14 EyeWorld Asia-Pacific | September 2024 EDITOR’S PICKS Selected cataract surgical tips presented at the Wisdom of the Kung Fu Masters symposium Naren’s Fluid Pillar: Improving the performance and safety of phacoemulsification machines by Naren Shetty, MD Chamber fluctuation or surge is a challenge that every phacoemulsification (phaco) machine aims to overcome. Surge, or collapse in the chamber, reduces the distance between the cornea and the posterior capsule, drawing them closer to the center and potentially leading to complications such as posterior capsular rupture or damage to the endothelium. However, a straightforward technique, termed “Naren’s Fluid Pillar,” promises to revolutionize the performance and safety of current phaco machines. The creation of Naren’s Fluid Pillar involves orienting the irrigation holes of the phaco probe towards the cornea and posterior capsule (anteriorposteriorly). This orientation generates a strong fluid force (fluid pillar) that pushes the cornea and posterior capsule apart. Consequently, when there is a break in the occlusion, the time for the fluid to exit the irrigation holes and reach the cornea or posterior capsule is drastically reduced. Additionally, the active force exerted by the fluid deepens the chamber, especially when there are few or no pieces in the capsular bag. Intraoperative OCT imaging has demonstrated this deepening effect when the ports are oriented anteriorposteriorly. Furthermore, pressure sensor data indicates reduced chamber IOP fluctuation with this orientation compared to when the holes are directed towards the angles. By implementing this simple technique, we can create Naren’s Fluid Pillar and enhance the performance and safety of our current phaco machines. DUCK by Thanapong Somkijrungroj, MD DUCK, or Down Under and CounterclocKwise is a novel surgical technique designed to rotate and refine the position of a 1-piece C-loop toric IOL. A 1-piece C-loop toric IOL is a standard treatment for regular corneal astigmatism in patients undergoing cataract surgery. Thus, the design of the IOL generally requires positioning in the capsular bag with clockwise rotation intraoperatively. DUCK is a safe, easy, and efficient technique designed for counterclockwise rotation, used to refine the final position of the toric IOL. With the standard IOL implantation technique via a temporal clear corneal incision, the IOL typically lands in
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