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22 | EYEWORLD DAILY NEWS | MAY 16, 2020 DAILY NEWS ASCRS VIRTUAL ANNUAL MEETING during the surgery but also in postoperative care, she added. These and more presenta- tions from this paper session can be found in SPS-101. Editors' note: Dr. Nahum and Dr. Santaella have no financial inter- ests related to their presentations. that ACIOL replacement with a scleral-fixated IOL combined with DMEK is a viable option in cases of ACIOL and PBK. Physicians should remember that these eyes have been operated on before and present multiple challenges, not only (8%), retinal detachment in one eye (8%), and primary failure due to persistent hy- phema in one eye (8%). The average endothelial cell loss at 6 months after surgery was 50%. Dr. Santaella said based on these results, they concluded FLACS highlighted in paper session hemorrhage following ophthal- mic procedures. The purpose of his study was to assess the vasocon- strictive effect of brimonidine 0.15% on reducing subconjunc- tival hemorrhage after suction ring application FLACS. The study was a masked, prospective, randomized controlled study and included all FLACS cases completed by one surgeon from June–August 2019. All subjects in the control and study groups underwent baseline preoperative imaging with the Oculus Keratograph 5M, Dr. Tam said. Bulbar redness score and analyzed area were recorded. All op- erated eyes then received the usual preoperative eye drops. Subjects in the study group Also in this session, Eric Tam, MD, Toronto, Cana- da, presented "The Effect of Brimonidine 0.15% on the De- velopment of Subconjunctival Hemorrhage Following Femto- second Laser Assisted Cataract Surgery." "Subconjunctival hem- orrhage following FLACS is a common side effect," Dr. Tam said. "Brimonidine is a selective alpha-2 adrenergic agonist that lowers intraoc- ular pressure and also has a vasoconstrictive effect." Pre- operative use of brimonidine to reduce conjunctival hem- orrhage has been studied for various ophthalmic procedures. But Dr. Tam noted that to date, there is no literature evaluating the vasoconstrictive effect of brimonidine on FLACS and no objective, standardized meth- od to quantify subconjunctival phaco time were also analyzed. All the data collected were analyzed using SPSS statistical software. To analyze the chang- es in pupil size in each group, the paired t-test was used, Dr. Germano said, and to com- pare the pupil size between the groups in each moment, the unpaired t-test was select- ed. Differences in pupil size between the groups in different moments were compared using an analysis of variance. In the study, 79 eyes of 67 patients were included, which were divided into 56 eyes in the femto group and 23 eyes in the conventional phaco group. The preoperative pupil diame- ter was similar in both groups, and there was an increase in pupil size after laser and before phaco. There was also a sig- nificant decrease in pupil size at the end of surgery in both groups, however, Dr. Germano noted there was no significant difference at the end of surgery between the groups. In the FLACS group, Dr. Germano said there was a transient increase in pupillary diameter after laser and a ten- dency for greater variation in the femto group (close to the significance limit). This study concluded that the occurrence of intraopera- tive miosis proved to be greater in the FLACS group compared to conventional phaco group. At the end, the mean pupil size diameter was similar. by Ellen Stodola Editorial Co-Director I n a paper session on fem- tosecond laser-assisted cataract surgery, Caroline Germano, MD, Sao Paulo, Brazil, presented "Comparison of Pupillary Diameter Varia- tion between Conventional Phacoemulsification Versus Femtosecond Laser-Assisted Cataract Surgery." The purpose of Dr. Germa- no's study was to evaluate and compare pupillary diameter variation before and after cat- aract surgery by conventional phacoemulsification vs. FLACS. The researchers also evaluated the relationship between pu- pillary diameter with surgery time and ultrasound time, as well as intraoperative pupillary diameter variation. The study was a prospec- tive, observational, randomized study, with a control group re- ceiving conventional phaco and a study group receiving FLACS. The LDV Z8 femtosecond laser (Ziemer) was used, which uses low energy and high frequency. All surgeries were performed under topical anesthesia with the same mydriatic eye drops preoperatively by the same sur- geon. To quantify the pupillary size, a surgical compass was used (anterior to the phaco procedure and at the end of the surgery). In the study group, mea- surements after laser were added. Surgical time and underwent DMEK combined with ACIOL removal and trans- scleral IOL fixation. Thirteen patients were included. There were several problems encoun- tered in follow-up, including rebubbling in four eyes (32%), hyphema in two eyes (15%), macular edema in one eye continued from page 20 continued on page 24 Dr. Tam shows eyes from the study group and the control group of his study preoperatively and postoperatively to demonstrate the change in bulbar redness score. The change in bulbar redness score from preop to postop between the two groups showed a statistically significant difference. Source: Eric Tam, MD, screenshot from presentation Results

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