Eyeworld Daily News

EW SHOW DAILY 52 Meeting Reporter Sunday, April 19, 2015 by Vanessa Caceres EyeWorld Contributing Writer F or surgeons curious about how to maximize their use of state-of-the-art refractive cataract technology, the standing-room-only event "Live Cataract Surgery and Debate" on Saturday morning helped provide some insights. "Live Cataract Surgery and Debate" showcased 4 live surgery cases with each followed by a debate from onsite panelists regarding ways to proceed on a certain surgical or clinical aspect. The program, spon- sored by Alcon (Fort Worth, Texas), featured live cataract surgery from Texas Eye Surgery Center in Hurst, Texas. The technology discussed during the program included the AcrySof Toric IQ IOL, the ORA intraoperative aberrometry system with VerifEye, the LenSx Laser for cataract surgery, the Centurion Vision System, and the Verion Image Guided System. The program was moderated by Don Serafano, MD, Los Alamitos, Calif. Surgeons participating in the program discussed the advantages of using newer generation versions of technology such as the ORA. "By using Verion and ORA, we can truly offer a customized surgical expe- rience," said Jerry Gang Hu, MD, Hurst, Texas, who performed live surgery on a 72-year-old female. When Dr. Hu first started to use ORA and its earlier predecessor, he was skeptical of the technology's IOL recommendations. However, as the ORA evolved, he began to follow its guidance more often. In the last 18 months, Dr. Hu has inserted more than 600 toric IOLs and has performed a LASIK enhancement in only 3 cases—an enhancement rate of less than 1%. "With ORA, it's reassuring to look at it and confirm what we are planning," said Cathleen McCabe, MD, Bradenton, Fla., who also performed live surgery at Texas Eye Surgery Center during the program. Despite the growth of automat- ed technology, Dr. Hu believes it is still important for surgeons to know how to perform safe manual ap- proaches, he said. A new ReSTOR IOL During the program, panelists also addressed the U.S. Food and Drug Administration's approval on Wednesday of the ReSTOR +2.5 D IOL for distance vision. "With every multifocal IOL, you lose some distance vision," said Richard Mackool, MD, Astoria, N.Y. "That's not really the case with the 2.5 IOL, and that's huge." As Rosa Braga-Mele, MD, Toronto, is based in Canada, she has had access to the +2.5 D IOL for some time and has used it in more than 50 patients. She said patients have successfully used it with vir- tually no glare or halos. "The key is knowing what the patient needs," she said. Related to the topic of IOL choices, program panelists also debated the value of treating astig- matism during cataract surgery. Although ophthalmologists often correct astigmatism when they prescribe glasses, not as many surgeons are correcting astigmatism during cataract surgery, said Kerry Solomon, MD, Charleston, S.C. How fluidics change IOP during surgery Another issue discussed during the program was the optimal target IOP for cataract removal. "With active fluidics, you don't need a high pressure for efficiency," said Bradley Black, MD, Jefferson, Ind., observ- ing that the patient operated on by Bret Fisher, MD, Panama City, Fla., had an IOP between 55 and 75 mm Hg. "We'll even go 30 to 40 in high myopes. The Centurion responds so quickly," Dr. Black said. "I use an IOP of 30. The pressure can be very different when you use active fluidics," said Richard Tipperman, MD, Bala Cynwyd, Pa. Dr. Tipperman also performed live surgery. Presenters and panelists dis- cussed the use of steroids and non- steroidal anti-inflammatory drugs to control postop inflammation, astig- matic marking, and other pearls. Other participants in "Live Cataract Surgery & Debate" were John Berdahl, MD, Sioux Falls, S.D., Lawrence Woodard, MD, Atlanta, and Elizabeth Yeu, MD, Norfolk, Va. EW Editors' note: This event was sponsored by Alcon. 'Live Cataract Surgery' event yields pearls for better refractive cataract surgical precision Dr. Serafano moderates "Live Cataract Surgery & Debate." Dr. Yeu, Dr. Solomon, and Dr. Berdahl during a debate at "Live Cataract Surgery and Debate."

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