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56 EW SHOW DAILY Sunday, April 21, 2013 Meeting Reporter Four surgeons, four live surgeries by Michelle Dalton EyeWorld Contributing Writer D uring this year's "Live Surgery: Advancements in Techniques and Technologies," four ophthalmologists performed cataract surgery at The Eye Institute of Utah (Salt Lake City). In the first live surgery, Michael C. Knorz, MD, Mannheim, Germany, implanted a ReSTOR +3 (Alcon, Fort Worth, Texas) lens after 888.myLENSTAR 888.myLENSTAR TA (888.695.3678) (888.695.3678) myLENSTAR.com myLENSTA .com TAR Breathe deeply. The unmatched accuracy of the LENSTAR® Optical Biometer takes the stress out of selecting the correct toric IOL. Along with LENSTAR's perfect Ks come superior outcomes for you and your patients. © 2013 Haag-Streit USA. All Rights Reser ved. 2013 Reserved. Visit us at Booth #1618. The Superior Practice. prepping the patient under the LenSx femtosecond laser (Alcon). The SoftFit patient interface "gives excellent suction," Dr. Knorz said. He made a 4.5 mm capsulotomy using a two chop, two cylinder technique (dubbed the hybrid). "I use viscoelastic (OVD) as a safeguard in case the capsulorhexis is not complete. Break the nucleus to let air escape, and make sure the pressure inside the bag comes back to normal before hydrodissection," he said. He uses a push-pull technique to remove fragments. During the second surgery, Ivan Ossma, MD, Cali, Colombia, implanted a toric lens in a 3+ nuclear sclerotic cataract. "It's very nice to embed the phaco tip and then stay within the rhexis to chop it," he said. He recommends surgeons leave the toric lens about 15 degrees off the mark "so OVD removal doesn't overshoot your lens beyond where you want it." He uses the AutoSert (Alcon) to implant toric lenses "because it gives me much more control than a normal plunger injector." Lawrence Woodard, MD, Atlanta, performed the third surgery in a patient with a high degree of astigmatism. "I always go back in with more OVD after hydrodissection for stability," he said. "Establish the flow before moving to ultrasound; I groove with one or two passes and then crack and turn." The safety of the soft tip "is so superior it's made the incidence of anterior capsule tear almost non-existent," said Robert H. Osher, MD, Cincinnati. The final live surgery was in a dense cataract pretreated with the LenSx. Robert J. Cionni, MD, Salt Lake City, used a spider web pattern to pulverize the central part of the nucleus. "Disperse the OVD on top of the capsulotomy to push the bubbles out of the way. I can aspirate the central nucleus and it comes out quite easily, the pieces here just fall apart, and my CDE is 0.82." At no point did Dr. Cionni use phaco power. "If the lens has been liquefied and you can aspirate it out easily, do it," he said. "If it's still difficult, put on a bit of phaco power." EW Editors' note: This event was sponsored by Alcon.