Eyeworld Daily News

2015 ASCRS San Diego Daily Wednesday-Ezine

EyeWorld Today is the official daily of the ASCRS Symposium & Congress. Each issue provides comprehensive coverage editorial coverage of meeting presentations, events, and breaking news

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Page 12 of 13

New FLACS complication among cases at 'World Cup of Challenging Cases' by Chiles Aedam R. Samaniego EyeWorld Asia-Pacific Senior Staff Writer had orthoptic treatment for hypero- pia who underwent femtosecond la- ser-assisted cataract surgery (FLACS). At Dr. Nosé's clinic, Dr. Francesconi said that an assistant performed the femtosecond laser treatments before patients had the phaco procedure with Dr. Nosé. These treatments are recorded, but Dr. Francesconi said that Dr. Nosé trusted the assistant and did not review all unremarkable femtosec- ond treatment procedures prior to performing phaco, and did not in this case. During the phaco procedure, Dr. Nosé realized that, at least in this case but perhaps also in all cases, he should have: a significant section of the Descemet's membrane was missing. Reviewing the femto treatment video, Dr. Nosé found that a defect in the Descemet's membrane had formed when the laser created the clear corneal incision. About a week after the FLACS procedure, Dr. Nosé performed Descemet's membrane endothelial keratoplasty (DMEK) to replace the missing tissue. Reviewing past videos, Dr. Nosé found another case in which the defect was made during the side port incision; that phaco case had gone unremarkably and so the complica- tion was missed. The machine was found to have a misalignment in the laser focus, and adjustments have been made. This being a new complication associated with a new procedure, Dr. Francesconi encouraged surgeons to watch out for the complication and report their cases. EW Editors' note: The doctors have no financial interests related to their talks. T he "World Cup of Challeng- ing Cases: Selected by the National Societies of Cata- ract and Refractive Surgery Around the Globe" clinical course offered attendees a taste of the challenges surgeons might typically—and not so typically—en- counter in their respective practices in different parts of the world. The cases were selected by the Brazilian Society of Cataract & Re- fractive Surgery (BRASCRS), India's Intraocular Implant and Refractive Society (IIRSI), the Indonesian Soci- ety of Cataract & Refractive Surgery (INASCRS), the Korean Society of Cataract & Refractive Surgery (KSCRS), and the Russian Society of Cataract & Refractive Surgery (RSCRS). Among the cases were a trau- matic cataract in which an incom- plete history (the patient denied history of trauma) resulted in "a surprise that shouldn't have been," presented by Brian Little, FRCOphth, London; three cataract cases performed by Myoung Joon Kim, MD, PhD, through hazy/opac- ified corneas with the help of retroil- lumination; and a cataract surgery that had to be delayed after a clear corneal incision and anterior capsu- lorhexis were already performed due to a persistent spike in IOP creating a rock-hard eye that was subsequent- ly referred to Boris Malyugin, MD, PhD, Moscow. Perhaps most interestingly, Claudia Francesconi, MD, São Paulo, Brazil, presented a case in which Walton Nosé, MD, PhD, São Paulo, Brazil, encountered a new complication associated with a new procedure. The complication occurred in a 65-year-old patient who as a child Are you a fan of EyeWorld? Like us on Facebook at facebook.com/EyeWorldMagazine Find us on social media EyeWorld@EWNews Keep up on the latest in ophthalmology! Follow EyeWorld on Twitter at twitter.com/EWNews

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