Eyeworld Daily News

ONSITE MAY 6, 2019 | EYEWORLD DAILY NEWS | 57 by Vanessa Caceres EyeWorld Contributing Writer different lens types in a 64-year- old male patient who had prior LASIK. By mixing and matching an ACTIVEFOCUS IOL (Al- con) in the dominant eye and a ReSTOR 3.0 (Alcon) in the non- dominant eye, defocus curves are able to overlap, and it helps with vision at different distances, he said. Dr. Mackool said that he will often use the ACTIVEFOCUS bilaterally but will make the non- dominant eye –0.75 to –1.25 D. During the session, panelists presented some of the newer products from Alcon, including: • The ACTIVE SENTRY Hand- piece and the Intrepid Hybrid Tip, which has a built-in fluidics pressure sensor • The NGENUITY 3D Visual- ization System, which allows surgeons to perform 3-D heads- up surgery; this potentially can provide ergonomic benefits • The Wanda Alcon Inventory Manager radio-frequency iden- tification scanner, which pro- vides an automatic scan of IOL inventory Editors' note: This event was sponsored by Alcon. Mackool showed how he used capsule retractors. "There's going to be significant manipulation, so why even take the chance [of problems]?" Dr. Mackool said. "I use them with every case with that type of nucleus." Although adding hooks or retractors takes extra time, put that in the context of providing better lifetime vision for a patient and avoiding unwanted complications, he said. Use of intraoperative aberrometry While presenting a video of sur- gery in a 64-year-old patient with a history of myopic LASIK, Bran- don Ayres, MD, Philadelphia, showed how he used the ORA System (Alcon) with intraoperative aberrometry. "I'm a true believe in ORA," Dr. Henderson said. "It's not perfect, but it's a great tool when you're struggling between lens powers." Dr. Donaldson said she will use ORA in high myopes when she would like more lens power guidance. Mixing and matching lenses John Berdahl, MD, Sioux Falls, South Dakota, discussed his use of intraop aberrometry and white cataracts, and for Fuchs' dystrophy patients, among sever- al other indications. Among her cataract patients, 30 to 40% have FLACS. Although she can't charge extra, she likes the extra safety features that FLACS provides for these cases. Dr. Donaldson will also use FLACS for astigmatism correction. The importance of verbal anesthesia During video case presentations, Dr. Donaldson provided constant verbal encouragement to the patient having the procedure. "I believe in verbal anesthesia and giving positive feedback the whole time," she said. Panelists said this was a reminder of how to put the patient at ease during surgery. Tackling a dense nucleus A case with a dense nucleus is never easy. "You go into these cases with a deep breath," said Richard Mackool, MD, Astoria, New York. However, Dr. Mackool offered some encouragement as well. "If you take your time, you can do this," he said. His video featured an 88-year-old patient with a deep nucleus, and Dr. A ttendees of "The Focal Point: Teachable Mo- ments in Cataract Sur- gery" got up close with surgeries performed by their peers—a close- ness provided by the event's 3D, high-definition surgical presentations. While donning special 3D glasses, presenting surgeons shared pearls and experiences with different aspects of cataract sur- gery. Bonnie Henderson, MD, Boston, moderated the session. The following are some of the highlights and tips shared. When to use femtosecond laser- assisted cataract surgery (FLACS) While presenting the case of a 59-year-old female patient with 1.25 D of astigmatism who was having second-eye cataract sur- gery, Kendall Donaldson, MD, Plantation, Florida, said she will use FLACS in dense cataracts, 3D event includes pearls, products, and surgery innovations Attendees enjoy a 3D symposium on Saturday night.

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