Innovations heralded in Breaking News session at ESCRS

MUNICH, Germany — From dual-optic IOLs to solid-state lasers for refractive surgery, this year’s Breaking News session here at the European Society of Cataract and Refractive Surgeons meeting piqued interest across several subspecialties.

Takayuki Akahoshi, MD, described a “knuckle” phaco tip, designed to increase both safety and efficacy in cataract surgery. His newest design phaco tip has a smooth spherical surface, so the posterior capsule is not ruptured even if the tip comes in direct contact, he said. The tip itself is bent at a 20-degree angle, and irrigation fluid flows out laterally.

“This tip can be used with the (Alcon) Legacy or Infiniti,” he said. “The nucleus can be removed in 2.6 seconds with very low energy. Total ultrasound time can be reduced significantly.”

Georg Korn, MD, said he believes direct solid state lasers “are excellent candidates for true scanning small-spot lasers for laser vision correction and customized laser vision correction.” He spoke about the LaserSoft, a diode-pumped solid-state laser from Katana Technologies, of Kleinmachnow, Germany. Dr. Korn is managing director of Katana.

He noted that solid state lasers are less expensive to operate than excimer lasers, and they can give the surgeon “excellent gaussian beam spot distribution.”

Matteo Piovella, MD, agreed with Dr. Korn. He reported 1-month results on 22 eyes using the LaserSoft. Mean residual sphere was – 0.24 D and mean cylinder was – 0.06 D. All patients were within 1 D of target.

Anthony Maloof, MD, discussed the concept of sealed capsule irrigation, or SCI. He said using SCI, surgeons can selectively cause cell death in parts of the capsule without damage to the remaining capsule. In a rabbit study, he found that by sealing the capsulorrhexis, chosen cells can be killed and removed safely without further damaging the eye.

“I am reminded of what Dr. Philippe Sourdille told us earlier in this Congress — you have to think of capsular opacification, not just posterior capsular opacification,” Dr. Maloof said. New methods such as SCI may be able to help surgeons avoid all capsular opacification, he said.

Stephen D. McLeod, MD, told attendees about a new dual-optic IOL from Visiogen, a one-piece silicone IOL with a 5-mm optic. It measures 9.5 mm in length and 9.8 mm wide, and it is 2.2 mm thick. The anterior optic ranges in power up to 35 D, and the posterior optic ranges in power from –1 to –15 D. Dr. McLeod said the dual-optic system can increase the optical effect caused by a given amount of lens movement, possibly increasing the accommodative amplitude that can be achieved by an IOL.

Arturo Perez-Arteaga, MD, spoke about microincision refractive lens exchange, or MIRLEX. The procedure involves extraction of the clear lens and the implantation of a microincision IOL with the ultrasmall-incision techniques currently gaining popularity for cataract extraction. But in this case the procedure is done for refractive purposes, not to remove a cataract.