Eyeworld Daily News

4 | EYEWORLD DAILY NEWS | MAY 7, 2023 ASCRS ANNUAL MEETING DAILY NEWS see the IOL move, you know you've gotten all the visco. If you do see it move, you've got to go in and get the viscoelsastic out. Dr. Hovanesian presented his thoughts on the utility of Apthera for low astigmatism. Dr. McCabe spoke about iris registration with toric alignment, using technologies like Veracity and Verion (Alcon) and LenSx (Alcon). Dr. Solomon's presen- tation was similar to Dr. McCabe's but he emphasized the importance of being consistent with what you do. Dr. Yeu said she thinks the preoper- ative planning is the most important part of astigmatism management, because when you put garbage in, you get garbage out. My favorite treatment for presby- opia at the time of cataract surgery Dr. Yeu won this session as well, sharing her favorite presbyopia treat- ment is planning for the first eye, reassessing, and then reconfirming for the second eye. She said you have to pause after the first eye and reas- sess whether the prediction error was within target and if the patient was satisfied. Then you can move forward with the second eye. If those were not achieved though, you can tailor vision with either a Vivity (Alcon) or Eyhance (Johnson & Johnson Vision) and/or adjust IOL power to account for a refractive miss. Dr. Fram spoke about using the Light Adjustable Lens for customized monovision, while Dr. Hovanesian talked about the using the latest IOL designs and materials. Dr. McCabe said her preferred option, especially for younger patients where the future of their eye health is uncertain, is nondiffractive IOLs, and Dr. Solomon spoke about mixing and matching presbyopia-correcting IOLs. Editors' note: The speakers have finan- cial interests with various ophthalmic companies. What am I doing differently this year? Dr. Yeu was voted best presentation for her talk about achieving great psuedophakic outcomes with post-RK patients. She showed several recent RK patients who received the IC-8/ Apthera IOL (Bausch + Lomb), all of whom were thrilled with their uncorrected vision postop. She also showed its utility in a keratoconus patient. Dr. Fram said she was looking at new IOL calculations for atypical eyes. For long eyes, the formulas do- ing well are Kane, Barrett Universal 2, and the Wang-Koch adjustment. Short eyes, the two formulas per- forming well are the Zeiss artificial intelligence and Cooke K2, she said. Post-corneal formulas she's using are the Barrett True-K TK, the EVO 2.0, and the ASCRS calculator. For irregu- lar astigmatism, Dr. Fram mentioned the Barrett True-K KCN, Hill-RBF, Holladay 1, SRK-T, Kane, and she said that IC-8 could be helpful. Dr. Hovanesian said his change was taking the EyeSustain pledge and considering all the areas that his practice and OR could become more sustainable. Dr. McCabe presented on how she's integrated small-aperture technology and the Light Adjustable Lens (RxSight). Dr. Solomon shared how he performed an EVO on a pseudophakic patient who was not a candidate for LASIK or PRK due to prior refractive surgery and too thin of a cornea. New technology on the horizon The audience also voted for Dr. Yeu's presentation of low-energy cata- ract surgery with MICOR (MICOR Industries). This is a paradigm shift, she said. The technology doesn't use thermal energy, ultrasound energy, or cavitation. Instead it uses mechanical agitation to dissolve the lens. There is minimal fluid through the eye but it maintains incredible chamber stability, firing 1,000 times less frequently than phaco at the same amplitude. She said the technology is easy to use, finger-controlled (no foot pedal), has a small footprint, and features cataract removal, capsu- lar polish, and vitrectomy all in one handpiece. Dr. Fram presented on the latest advancements in phaco technology, like the Centurion with Active Sentry (Alcon) and Quatera 700 (Carl Zeiss Meditec), which achieves cham- ber stability, efficiency, and safety at higher flow rates. Dr. Solomon presented on this technology and the CT Lucia 621 (Carl Zeiss Meditec). Dr. Hovanesian presented on a new option for situations where the pa- tient has the wrong IOL. AccuraSee (Onpoint Vision) is a nonpowered lens with 10 D of add in the center that, in its current generation, is being used for patients with AMD. He said, however, that it has possi- ble applications for other situations: refractive adjustments, multifocality, drug delivery, and addressing dys- photopsias. This lens sits on top of an existing IOL. Dr. McCabe shared information on Vista 1-Step (Vista Ophthalmics), a single-use vitrector that serves as the needle into the eye and the vitrector with the ability to cut in both directions. She also presented on iDose (Glaukos), which is currently being investigated as long-term travoprost-eluting implant for IOP lowering. My best pearl for astigmatism management Dr. Fram was voted the winner for her presentation in this category. The best pearl she said is to make sure you go behind the lens and get all the viscoelastic out, then move the lens into the proper location. She taps the toric IOL to the posterior capsule a little, then goes in with BSS or intracameral moxifloxacin and pulses it into the AC. If you don't continued from page 1

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