Eyeworld Daily News

8 Wednesday, April 22, 2015 EW SHOW DAILY by Chiles Aedam R. Samaniego EyeWorld Asia-Pacific Senior Staff Writer 'What we really need' in new technology symposium greater endothelial cell loss with the femtosecond laser than with a dia- mond knife, and Dr. Lindstrom said it was the first thing they turned off on their femto laser. A number of very exciting technologies were featured at the symposium. In the Capsulorhexis category, Dr. Osher asked Dr. Chang to describe the Zepto capsulorhexis device, a nickel titanium (nitinol) ring surrounded by silicone that can be straightened into a rod-like in- strument for insertion through a cat- aract surgery main incision. Nitinol is a shape-memory alloy; once inside the anterior chamber it returns to its original shape. The silicone creates some suction to fix the ring to the anterior capsule. Once it is apposed, the ring employs a proprietary cleavage mechanism using a series of vaporizing pulses to create a perfect, almost instantaneous capsulorhexis. In the same category, Dr. Packard described a thermal laser that they've so far used to create perfect capsulorhexes in "thousands of rabbit and hundreds of cadaver eyes." Unlike femtosecond lasers, the device is only about 6 x 4 inches and bolts right under a standard operating microscope. "This was a no-brainer," Dr. Osher said. "Somebody was going to be smart enough to come up with something that was small and quick and reliable and inexpensive relative to what we're currently using." These are just 2 of the most exciting examples from the surfeit of new technologies presented at the symposium. But perhaps Dr. Osher's comments on a promising but also potentially contentious new product in development best reveal the true spirit of the session: "The jury's out, but I congratulate the company be- cause they're doing something new, they're doing something different. That's what we need." More than just the items on its admittedly impressive list of aston- ishing new technologies, Dr. Osher's new technology symposium's answer to the question "What do we really need?" is in its celebration of the scientific spirit of experimen- tation and inquiry—continuously thinking outside the box to keep the field advancing toward better and better outcomes. EW that he was particularly excited about in each category, and asked members of the panel to comment and/or suggest their own examples. It wasn't all about new tech- nologies exactly. In the Incision and Closure category, Dr. Osher described his preferred 3-plane inci- sion using a diamond knife. Many panelists expressed their preference for manual incisions over femto- second laser incisions—Dr. Chang cited a paper by Brendan Vote, MD, Launceston, Australia, that showed or could be essential to an ophthal- mic surgical practice. On the surface, that's exactly what the symposium is: Dr. Osher structured the symposium around a series of categories—Diagnostic, Incision and Closure, Astigmatism Management, Small Pupil Manage- ment, Capsulorhexis, Phaco, IOL Delivery, IOLs, Toric IOL Alignment, Intraoperative Aberrometry, New Drug Concepts, and Education. He supplied some examples of cutting- edge techniques and technologies "W hat comes around goes around," said Robert Osher, MD, Cincinnati, opening a revival of his new technology symposium. "I organized a perennial new technol- ogy symposium in the early 1980s." He'd discontinued the symposium in favor of his "real love"—the video symposium of challenging cases and complication management. To celebrate the return of this unusual scientific symposium, Dr. Osher invited an all-star panel consisting of Graham D. Barrett, FRANZCO, Perth, Australia; Abhay Vasavada, MD, FRCS, Ahmedabad, India; Boris Malyugin, MD, Moscow; Virgilio Centurion, MD, São Paulo, Brazil; Richard B. Packard, MD, London; David F. Chang, MD, Los Altos, Calif.; and Richard Lindstrom, MD, Minneapolis, Minn. Dr. Osher provided a blanket disclosure, perhaps requiring of the audience a less absolutist or dis- missive, more thoughtful form of skepticism: "Please assume, when you hear things today, that all the surgeons may be financially in- volved." The symposium was titled "What Do We Really Need?" sug- gesting that the session would pro- pose or recommend a laundry list of technologies that would or should Dr. Osher discusses new technology.

• Cover