Eyeworld Daily News

29 EW SHOW DAILY ASCRS•ASOA Symposium & Congress, Los Angeles 2017 viscosurgical device to minimize the risk for capsule entanglement with the leading eyelet of the CTR. First, Dr. Page stains the vitreous and immediately takes care of it if it is prolapsing into the wound. A dispersive viscoelastic tamponades the vitreous. Then he goes under the anterior capsule to the haptic-op- tic junction, while continuously injecting OVD. He uses iris hooks to stabilize the bag. A 10-0 nylon suture is placed through the leading eyelet of the CTR, and it provides a visible tracer when the eyelet goes under the iris and conforms if it be- comes stuck. Microforceps pull stuck sutures centrally, which mitigates some of the fibrosis. Once the haptic is released from the plunger, the trailing eyelet is placed in the bag using a microfor- ceps. To get the leading eyelet past areas of fibrosis, Dr. Page uses the suture-guided CTR, while another forceps can give him different angles of attack. "In this case, I'm adding more viscoelastic to do a little bit of viscodissection, and the CTR jumps into position where it needs to," Dr. Page said. After the sutures are cut and pulled out of the leading eyelet, he addresses vitreous in the anterior chamber and removes the viscoelas- tic. The approach resolved the Z syndrome in the patient and left the lens in good position. However, the procedure left the patient with best corrected vision of 20/40. "I had a good anatomic result but the vision was still not where it needed to be," Dr. Page said. The patient required a rigid gas permeable contact lens, and general- ly patients requiring such devices are not good candidates for premium IOLs. INDICATIONS AND USAGE PROLENSA ® (bromfenac ophthalmic solution) 0.07% is a nonsteroidal anti-infl ammatory drug (NSAID) indicated for the treatment of postoperative infl ammation and reduction of ocular pain in patients who have undergone cataract surgery. IMPORTANT SAFETY INFORMATION ABOUT PROLENSA ® • PROLENSA ® contains sodium sulfi te, a sulfi te that may cause allergic type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people. The overall prevalence of sulfi te sensitivity in the general population is unknown and probably low. Sulfi te sensitivity is seen more frequently in asthmatic than in non-asthmatic people. • All topical nonsteroidal anti-infl ammatory drugs (NSAIDs), including bromfenac, may slow or delay healing. Concomitant use of topical NSAIDs and topical steroids may increase the potential for healing problems. • There is the potential for cross-sensitivity to acetylsalicylic acid, phenylacetic acid derivatives, and other NSAIDs, including bromfenac. Use with caution in patients who have previously exhibited sensitivities to these drugs. • There have been reports that ocularly applied NSAIDs may cause increased bleeding of ocular tissues (including hyphemas) in conjunction with ocular surgery. Use with caution in patients with known bleeding tendencies or who are receiving other medications which may prolong bleeding time. • Use of topical NSAIDs may result in keratitis. Patients with evidence of corneal epithelial breakdown should immediately discontinue use of topical NSAIDs, including bromfenac, and should be closely monitored for corneal health. Patients with complicated ocular surgeries, corneal denervation, corneal epithelial defects, diabetes mellitus, ocular surface diseases (e.g., dry eye syndrome), rheumatoid arthritis, or repeat ocular surgeries within a short period of time may be at increased risk for corneal adverse events which may become sight threatening. Topical NSAIDs should be used with caution in these patients. Post-marketing experience with topical NSAIDs suggests that use more than 24 hours prior to surgery or use beyond 14 days post-surgery may increase patient risk for the occurrence and severity of corneal adverse events. • PROLENSA ® should not be instilled while wearing contact lenses. The preservative in PROLENSA ® , benzalkonium chloride, may be absorbed by soft contact lenses. Lenses may be reinserted after 10 minutes following administration of PROLENSA ® . • The most commonly reported adverse reactions in 3%-8% of patients were anterior chamber infl ammation, foreign body sensation, eye pain, photophobia, and blurred vision. Please see brief summary of full Prescribing Information for PROLENSA ® on adjacent page. References: 1. PROLENSA Prescribing Information, April 2013. 2. Data on fi le, Bausch & Lomb Incorporated. 3. Baklayan GA, Patterson HM, Song CK, Gow JA, McNamara TR. 24-hour evaluation of the ocular distribution of (14)C-labeled bromfenac following topical instillation into the eyes of New Zealand white rabbits. J Ocul Pharmacol Ther. 2008;24(4):392-398. PROLENSA is a registered trademark of Bausch & Lomb Incorporated or its affi liates. © Bausch & Lomb Incorporated. All rights reserved. Printed in USA. PRA.0188.USA.15 The PROLENSA ® Effect POWERED FOR PENETRATION Advanced Formulation to Facilitate Corneal Penetration 1-3 pH e ffect Hal og en a ti on e ffect PROLENSA ® delivers potency and corneal penetration with QD dosing at a low concentration 1-3 continued on page 30 Audience members listen to a presenter discuss a simple technique to prevent common CTR complications.

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