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3 EW SHOW DAILY 2018 ASCRS•ASOA Annual Meeting, Washington, D.C. technique is phenomenal. … It's easy to use, easy to learn, and actual- ly minimally invasive," Dr. Solomon said. Elizabeth Yeu, MD, Norfolk, Virginia, and David Chang, MD, Los Altos, California, both spoke about using Zepto (Mynosys, Fre- mont, California) for automated capsulotomy creation. Stephen Slade, MD, Houston, discussed putting extended depth of focus and multifocal lenses in previous refractive surgery patients, and John Hovanesian, MD, Laguna Hills, California, spoke about microbleph- aroexfoliation (BlephEx, Franklin, Tennessee) before taking biometry for cataract surgery. New technology on the horizon In terms of new technology on the horizon, Dr. Chang was voted the winner for his presentation on Liquid Vision (Presbyopia Therapies, Coronado, California) eye drops as a topical presbyopia-correcting thera- py. Dr. Chang said the perfect pres- byopia correction would work for both phakic and pseudophakic eyes; it would have guaranteed centration on the visual axis; no unwanted images or halos; it would be revers- ible; have a zero-complication rate; and be inexpensive and permanent. The perfect device, Dr. Chang said, is actually our iris. He said Liquid Vision makes use of the iris to drive near vision with a weak mydriatic aceclidine and tropicamide drop. Dr. Chang noted that it complements spectacles, con- tact lenses, and IOLs; it's fast-acting with a 30-minute onset, allowing for office trials; lasts about 4 hours with the potential for a second drop, if needed; and it's binocular. Phase 2b trials are underway with this drop. Dr. Yeu presented on Tear- Care (Sight Sciences, Menlo Park, California), a thermal lid therapy system to melt meibum for manual expression. Dr. Solomon discussed the Harmoni Modular IOL (ClarVista Medical, Aliso Viejo, California). Dr. Slade described keratophakia with allogenic grafts that could be either an inlay or an onlay (Allotex, Reno, Nevada). Dr. Hovanesian described the benefits of the IC-8 IOL (AcuFo- cus, Irvine, California). Best tip for improving practice efficiency, patient experience Dr. Hovanesian took this category, describing how to make the 43 steps that generally are required for cat- aract surgery patients simpler with MDbackline (New Orleans). This software explains various aspects of the surgery and technologies in simple language, provides alerts for when patients need to remove their contact lenses or start drops, and even drives premium lens conver- sions, Dr. Hovanesian said. Other tips included a descrip- tion of the Light Adjustable Lens (RxSight, Aliso Viejo, California), which Dr. Chang said could reduce the time physicians have to spend explaining options preoperatively or correcting misses postoperatively; the importance of creating a patient journey through video education and keeping it simple from Dr. Yeu; using a surgical planning tool like Veracity (Carl Zeiss Meditec, Jena, Germany) from Dr. Solomon; and advice from Dr. Slade that the time to make investments in your practic- es, whether it be space, technology, or personnel, is now. Best tip for improving the ocular surface The audience agreed most with Dr. Yeu about the value of an amniotic cytokine extract (Genesis, Ocular Science, Manhattan Beach, Califor- nia) and its applicability for a variety of ocular surface issues. Dr. Chang spoke about sus- tained-released postop medication for cataract surgery; Dr. Solomon spoke about the convenience and cost-effectiveness of Less Drops (Imprimis, San Diego); Dr. Slade described a gel bandage contact lens that can be used for even extreme ocular surface issues by EyeGate (Waltham, Massachusetts); and Dr. Hovanesian shared research data that strongly supports the use of a branded NSAID over a generic based on the patient experience. Best pearl for presbyopic IOL patient satisfaction The best pearl for presbyopic IOL patient satisfaction went to Dr. Yeu who recommended making patient-centered considerations (work/hobbies, motor eye domi- nance, height, prior multifocal or monovision contact lens usage, prior refractive surgery, and ocular comorbidities) when deciding on using mini-monovision or mix and match IOLs. Dr. Chang emphasized the im- portance of using a digital alignment system with toric IOLs. Dr. Solomon spoke on hitting the reactive target by avoiding errors and optimizing surgeon factors and alignment. He also said it's important to have a strategy for enhancement postop and talk to the patient about that strategy in the preop visits. When Advancing CATARACT SURGERY LenSx ® LASER ® CENTURION ® VISION SYSTEM IMPORTANT PRODUCT INFORMATION CAUTION: Federal (USA) law restricts this device to sale by, or on the order of, a physician. As part of a properly maintained surgical environment, it is recommended that a backup IOL Injector be made available in the event the AutoSert ® IOL Injector Handpiece does not perform as expected. INDICATION: The Centurion ® Vision System is indicated for emulsification, separation, irrigation, and aspiration of cataracts, residual cortical material and lens epithelial cells, vitreous aspiration and cutting associated with anterior vitrectomy, bipolar coagulation, and intraocular lens injection. The AutoSert ® IOL Injector Handpiece is intended to deliver qualified AcrySof ® intraocular lenses into the eye following cataract removal. The AutoSert ® IOL Injector Handpiece achieves the functionality of injection of intraocular lenses. The AutoSert ® IOL Injector Handpiece is indicated for use with the AcrySof ® lenses SN6OWF, SN6AD1, SN6AT3 through SN6AT9, as well as approved AcrySof ® lenses that are specifically indicated for use with this inserter, as indicated in the approved labeling of those lenses. WARNINGS: Appropriate use of Centurion ® Vision System parameters and accessories is important for successful procedures. Use of low vacuum limits, low flow rates, low bottle heights, high power settings, extended power usage, power usage during occlusion conditions (beeping tones), failure to sufficiently aspirate viscoelastic prior to using power, excessively tight incisions, and combinations of the above actions may result in significant temperature increases at incision site and inside the eye, and lead to severe thermal eye tissue damage. Good clinical practice dictates the testing for adequate irrigation and aspiration flow prior to entering the eye. Ensure that tubings are not occluded or pinched during any phase of operation. The consumables used in conjunction with ALCON ® instrument products constitute a complete surgical system. Use of consumables and handpieces other than those manufactured by Alcon may affect system performance and create potential hazards. AES/COMPLICATIONS: Inadvertent actuation of Prime or Tune while a handpiece is in the eye can create a hazardous condition that may result in patient injury. During any ultrasonic procedure, metal particles may result from inadvertent touching of the ultrasonic tip with a second instrument. Another potential source of metal particles resulting from any ultrasonic handpiece may be the result of ultrasonic energy causing micro abrasion of the ultrasonic tip. ATTENTION: Refer to the Directions for Use and Operator's Manual for a complete listing of indications, warnings, cautions and notes. © 2016 Novartis 12/16 US-CNT-16-E-5196 it comes to IOL exchange, Dr. Slade said the history is important to consider when addressing multifocal IOL complaints, and your decision to exchange should be made earlier with a plan no later than 3 months. Dr. Hovanesian presented research that supported the mixing of low- and medium-add multifocal IOLs. Compared to those who had the same multifocal IOL in both eyes, the mixed patients had less of a need for glasses at computer dis- tance and had significantly less glare and halos. Compared to the binoc- ularly implanted group, the mixed group showed similar satisfaction, overall spectacle independence, best corrected visual acuity, and refrac- tive accuracy. EW Editors' note: The physicians have financial interests with various ophthalmic companies. Rapid-fire continued from page 1

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