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Efficient clear corneal incision cataract surgery is focus of AAO course in Orlando
Recent changes in the phaco techniques also have added to the greater efficiency of today’s state-of-the-art surgery.
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---Clear corneal incision, which, according to Dr. Maloney, is the most impactful innovation in cataract surgery since phaco.
“Clear corneal incisions [CCIs] have been the most impactful innovation in cataract surgery since phaco was introduced in 1967,” according to William F. Maloney, MD, course director of “Clear corneal small incision cataract surgery: current state of the art,” to be presented at the annual meeting of the American Academy of Ophthalmology. “The added efficiency with CCIs is really remarkable. Surgical time is reduced by 30% on average. This course will focus on recent changes in the clear corneal incision technique, which have made the transition much easier,” Dr. Maloney added. In addition, Dr. Maloney will emphasize the introduction of a new generation of metal blades, which have been designed and manufactured specifically for the new CCIs. Diamond blades are no longer required to move to CCI. “These new metal blades are excellent,” according to Dr. Maloney, who will discuss his experience in evaluating several CCI metal blades from Sharpoint, Beaver, Alcon and others.
Recent changes in the phaco techniques also have added to the greater efficiency of today’s state-of-the-art surgery. The trend toward chopping is due to its greater efficiency when compared with the traditional divide-and-conquer techniques.
“Chopping itself has changed as well. We now understand that this maneuver can begin in the center of the nucleus, which for many has greatly simplified the classic phaco-chop originally described by Nagahara,” said Louis D. “Skip” Nichamin, MD, who will describe the greater efficiency inherent in this new vertical “phaco-quick-chop” technique.
Another topic will be the trend toward phaco performed out of the capsular bag. The supracapsular approach to phaco has its appeal in a significant reduction in capsular rupture and vitreous loss, even in pseudoexfoliation cases, according to Dr. Maloney, who will detail several popular variations of this approach including Brown’s “phaco-flip,” Lindstrom’s “tilt-and-tumble” and the supracapsular quick chop techniques that he currently uses.
In his lecture on “Foldable IOLs: recent advances in materials and insertion devices,” Dr. Nichamin will outline the most efficient use of foldable IOLs, which he feels are rapidly becoming the standard IOL used in routine cases.
“The latest generation of three-piece IOL injection devices offer greater efficiency in a sterile, closed system. They appear to be not only simpler, but safer to use in most cases,” Dr. Nichamin said.
R. Bruce Wallace III, MD, a recognized authority on refractive outcomes in cataract surgery, will speak on techniques for axial length measurement and IOL calculation that can significantly improve the accuracy of refractive results. “As our cataract surgery is increasingly judged by refractive results, this is the area that often makes the greatest difference in patient satisfaction,” said Dr. Wallace, who will detail immersion A-scan techniques and new IOL calculation formulas by Hoffer and Holladay.
Other topics covered
Other topics to be covered in this comprehensive course are topical anesthesia, recent changes in the ideal size of the continuous curvilinear capsulorrhexis and efficient management of vitreous loss for the anterior segment surgeon.
For Your Information:
- “Clear corneal small incision cataract surgery: current state of the art” (course #573) will be presented on Tuesday, Oct. 26, 2-4:15 pm, in Room 307A at the American Academy of Ophthalmology annual meeting in Orlando. Because attendance to this course has been high in the past, attendees are encouraged to arrive early as seating is limited.