EyeWorld India September 2018 Issue

continued on page 29 EWAP CATARACT/IOL 27 September 2018 ing later that a completely phaco- free procedure can be done with MSICS and miLOOP, bringing the fragments through a smaller inci- sion than with typical MSICS. She also said she finds it useful in small pupil cases. “I have found it helpful be- cause those cases tend to be the ones where if you don’t get a good chop in the beginning, you end up bowling them out, and it becomes a stressful situation where you’re trying to grab that epinuclear bowl under the pupil and bring it in,” Dr. MacDonald said. “If you can divide the lens into four quadrants and remove those four quadrants with phaco, that small pupil case becomes a simple case.” Overall, Dr. MacDonald said she thinks learning to use mi- LOOP is intuitive, which for her, at the start, was the sticking point. “What’s different for me is that with most tools I’ve used in sur- gery, I’ve had to learn how to ef- ficiently manipulate them. I’ve re- alized with this tool, I don’t have to develop a technique but just follow the directions. All I have to do is place the miLOOP in under the anterior capsule and push the button to fully expand it. Once it is fully expanded, I gently sweep the miLOOP between the capsule and the nucleus by rotating my wrist and keeping the instrument centered in the eye. Trusting the instrument was part of my learn- ing curve—understanding that it would follow the directions and it would just work.” William Wiley, MD , assis- tant clinical professor of ophthal- mology, University Hospitals/Case Western University, Cleveland, who was not involved in the Brit- ish Journal of Ophthalmology study but did present research on mi- LOOP at the ASCRS•ASOA Annual Meeting, said he has been using