pull out the haptic. Mohan Rajan, MBBS, DO, FACS, FRCS, India, closed the session by discussing glued IOLs and iris fixated lenses. Glued IOLs are a new concept aimed at fixing a posterior chamber IOL (PCIOL) in eyes with no capsule. The glue used during surgery is a quick-acting surgical fibrin glue sealant derived from human blood plasma; this glue may be used to assist sutureless PCIOL implantation and can be easily performed with the available IOL designs with minimal surgical time. The advantages of glued IOLs, Dr. Rajan shared, is that there is an easy learning curve, no occurrence of pseudophakodonesis nor secondary glaucoma, and good dilation is possible post-surgery for retina evaluation. With many case presentation videos in this masterclass session, audience members were able to follow along the various techniques our surgeons shared during more complex surgeries. On the Horizon-What’s New in IOLs? A variety of presenters during the afternoon session, “On the Horizon-What’s New in IOLs?”, explored new IOL designs in form and function. Chul Young Choi, MD, South Korea, began the session by presenting a variety of new features in intraocular lens (IOLs) including violet light-filtering IOLs. These IOLs allow full transmission of healthy blue light and provide better contrast especially during night time. Another feature of IOLs that may improve outcomes is utilizing smoother and more regular surface design in reducing surface scattering to a greater degree. One other feature of IOLs discussed was high-water content trifocal IOLs, presented by Young Sik Yoo, MD, South Korea, which provides better visual outcomes especially at a near distance. “It is the specific optic design related to reducing chromatic aberrations that might improve near vision with these relatively high-water content trifocal IOLs,” said Dr. Yoo. With the many different IOL choices that are present, it may be difficult to decide which one is right for your patient. Ji Eun Lee, MD, PhD, South Korea, offered that patients suitable for the Synergy IOL (a presbyopia-correcting IOL) are those who expect good uncorrected distance visual acuity (VA) and understand the limitations of this IOL. On the other hand, patients suitable for the Symfony IOL (extended depth of focus IOL) are those who desire both distance and intermediate VA and have no problem with wearing glasses for near vision. With the Artis Symbiose, a multifocal hydrophobic IOL, Dr. Gerd Auffarth, MD, FEBO, Germany, explains that it provides good functional distance, near, and intermediate vision with low glare sensitivity and photoptic phenomena. Ultimately, Dr. Auffarth said that 80% of the lenses he implants are some type of monofocal option, even though a multitude of IOL options exist in today’s IOL world. In a hybrid monovision approach, Kimiya Shimizu, MD, PhD, Japan, aims to use a monofocal IOL in the dominant eye and a multifocal IOL in the nondominant eye. This technique is a rescue approach for those dissatisfied after bilateral multifocal IOL implantations and is also effective for correcting presbyopia in cataract surgery. Squid Game-Challenging Cases Cataract surgery may be challenging, just like partaking in Squid Game, in many different ways, and the key to its success is to be aware of the many issues that can arise. Being prepared for all situations will allow surgeons to successfully manage their patients. In the late afternoon session, “Squid Game-Challenging Cases”, capsular tension rings (CTR) were discussed as a preferred instrument in treating weak zonules. Though iris retractors, modified capsular tension rings (MCTR), or capsular tension segments (CTS) may also be appropriate instruments for managing zonular issues, CTRs support localized zonular dehiscence and generalized zonular weakness. They prevent optic decentration and tilt of the IOL while minimizing fibrosis and collapse of the capsular bag. CTRs may be inserted, either with an injector or manually, before the removal of the nucleus as it provides safer surgery and equatorial support to the bag. However, complications may, at times, arise such as inadvertent threading of a CTR through a capsule retractor loop. Solving this issue involves opening or EWAP meeting reporter banner.indd 1 27/07/2022 10:22 AM
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