Eyeworld Daily News

EW SHOW DAILY 46 Meeting Reporter Sunday, April 15, 2018 by Vanessa Caceres EyeWorld Contributing Writer into book pages, Dr. Berdahl said. There should not be resistance. If you do feel resistance, you may be hitting the back wall of the sclera. 6. Try technology that is more ergonomically comfortable. Rob- ert Cionni, MD, Salt Lake City, described his use of the TrueVision 3D Surgical system (Santa Barbara, California) and said it "literally saved my life in the OR. Now I feel like I'm on a couch watching a football game." This is import- ant as many ophthalmologists struggle with back or neck issues from their surgical body position- ing. The addition of the Ngenuity 3D Visualization System (Alcon) is also helping surgeons, the panel- ists added. 7. Consider the AcrySof IOL with ActiveFocus optical design (Al- con) for patients with astigma- tism. The ActiveFocus design does not compromise distance vision like other presbyopia-correcting IOLs, according to Alcon. With premium IOLs, the ActiveFocus is among the closest one to an aspheric monofocal IOL, said Dr. Mackool, who was part of the IOL design. The ActiveFo- cus also has the least chance of causing glare. When using this IOL, Dr. Mackool will aim for –0.5 D or –0.75 D in the nondominant eye and plano in the dominant eye. However, in patients with 0.5 or more of coma, there is a higher risk of glare or halos; in those patients, the ActiveFocus may not be the best option, Dr. Mackool said. EW Editors' note: This event was sponsored by Alcon. down and make sure you are do- ing things right—and reassure the patient as well, panelists added. 2. Run through surgical challenges mentally in advance. This can help you decide how to handle them appropriately should they occur, Dr. Mackool said. Even when you make great surgical decisions, be prepared to still en- counter occasional complications, said Donald Serafano, MD, Long Beach, California. 3. Provide "verbal anesthesia" throughout surgery. When Eliz- abeth Yeu, MD, Norfolk, Virginia, showed a few of her cases, panel- ists gently teased her about how she constantly explained to pa- tients what was happening during the docking process, assured them they were doing well, and gave other verbal commentary. However, they all agreed it was a useful way to make patients feel more comfortable. This ultimately makes for a calmer surgical day, said Brandon Ayres, MD, Bala Cynwyd, Pennsylvania. 4. Make sure to mention MIGS. These days, if you don't let a patient with a cataract and mild glaucoma know about MIGS, you aren't presenting all of their op- tions to them, said John Berdahl, MD, Sioux Falls, South Dakota. With the addition of Richard Lewis, MD, Sacramento, Califor- nia, to the morning's discussion, panelists said it showed that glaucoma had come of age within comprehensive ophthalmology. 5. Watch your positioning during MIGS. Insertion of the CyPass Mi- cro-Stent (Alcon, Fort Worth, Tex- as) below the scleral spur should feel like you are inserting a pencil helping patients feel more comfort- able during the use of femtosecond cataract technology. Here's a sampling of pearls shared during the session: 1. Take your time when you have in-the-moment complications, recommended Richard Mackool, MD, Astoria, New York. He shared with the audience a particularly challenging case with a dense cat- aract. Although the first instinct may be to rush and get through things, this is the time to slow S aturday morning got off to a unique start for attend- ees at "New Dimensions in Cataract Surgery – An Ed- ucational and Interactive Event Brought to You by the Alcon Experience Academy." Attendees were able to watch surgery in 3-D and hear seasoned peers share pearls to improve cataract surgery. Panelists discussed a variety of surgical challenges and scenari- os, ranging from toric IOL patient selection to complicated cases to Sharing pearls for better, more sophisticated cataract surgery Dr. Berdahl comments on cataract and MIGS during an event where attendees got to watch surgery in 3-D.

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