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EW SHOW DAILY 22 ASCRS Symposia Tuesday, April 21, 2015 The technique works in 3 steps, Dr. Ventura said. The first is partial centration with a capsular tension ring (CTR). The second is placing the IOL with the amputated haptic. The third is checking final centration. To use the Ventura amputated IOL haptic technique, Dr. Ventura said there are a few primary require- ments. The subluxation must be less than 210 degrees. There should be no vitreous in the anterior chamber and zonular remnant in the area of subluxation. EW Editors' note: Dr. Trindade has finan- cial interests with Morcher (Stuttgart, Germany). Dr. Ventura has no related financial interests. address both the capsulotomy and astigmatism. After docking the pa- tient, the laser system automatically places the capsulotomy centered on the limbus. With the technique, she said it's important to plan how much of the haptic to amputate. She uses corneal scissors to cut 1 haptic. After folding the lens, she will insert the first haptic that wasn't touched and then rotates the lens to place the second amputated haptic in the bag. Use a second instrument to do a fine touch and make sure the optic is well centered and where you want it to be, she said. On the first day postop, the patient in her case was stable. by Ellen Stodola EyeWorld Staff Writer this implant is similar to any IOL implantation, he said. It can also be used with irregular corneas. Bruna Ventura, MD, Recife, Brazil, presented on the femtosec- ond laser and the Ventura amputat- ed IOL haptic technique in Marfan syndrome. Her case involved a 19-year-old woman who had low vision since childhood, exotropia, and BCVA of 20/100. During the slit lamp exam, it was seen that the patient had a subluxated lens and a normal fundus exam. The 2 chal- lenges to deal with for the patient were the capsulorhexis and the centration of the IOL bag. Dr. Ventura decided to use the femtosecond laser for this patient, which was good because it could C hallenging cases and complication management were looked at in a video symposium sponsored by the Brazilian Association of Cataract and Refractive Surgery (BRASCRS). Claudio Trindade, MD, Belo Horizonte, Brazil, presented first in the session on correcting myopia and fixed mydriasis with a pinhole intraocular implant. He shared a case where the patient underwent bilateral cataract surgery, and the right eye had an IOP spike in the first hours after surgery and ended with fixed mydriasis. This patient was extremely unhappy with the result for 3 rea- sons, Dr. Trindade said. The glare and light sensitivity, uncorrected distance vision, and corrected vision not being as good as the fellow eye were all troublesome factors. The patient was given spectacles for dis- tance, which she didn't like. Follow- ing that, an unnecessary posterior YAG capsulotomy was performed with no improvement. Dr. Trindade decided to use a pinhole intraocular implant for this patient. The implant can be inject- ed into a single 2.2-mm incision. It has no refractive power and acts on the pinhole principle. The patient was pleased with improvement in uncorrected vision and reduction in light sensitivity and glare symptoms, he said. She went from being 20/200 to 20/30. "This device has an interesting feature of being totally transparent to infrared light," he said. Last year, Dr. Trindade said human proof of concept was presented on the pinhole implant. He also explained the evolution of the product and described the process of progress- ing to where it is today. He said the implant is currently being refined, and this is the third-generation prototype. The technique used with Video case presentations showcase challenging cases and complications Dr. Trindade presents a video case involving a pinhole intraocular implant. Now live at www.EWrePlay.org

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