EyeWorld Asia-Pacific September 2018 Issue

tance of being careful where you store these lenses and not to store them near any chemicals. Gerd Auffarth, MD , Heidel- berg, Germany, presented “Preload- ed Systems: Ins and Outs.” Dr. Auffarth discussed clinical ease of injection, complication of injec- tor systems, injector force analysis, and damage to injector systems. He noted complications that could occur relating to haptics, particu- larly when they are sticking to- gether or sticking onto the anterior surface. Based on studies looking at different preloaded systems, Dr. Auffarth had several conclusions. Implantation and unfolding be- havior among hydrophobic IOLs revealed large variability, he said. The HOYA (Singapore) injectors showed excellent performance in the Miyake-Apple Video Analysis. He added that haptic adhesions to the optic can be of clinical significance, especially in compli- cated cases. Injector force pushup systems vary among contemporary preloaded systems, Dr. Auffarth said, and improvement of injector systems reduces the damage of the plunger/cartridge to the IOL. Live/Video Surgery Sessions Live/Video surgery sessions were sponsored by ZEISS (Carl Zeiss Meditec, Jena, Germany), John- son & Johnson Vision (Santa Ana, California, U.S.), and Alcon (Fort Worth, Texas, U.S.). The ZEISS video symposium explored topics including iOCT, alignment, trifocal IOLs, and EDOF lenses. Thanapong Somkijrun- groj, MD , Bangkok, Thailand, pre- sented first on the topic of “iOCT Assisted Complicated Cataract Surgery.” He introduced the ZEISS Callisto 3.6 intraoperative OCT, stressing some of its major features. It fully integrates with the surgical microscope, it’s fully compatible with indirect non-contact vitrec- tomy viewing system (particu- larly helpful for the vitreoretinal surgeon), it projects directly into the surgeon’s right eye, it’s self- controlled and manipulated by the surgeon, it provides real-time HD intraoperative OCT, and also pro- vides real-time decision-making. Han Bor Fam, MD , Singa- pore, discussed alignment in his presentation, and he particularly highlighted the IOLMaster 700 and the Callisto 3.6. He noted the process for get- ting the reference image with the IOLMaster 700. After getting the image, he said the image can be transferred to the Callisto system for use in the OR, based on what is captured by IOLMaster. Using the Callisto 3.6 system, Dr. Fam said it is important to have good exposure, a well-centered eye, appropriate magnification, and good illumination. He uses the Callisto system to tell him where to make the main incision. Callisto provides computer-as- sisted real-time alignment, Dr. Fam concluded. It supports very well with consistent wound alignment, toric IOL alignment, IOL centra- tion, continuous circular capsu- lorhexis, and astigmatic incisions. Next, Mohamad Rosman, MD , Singapore, discussed “My Ex- perience with the Zeiss Trifocal In- traocular Lens.” He said he uses the Zeiss trifocals because of the ease of preoperative calculation, and ease of use during surgery (pre-loaded, can be inserted through smaller incisions, easy centration, and rotational stability). Dr. Rosman also stressed appropriate patient selection and shared his surgical technique with these trifocals. To conclude the session, S.P.S. Grewal, MD , Chandigarh, India, discussed his experience with EDOF lenses, particularly high- lighting the ZEISS AT LARA lens. The AT LARA, Dr. Grewal said, is an aspheric, plate-haptic, hydrophilic acrylic lens with a hydrophobic surface. It has an op- timized aberration-neutral aspheric diffractive design with an optical bridge to continuously extend the range of focus. He described is as: “L” – “light bridge” optical design, “A” – aspheric optics, “R” – reduced visual side effects, and “A” – ad- vanced chromatic optics. From his experience with the AT LARA, Dr. Grewal shared several things he has learned: Patients achieve excellent range of vision, even for near. The lens appears very well cen- tered with great stability (advan- tage of plate haptics). When combining with FLACS, he prefers to create a 6–mm cap- sulotomy centered on the scanned capsule. With plate haptics, when ex- continued on page 68