My Initial Experience with miLOOP® Don Pek, Singapore With today’s advancing technology, Don Pek, MD is able to improve his surgical process with the miLOOP®. The lens fragmentation device itself consists of a micro-thin super-elastic snare that self-expands, using nitinol filament technology. Studies have been conducted on the efficacy and performance of the device. In one particular study that Dr. Pek presented,2 101 eyes of 101 subjects with grade 3 to 4+ nuclear cataracts were randomised to phacoemulsification alone or phacoemulsification using the miLOOP®. The results of this study showed that phacoemulsification with the miLOOP® was as safe as phacoemulsification alone. At one month after surgery, BCVA averaged 20/27 Snellen in phacoemulsification with miLOOP® eyes and 20/24 in controls. Endothelial cell loss after surgery was low and similar between the two groups. There was also a significant reduction in ultrasound energy (cumulative dispersed energy (CDE) units) in eyes that received phacoemulsification with miLOOP® compared with controls. Additionally, no direct complications were caused by the miLOOP®. Dr. Pek continued his presentation with a case presentation, showing his technique with a video. In one patient with relatively soft cataracts and a large pupil, Dr. Pek was able to start off with the conventional phacoemulsification steps. He then performed hydrodissection and gently rotated the lens. At first, entering the lens with the miLOOP® was a challenge, but Dr. Pek was able to complete the procedure successfully. Dr. Pek tilted the loop of the device down to gently touch the lens with the slide below the capsulorhexis. In the video, webinar participants were able to see Dr. Pek’s index finger pushing the slide in order to deploy the snare of the miLOOP®. The next steps are rotating, reversing, and then retracting the slider, which resulted in a beautiful cut. Dr. Pek then lifted the loop up. After implantation of the IOL, Dr. Pek stated that he felt good about the procedure and that it is “a lot easier than it looks. After a few cases, I was very happy and gained confidence.” Dr. Pek was able to perform his first 9 cases with no complications. Dr. Pek provided specific steps and advice on how to successfully use the miLOOP® device. First, it is important to check the device and hold the miLOOP® with the dominant hand like a pen. The surgeon should push the slider and check the wire loop before continuing. When entering the wound, Dr. Pek explained that the completely and the loop lifted out of the lens. Additionally, Dr. Pek advised that this technique should not be used on posterior polar cataracts, for cutting IOLs, nor on uncooperative patients or patients with movement disorders. With a gentle learning curve, miLOOP® provides less phacoemulsification energy, protects the endothelium, and conserves the zonules. With all the advantages miLOOP® offers, Dr. Pek believes that this device affords predictable surgical complexity and time, making the surgical process easier for cataract surgeons and providing surgical benefit to patients on the receiving end. References: 1. Song JE et al. J Ophthalmol. 2021 2. Ianchulev, T et al. Br J Ophthalmol. 2019 Media placement sponsored by Carl Zeiss Meditec AG 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. Cataract and Refractive Surgery In a demonstration video, Dr. Pek shows how the miLOOP® slides over the cataract to ensure it is under the capsulorhexis. surgeon should turn the device body away from oneself to align the loop with the wound. The surgeon should then enter with the loop through the wound until the bellows touch the wound. Then, the device body should be turned back towards the surgeon to rest on the dominant hand. Deploying the loop involves pushing the slider to expand the loop while keeping the cannula centered on the cataract. Dr. Pek stated that it is important to ensure the loop is inferior to the capsulorhexis. The loop can then be expanded completely while keeping the cannula centered. The next step involves sweeping by pronating the wrist to sweep the loop from the lens equator to past the posterior pole. Then, the surgeon must reverse the rotation in order to align the two ends of the loop. While performing the cutting step, the surgeon should watch that the capsulorhexis does not move; the slider can then be retracted i
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