Mackool has no financial interests related to his lecture. Adverse Events: The most frequently reported adverse event that occurred with the TECNIS® Toric 1-Piece IOL was surgical reintervention, which occurred at a rate of 3.4% (lens repositioning procedures and retinal repair procedures). Other reported events included macular edema, which occurred at a rate of 2.9% and retinal detachment which, occurred at a rate of 0.6%. Caution: Federal law restricts this device to sale by or on the order of a physician. Attention: Reference the Directions for Use labeling for a complete listing of Indications, Warnings and Precautions. Richard J. Mackool Sr., MD, delivers the Innovator's Lecture.

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