EyeWorld Asia-Pacific June 2016 Issue

June 2016 EWAP NEWS & OPINION 65 Team Asia-Paci c comprising Amar Agarwal, MD (India), Graham Barrett, MD (Aus- tralia), Soon Phaik Chee, MD (Singapore), and Hungwon Tchah, MD (South Korea) Hungwon Tchah, MD, voted winner of the Freestyle event at the 2016 Cataract Surgery Olympics. Dr. Barrett said that a sense of curiosity fostered beyond childhood into adulthood, coupled with inspiration not only from oneself but from mentors and friends, and persistence are the source of creativity and innovation. “I am truly humbled by this honor. When you present among a big group like this and your slides go wrong, you get tense,” he said, referencing an earlier technical glitch with his presentation, “I’m not. I’m relaxed. I’ve enjoyed every moment of it … and really that’s because I just feel among friends.” Team North America takes home gold in 2016 Cataract Surgery Olympics During the 2016 Cataract Surgery Olympics session, teams of surgeons from around the world competed in sharing video case presentations with attendees. David F. Chang, MD , Los Altos, California, and Richard S. Hoffman, MD , Eugene, Oregon, moderated the session. The North American team included surgeons from the United States and Canada, including Kevin Miller, MD , Los Angeles, Ike Ahmed, MD , Toronto, Canada, Tal Raviv, MD , New York, and Robert Weinstock, MD , Largo, Florida. The Asia-Pacific team included Amar Agarwal, MD , continued on page 66 Chennai, India, Graham Barrett, MD , Perth, Australia, Soon- Phaik Chee, MD , Singapore, and Hungwon Tchah, MD , Seoul, South Korea. Making up the team from Latin America was Arnaldo Espaillat, MD , Santo Domingo, the Dominican Republic, L. Felipe Vejarano, MD , Popayán, Colombia, Cecilio Velasco, MD , Mexico City, and Bruna Ventura, MD , Recife, Brazil. Finally, the team from Europe and the Middle East included Ehud Assia, MD , Tel-Aviv, Israel, Khaled Abdel Rahman Khalifa, MD , Cairo, Egypt, Brian Little, MD , London, and Boris Malyugin, MD , Moscow. Judges of the session were Luis Izquierdo, MD , Lima, Peru, Bonnie An Henderson, MD , Boston, David Spalton, MD , London, and Ronald Yeoh, MD , Singapore. The “events” of the session were the Cataract Pentathlon, where up to five devices could be used; the Cataract Marathon, which tested endurance; the IOL Gymnastics, which showed skill and creative maneuvers; and Freestyle Surgery, where “anything goes.” The Asia-Pacific team presented first. Dr. Barrett presented on a case where he initially saw no IOL but then he put in a contact lens and noticed that it was sitting on the macula. The patient ended up needing a vitrectomy followed by a closed loop lens. Dr. Barrett offered several lessons learned from the case. Always check the case supine prior to turning up for surgery, he said. It’s also possible to convert a 3-port vitrectomy into a scleral fixated IOL with 7-0 Gore-Tex, he said. Finally, he added that for this type of technique, some are better than other lenses, but according to Dr. Barrett, a closed loop 4-point lens is ideal. The next team to present was the one from Europe and the Middle East. Dr. Malyugin presented the freestyle case for the team. He showed a case with the femtosecond laser. When the patient arrived, he noticed that the pupil was constricted, and Dr. Malyugin decided to use a second-generation Malyugin ring in a 2-mm incision to expand the pupil. The patient had previously undergone penetrating keratoplasty (PK). His plan was to implant a custom-made toric IOL with 12 D of cylinder, so he needed good exposure of the pupil and lens and wanted control how the IOL would be positioned in the capsular bag. Dr. Malyugin also showed a second case with an initially small pupil and detailed his technique for expansion in order to be able to apply femtosecond laser energy to that particular patient. The third presenting team was the one from Latin America. Dr. Vejarano presented a case where his technician unexpectedly hit his hand during surgery. Meanwhile, Dr. Ventura showed her Ventura amputated IOL haptic technique. Last but not least, the team from North America presented. Dr. Raviv showed a case of anterior capsule tear with a toric IOL. When looking at past research, Dr. Raviv learned that anterior capsular tears in extra cap didn’t really extend peripherally. The anterior zonules were bridging the tears, stretching, and preventing extensions, he said. However, now you can see these extensions. He offered a number of measures to avoid this, including filling the eye with OVD before withdrawing I/A, using gentle insertion of a one-piece acrylic IOL, hydrating incisions before OVD removal, and ensuring watertight closure postoperatively. In the end, Dr. Miller won the Cataract Pentathlon event, Dr. Ahmed won the Cataract Maratho n