EyeWorld India September 2021 Issue

in Cataract and Refractive Surgery isfied with significantly improved vision. Although the IOLMaster is a pow- erful tool, there may be cases that present dissimilarity in topog- raphy. In another case study, a 60 year-old female patient came in for cataract surgery with no previous procedures done. Dr. Fam compared imaging from the IOLMaster with the CSO topog- rapher. He stated that one can see irregularities in the center of the corneal map and that the IOLMaster 700 is less sensitive to changes in the very center of the cornea. However, the periphery of the central and paracentral cor- nea show similar pattern in both systems. In summary, Dr. Fam believes that the IOLMaster 700 is a very functional system. It may be less detailed than others but the maps that are generally similar to central and paracentral of a full topography. For cataract surgery, Dr. Fam says “the IOLMaster 700 should be more than adequate for the majority of the cornea in cataract practice. However, he cautions - if there is a flat, gen- tle, or vague pattern within the cornea, you may want to explore about the possibilities of post- LASIK surgery or some other abnormalities.” Overall, though, the IOLMaster provides very good biometry, IOL power calculations, IOL toric power calculations, and IOL toric power alignment. This system also provides basic cornea screening and indirect dry eye assessment, which are im- portant assessments to perform during preoperative screening. From the panel discussion, Flo- rian Kretz, MD, FEBO, Germany said, “I do believe the IOLMaster 700 brings a big benefit for toric IOLs. It makes the process simple and handy.” Intra-operative OCT Phacoemulsification Namrata Sharma, MD, India Namrata Sharma, MD, India presented a series of demon- strative videos to show the value of intraoperative-optical coher- ence tomography (I-OCT) guided phacoemulsification surgery and how it has refined her practice. Through a variety of examples, Dr. Sharma showed and described how surgeons can view the depth of a side port being made through I-OCT, how one can make out the incision of the main port, and how one can see the capsulor- hexis flap being lifted. The I-OCT proves useful for the capsulor- hexis flap when corneal haze is present because, if the flap is lost, the surgeon is able to identify it. Surgeons are also able to view, through I-OCT, hydrodissection, sculpting, the cortical plate, and posterior capsule bulge. Addition- ally, IOL insertion can be made easier with I-OCT imaging, and the IOL-capsular gap can be seen after the insertion of the IOL. Wound hydration is made easier by allowing surgeons to see the spindle that has formed on the OCT and thus can address hydra- tion needs accordingly. In situations when the white cataract is so dense that it is completely full of fluid, the I-OCT is useful for surgeons to view, assess, and continue their proce- dures. Another useful situation is in capsular distension syndrome in which surgeons can see the increased lenticular capsular gap. With corneal haze, I-OCT can help guide surgeons to relocate the edge of the capsulorhexis when it becomes hidden. Dr. Sharma discussed one pedi- atric case in which various steps were performed. After irrigation and aspiration was performed post-hydromaneuvers, there was a breach in the posterior capsule. Dr. Sharma was able to perform anterior vitrectomy following the posterior capsulorhexis being finished. From the I-OCT, one can see the edges of the anterior rhexis and the foldable IOL being placed. Furthermore, the forming spindle can be seen as well as the anterior capsule rim and the IOL. In a different case of diabetic cat- aract, I-OCT helps in rhexis flap simplification. Dr. Sharma showed that the flap can be elevated and seen on the nucleus through the I-OCT. Then, the nucleus is rocked to decompress the bag and the miLOOP is loaded and in- troduced. The loop is then passed under the rhexis margin and progressively opened and rotated. “As you go underneath the rhexis, you can see the miLOOP Media placement sponsored by Carl Zeiss Meditec AG Figure 1. Dr. Sharma shows how intraoperative OCT (I-OCT) helps with rhexis flap simplification in which the flap is elevated and can be seen on the nucleus through the I-OCT. Not all products, services or offers are approved or offered in every market and approved labeling and instructions may vary from one country to another. The statements of the authors of this supplement reflect only their personal opinion and experience and do not necessarily reflect the opinion of Carl Zeiss Meditec AG or any institution with whom they are affiliated. Carl Zeiss Meditec AG has not necessarily access to clinical data backing the statements of the authors. The statements made by the authors may not yet been scientifically proven and may have to be proven and/or clarified in further clinical studies. Some information presented in this supplement may only be about the current state of clinical research and may not be part of the official product labeling and approved indications of the product. The authors alone are responsible for the content of this supplement and any potential resulting infringements resulting from, in particular, but not alone, copyright, trademark or other intellectual property right infringements as well as unfair competition claims. Carl Zeiss Meditec AG does not accept any responsibility or liability of its content.