EyeWorld Asia-Pacific September 2014 Issue

32 EWAP CATARACT/IOL September 2014 « Moria One Use- Plus SBK: • is safe and accurate, • has no learning curve, • is faster than FemtoLASIK, • offers more postop comfort.» LASIK Surgery MORIA S.A. 15, rue Georges Besse 92160 Antony FRANCE Phone: +33 (0) 1 46 74 46 74 - Fax: +33 (0) 1 46 74 46 70 moria@moria-int.com - www.moria-surgical.com • Thin, 100-micron, planar flaps • Accuracy and predictability equivalent to Femto-SBK • Smoother stromal bed • No femto-complications • … At a fraction of the cost Think Thin SBK without compromise Bharti S, Safety and efficacy of femtosecond laser in construction of LASIK flap. 68 th annual congress of the AIOC, Jan 21-24, 2010; Kolkata, India. Dr. Bharti has no financial interest and is not a paid consultant for Moria. Download long-version testimonials on: www.moria-surgical.com Roundtable with 7 international SBK experts, #66076B Compendium of clinical and laboratory cases, #66083EN Keratome One Use- Plus SBK (Moria) Femto Da Vinci ® (Ziemer) Nb of eyes First 80 First 100* Flap thickness OD: 110.9 ± 8.9 OS: 110.3 ± 8.5 93.0 ± 6.0 Free cap None 3% Incomplete flap None 1% Unexpected too small flap None 1% (5.5 mm diameter) Tissue bridges to break None 17% (3 causing stromal loss) Buttonhole None 1% (eye #4) Sudhank Bharti, MD (New Delhi, India) * Complication rate has reduced markedly with experience necessary due to the small pupil. By one month postoperatively, both groups had comparable IOP and visual acuity outcomes, he said. Ring vs. hooks Dr. Khouri and his colleagues also conducted a retrospective analysis of small pupil cases. In their series, 20 eyes underwent pupil expansion using the Malyugin ring and another 20 received iris hooks. In the Malyugin ring group, visual rehabilitation was complete on the first postoperative day for the group as a whole. “This group’s average visual acuity on the first day was the same as their final visual acuity 18 months later,” Dr. Khouri explained. In the hooks group, in contrast, visual recovery was delayed. “At postoperative day 1 and week 1, the average visual acuity in the hooks group was substantially below that of the ring group and did not reach its final equivalent until 1 month postoperatively,” he said. Mean IOP was comparable in both groups at all time points, he added. This study was strengthened by the use of small pupil cases in both the active and control groups, making the results more directly attributable to the method of pupil expansion rather than the need for pupil expansion. Practical applications These studies help shine some light on the benefits of pupil expansion and the relative pros and cons of various pupil expansion tools. Important issues include performance, in terms of visual recovery after surgery, and safety, in terms of complications such as elevated IOP. Both studies found no detrimental effect of the Malyugin ring on visual recovery. “The speed of visual recovery was faster with the Malyugin ring than with the iris hooks in our study,” Dr. Khouri pointed out. Likewise, both studies found no detrimental effect of the Malyugin ring on postoperative IOP. “The use of the Malyugin ring for pupil expansion during cataract surgery was not an independent risk factor for postoperative increased IOP,” said Dr. Fay. He concluded, “The potential risks of the Malyugin ring are likely outweighed by the benefits of improved surgical exposure and reduced likelihood of intraoperative complications. EWAP Editors’ note: Drs. Fay and Khouri have no financial interests related to this article. Contact information Khouri: albertkhouri@hotmail.com Fay: jdfay84@gmail.com Intraoperative - from page 30