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EW SHOW DAILY 16 ASCRS Symposia Tuesday, May 10, 2016 by Ellen Stodola EyeWorld Senior Staff Writer Team North America takes home gold in 2016 Cataract Surgery Olympics D uring the 2016 Cataract Surgery Olympics session, teams of surgeons from around the world com- peted by sharing video case presentations with attendees. David Chang, MD, Los Altos, California, and Richard Hoffman, MD, Eugene, Oregon, moderated the session. The North American team included surgeons from the United States and Canada, including Kevin Miller, MD, Los Angeles, Ike Ahmed, MD, Toronto, Tal Raviv, MD, New York, and Robert Weinstock, MD, Largo, Florida. The Asia-Pacific team included Amar Agarwal, MD, Chennai, India, Graham Barrett, MD, Perth, Austra- lia, Soon-Phaik Chee, MD, Singa- pore, and Hungwon Tchah, MD, Seoul, South Korea. Making up the team from Latin America was Arnaldo Espaillat, MD, Santo Domingo, Dominican Republic, L. Felipe Vejarano, MD, Popayán, Colombia, Cecilio Velasco, MD, Mexico City, and Bruna Ventura, MD, Recife, Brazil. Finally, the team from Europe and the Middle East included Ehud Assia, MD, Tel-Aviv, Israel, Khaled Abdel Rahman Khalifa, MD, Cairo, Egypt, Brian Little, MD, London, and Boris Malyugin, MD, Moscow. Judges of the session were Luis Izquierdo, MD, Lima, Peru, Bonnie Henderson, MD, Boston, David Spalton, MD, London, and Ronald Yeoh, MD, Singapore. The "events" of the session were the Cataract Pentathlon, where up to 5 devices could be used; the Cataract Marathon, which tested en- durance; the IOL Gymnastics, which showed skill and creative maneu- vers; and Freestyle Surgery, where "anything goes." The Asia-Pacific team present- ed first. Dr. Barrett presented a case where he initially saw no IOL but then he put in a contact lens and noticed that it was sitting on the macula. The patient ended up needing a vitrectomy followed by a closed loop lens. Dr. Barrett offered several lessons learned from the case. Always check the case supine prior to turning up for surgery, he said. It's also possible to convert a 3-port vitrectomy into a scleral fixated IOL with 7-0 Gore-Tex, he said. Finally, he said that for this type of technique, some lenses are better than others, but a closed-loop 4-point lens is ideal. The next team to present was from Europe and the Middle East. Dr. Malyugin presented the freestyle case for the team and showed a case with the femtosecond laser. When the patient arrived, he noticed that the pupil was constricted, and Dr. Malyugin decided to use a second-generation Malyugin ring in a 2 mm incision to expand the pupil. The patient had previously undergone penetrating keratoplas- ty (PK). His plan was to implant a custom-made toric IOL with 12 D of cylinder, so he needed good expo- sure of the pupil and lens and want- ed to control how the IOL would be positioned in the capsular bag. Dr. Malyugin showed a second case with an initially small pupil and detailed his technique for expansion in order to be able to apply femtosecond la- ser energy to that particular patient. The third presenting team was from Latin America. Dr. Vejarano presented a case where his tech- nician unexpectedly hit his hand during surgery. Meanwhile, Dr. Ventura presented the Ventura amputated IOL haptic technique. Last but not least, the team from North America presented. Dr. Raviv showed a case of an anterior capsule tear with a toric IOL. When looking at past research, Dr. Raviv learned that anterior capsular tears in extra- cap didn't extend peripherally. The anterior zonules were bridging the tears, stretching, and preventing extensions, he said. However, now you can see these extensions. He of- fered a number of measures to avoid this, including filling the eye with OVD before withdrawing I/A, using gentle insertion of a 1-piece acrylic IOL, hydrating incisions before OVD removal, and ensuring watertight closure postoperatively. In the end, Dr. Miller won the Cataract Pentathlon event, Dr. Ahmed won the Cataract Marathon event, Dr. Ventura won the IOL Gymnastics event, and Dr. Tchah won the Freestyle Surgery event. The judges chose the second and third place teams, with the team from Europe/the Middle East taking home the bronze, and the team from the Asia-Pacific taking the silver. Based on audience votes, the North Amer- ican team came in first and took home gold. Editors' note: Dr. Raviv has financial interests with Abbott Medical Optics (Abbott Park, Illinois), Alcon (Fort Worth, Texas), Bausch + Lomb (Bridge- water, New Jersey), Glaukos (Laguna Hills, California), and Ocular Thera- peutix (Bedford, Massachusetts). Dr. Malyugin has financial interests with Alcon, Carl Zeiss Meditec (Jena, Ger- many), and MST (Redmond, Washing- ton). Dr. Barrett has financial interests with Alcon, Bausch + Lomb, Haag-St- reit (Koniz, Switzerland), and MST. The other physicians have no financial interests related to this article. The North American team poses with the judges after winning the 2016 Cataract Surgery Olympics. T oday may be the last day of the ASCRS meeting, but that doesn't mean the symposia offered are any less informative and relevant. All sessions are held in the convention center. "Four Years of Femtosecond Laser-Assisted Cataract Sur- gery" will examine the role that femtosecond laser-assisted cataract surgery has within ophthalmology right now. It will be held from 8:00–9:30 a.m. in Great Hall B and C. The fast-paced "X-Rounds: Refractive Cataract Surgery to the Max" will feature the latest and greatest in refractive cataract surgery. Leading surgeons will discuss new advances in cataract surgery, femtosecond laser cataract surgery, refractive IOLs, and case management. The panel will facilitate discussion on current refractive cataract issues that today's ophthalmologists are facing. Audience response keypads will be used to further interaction among faculty and attendees. This one is from 10:00–11:30 a.m. in Great Hall A and D. "The Best of ASCRS 2016," from 1:00–2:30 p.m. in room 255–257 will cover in Spanish the highlights of the meeting. The symposium is sponsored by ALACCSA-R. EW Don't miss out on today's symposia by Vanessa Caceres EyeWorld Contributing Writer

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