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Tackling Weak Zonules and Using Capsular Tension Devices

Speakers: Kenneth J. Rosenthal MD

Tags: Capsular tension ring, ASCRS Course 22-107: Tackling Weak Zonules and Using Capsular Tension Devices, Zonules, 2013, cataract, Annual Meeting, ASCRS MediaCenter

Course will cover techniques, indications, and pitfalls for the use of capsular tension rings, retractors, and other surgical techniques in patients with capsular-zonular complex pathology. Strategy for preoperative evaluation, intraoperative clues to unstable or potentially unstable zonules will be presented. Case presentations and a discussion of surgical approach and selection of capsular device(s) and techniques for implantation will be discussed.

Understanding Ophthalmic Viscosurgical Devices to Optimize Their Use in Cataract Surgery and Complications

Speakers: Steve A. Arshinoff MD FRCSC

Tags: Viscoelastics, Ophthalmic Viscosurgical Devices, 2013, ASCRS Course 21-401: Understanding Ophthalmic Viscosurgical Devices to Optimize Their Use in Cataract Surgery and Complications, OVD, Annual Meeting, ASCRS MediaCenter

Course will consist of a slide and video presentation of rheologic properties, classification, and varied utilization techniques for different OVD types. New OVDs, recent discoveries, and principles and techniques to prevent and manage complications and postoperative IOP will be covered. Ample opportunity for discussion will be available.

Achieving Proper Centration and Alignment in Intraocular and Keratorefractive Surgery

Speakers: Jonathan B. Rubenstein MD

Tags: 2013, Annual Meeting, limbal relaxing incisions, ASCRS Course 23-208: Management of Astigmatism in Conjunction With Clear Corneal Phaco Surgery, Astigmatism, ASCRS MediaCenter

Course will cover management techniques for preexisting astigmatism, particularly in conjunction with contemporary phaco surgery, with primary emphasis on intralimbal relaxing incisions.

Astigmatism Prediction Errors With Various Devices in Eyes With Toric IOL Implantation

Speakers: Douglas D. Koch MD

Tags: ASCRS Innovators Session, 2013, toric IOL, Astigmatism prediction errors, Annual Meeting, posterior corneal astigmatism, ASCRS MediaCenter

Purpose: To evaluate the prediction errors of corneal astigmatism (CA) with various devices in eyes with toric IOL implantation. Methods: We measured 42 eyes of 42 patients using 4 devices that estimate total CA from anterior CA only (IOLMaster, Lenstar, Atlas, and manual keratometer) and one device that calculates total CA using ray-tracing method based on anterior and posterior CA (Galilei). The manifest refraction and toric IOL alignment were recorded 3 weeks postoperatively. The ideal CA was calculated by subtracting the effective power of toric IOL at corneal plane estimated using the Holladay 2 consultant from the post-op manifest refractive astigmatism. The prediction error was obtained by subtracting the ideal CA from the CA measured by each device. Vector analysis was used in all calculations. Results: With IOLMaster, Lenstar, Atlas, and manual keratometer post-op CA, respectively, the prediction errors were 0.53 D@100 degrees, 0.48 D@108 degrees, 0.24 D@106 degrees, and 0.49 D@102 degrees in the with-the-rule group (n=18); 0.24 D@90 degrees, 0.29 D@101 degrees, 0.36 D@106 degrees, and 0.28 D@71 degrees in the against-the-rule group (n=24). With Galilei, the prediction errors were 0.28 D@103 degrees in with-the-rule group, and 0.29 D@169 degrees in the against-the-rule group. Using our earlier nomogram for toric IOL selection, the post-op manifest astigmatism were 0.07 D@22 degrees and 0.11 D@158 degrees in with-the-rule and against-the-rule groups, respectively. Conclusion: Using devices measuring anterior corneal astigmatism only, consistent prediction errors in the vertical meridian with magnitude of 0.24 - 0.50 D were found, indicating the effect of posterior corneal astigmatism. An updated toric IOL selection nomogram accounting for posterior corneal astigmatism will be proposed.

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