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EW SHOW DAILY 44 Meeting Reporter Sunday, May 7, 2017 feature is that the handpiece is dis- posable, said Rosa Braga-Mele, MD, Toronto. The patient with Dr. Batra received the AcrySof IQ ReSTOR ActiveFocus IOL (Alcon). "The risk of unwanted side effects is the least of all the [multifocal] lenses, and that's how you present it to patients," Dr. Mackool said. Dr. Batra likes the lens because he has many patients who are Silicon Valley executives who want exceptional distance and computer vision. "I've found the lens is great for almost everyone," he said. Another surgery featured in the session was a 72-year-old female receiving an AcrySof IQ IOL and a CyPass Micro-Stent. The surgery was done by John Davidson, MD, Ventura, California. Some pearls panelists offered with the combined procedure is proper positioning of the patient's head for good visibility, hyperinflating at the nasal angle, and getting comfortable with the go- nioprism. Although not all surgeons may feel comfortable with gonoisco- py, they will find it is relatively easy once they have enough experience with it, Dr. Woodward said. When using the CyPass, Dr. Vold advises stopping all medica- tions after surgery. "We're hopeful and optimistic about lowering the IOP," with the CyPass, he said. Studies indicate that more than 70% of patients have a 20% or more reduction in IOP, and almost 93% of patients are still off their glaucoma medications at 2 years. Another surgery featured during the session was a 76-year-old female receiving a ReSTOR ActiveFocus toric IOL; the surgery was led by Dan Tran, MD, Orange, California. Richard Tipperman, MD, Philadelphia, also participated in the panel; Andrew Maxwell, MD, was the facility host for live surgery. EW Editors' note: This event was sponsored by Alcon. by Vanessa Caceres EyeWorld Contributing Writer Fresno Surgical Hospital, Fresno, California. The session interspersed the cases with commentary from panelists on site at the session. In one case done by Nicholas Batra, MD, San Leandro, California, in an 86-year-old male, the surgery went well but there was trouble capturing an ORA (Alcon) intraoper- ative image, and it required multiple tries. That's an unusual situation, said moderator Terry Kim, MD, Durham, North Carolina. In fact, panelist Steven Vold, MD, Fay- etteville, Arkansas, sees it as a sign of smart technology that will not take a reading if conditions are not optimal (surgeons can rehydrate the cornea to help alleviate this issue). Panelists addressed Dr. Batra's use of the Intrepid Transformer I/A handpiece. "I'm impressed with how it performed," said Lawrence Woodward, MD, Atlanta. "There's an ease of going between bimanual and coaxial." Another advantageous time," he said. The procedure itself received mixed but vocal reaction from surgeons, with heated argu- ments about it common at major clinical meetings. Phaco was not widely adopted until 1985, when foldable IOLs were introduced. At that point, there was a "massive conversion" to phaco by cataract surgeons. Dr. Mackool also addressed advances in phaco tech- nology through the years and "wars" he has had with other renowned surgeons over the years on topics like bottle height. With phaco so common nowa- days, Dr. Mackool had some heavy praise to heap on the procedure and its implementers and innovators. "I think that more humans have ben- efited from phaco than any other procedure in the history of man- kind," he said. After Dr. Mackool's talk, session attendees turned their attention to three live surgical cases done at S aturday's "Alcon Live Sur- gery" event spanned the phacoemulsification spec- trum from a historical look at phacoemulsification's history to live surgery featuring a variety of Alcon (Fort Worth, Texas) products. The program began with Richard Mackool, MD, Astoria, New York, leading a retrospective review on 50 years of phaco. Dr. Mackool was a medical student when phaco was introduced by Charles Kelman, MD, in 1967. "I guess they asked me to speak because everyone else is dead," Dr. Mackool quipped. Dr. Mackool said he looked at Dr. Kelman as a Babe Ruth-type star, even though the early technology was clunky, and the first phaco took 4 hours. Dr. Mackool showed an image of the first technology used with phaco, commenting on its large size. "It really wasn't ready for prime Alcon live surgery focuses on modern cataract approaches—and some history The session began with a historical look at phacoemulsification's history by Dr. Mackool.

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