33
EW SHOW DAILY
ASCRS•ASOA Symposium & Congress, New Orleans 2016
Editors' note: Dr. Vasavada has finan-
cial interests with Alcon. The other
speakers have no financial interests
related to their comments.
notice was the eye was looking
down slightly and dimpling.
He ended up going through the
zonules to the posterior capsule and
had a situation of an IOL in the bag.
Even more troubling was the fact
that it was a single-piece IOL. With
such a large defect, Dr. Vasavada de-
termined it was probably not safe to
leave the IOL where it was because it
could sink backward.
Dr. Vasavada said he learned
several important lessons with this
complication. The first lesson was
about the direction of the injec-
tion. The entry needs to be directed
toward the center of the globe, he
said. Dr. Vasavada's entry was more
horizontal and through the posterior
capsule. He also added that thor-
ough postoperative monitoring is
key, reverse capture is an option for
stable IOL fixation, and to measure
the distance of 3.5 mm from the
limbus.
Dr. Burger said she thinks that
reverse optic capture is underutilized
and "pretty easy" to do. She said she
has used this before for low torics,
and it's an "elegant tool that main-
tains a lot of anatomical structures."
Dr. Al-Mohtaseb added some-
times you can create more problems
taking out the lens and putting in a
3-piece than leaving in the lens and
doing a reverse optic capture. Her
pearl was to use a lot of OVD.
Dr. Yeu next brought up the
question of what to do in the case of
a prolapsed iris. "There's a difference
between what you do and what
you should do," Dr. Garg said. He
said that using viscoelastic to push
it back may not be the best option,
and he suggested decompressing the
eye first in order to soften it.
Dr. Garg then discussed a case
with a tough iris. Sometimes a little
more anesthetic is helpful, he said,
and be careful not to snag the
rhexis, especially if putting in a
Malyugin ring.
Panelists weighed in on whether
they would choose a Malyugin ring
or iris hooks with a floppy iris. Dr.
Zavodni said the Malyugin ring is
easy and fast. Meanwhile, Dr. Al-
Mohtaseb added that she will use
iris hooks when concerned about
zonular loss.
Dr. Yeu said there may be a
learning curve when using differ-
ent iris devices, and there could be
certain situations when hooks or
rings are preferred. If you don't want
to add extra hardware into an eye,
she said a hook may be preferable
because it's minimal, and you can
gain access to it right away. EW
Innovation and craftsmanship that helps you rise above.
Haag-Streit vision spans more than 150 years. Our goal is simple: to develop ever more useful tools for the precise
understanding of the human eye. At Haag-Streit, you will see the future clearly.
80O.787.5426
haag-streit-usa.com
© 2016 Haag-Streit USA. All Rights Reserved.
Visit
us
at
ASCRS
2016
Booth
#245
FAMOUS
FOR SEEING
WHAT OTHERS
CAN'T.
Octopus 600
Reliance
FX920
LENSTAR APS
Haag-Streit Surgical
Hi-R NEO 900
Haag-Streit
BQ 900 LED
Haag-Streit
