EyeWorld India September 2022 Issue

organizing committee hopes that all delegates will enjoy the charm of Seoul. The 2022 APACRS Certified Educator (A.C.E.) award was presented to three surgeons: Con Moshegov, MD, Australia (posthumous), Tae-Young Chung, MD, South Korea, and Yeo Tun Kuan, MD, Singapore. Finally, the 2022 APACRS Gold Medal award was presented to Hungwon Tchah, MD, South Korea. “I joined APACRS about 20 years ago and since then, APACRS and KSCRS have worked very hard to build a good relationship. It is a great honor to receive this gold medal, especially in Seoul. It’s a joint meeting and a joint medal.” Crash Landing [On You] - Cataract Complications “If you say you don’t have many complications [in your surgeries], it means you don’t perform many surgeries. If you do a lot of surgeries, you will encounter a lot of complications,” said Pannet Pangputhipong, MD, Thailand. In this afternoon session, speakers shared some of their tips for ensuring safe surgeries and techniques for minimizing complications in the surgical setting. One obstacle surgeons may face in cataract surgery is vitreous loss. Once vitreous loss occurs, it must be treated immediately. To facilitate cataract surgeons in handling vitreous loss, phaco machines have a built-in device for anterior vitrectomy (A-vit). Yoshihiko Ninomiya, MD, Japan, explained some advantages of practicing three-port vitrectomy in vitreous loss situations. These advantages include freeing both hands by fixing the infusion cannula, cutting the vitreous from the vitreous base, and simultaneously taking care of the fundus pathology. Surgeons must also pay careful attention during cataract surgery to prevent serious corneal complications. One serious corneal complication is corneal edema: swelling of the corneal stroma due to damage to the corneal endothelium. Corneal edema, which may resolve within a few days or weeks after surgery, results in decreased visual acuity. Young Joo Shin, MD, PhD, South Korea stated that treating corneal edema consists of four important points. Surgeons must eliminate the cause of the edema by lowering intraocular pressure (IOP) and treating inflammation, enhance surface dehydration, treat patients’ pain with lubricants, and restore anatomy (DSAEK, DMEK, or PKP). Situations of IOL explantation may also pose challenges during cataract surgery. Reasons for IOL explantation may include IOL power miscalculation, IOL calcification, and IOL subluxation from the capsular bag, said Hadi Prakoso, SpM(K), Indonesia. It is important to preserve the capsular bag during explantation. Dr. Prakoso provided his tips on how to successfully explant an IOL from the capsular bag. “The first challenge is to release the IOL from its attachment to the capsular bag. Another challenge is taking the IOL out of the bag and finally preserving the capsular bag from rupture or zonular loss,” said Dr. Prakoso. Many of these cataract challenges and complications were shown to be managed successfully through careful observation and treatment, as seen in the various case presentations during this session. Cutting Edge of Corneal & Refractive Surgery In the symposium “Cutting Edge of Corneal & Refractive Surgery,” John Chang, MD, Hong Kong SAR, shared his early experience with the Visumax 800 (Carl Zeiss Meditec). This laser, he said, is four times faster than the previous version and allows closer spot sizes for easier separation and lower risk of lenticule or cap tear. It can be used for lower myopia since it is easier and so safer to separate even thin lenticules. It has better centration, better astigmatism treatment which can be matched to cornea markings after suction, and better ergonomics. Dr. Chang said that he has completely switched to the Visumax 800 for flap making since he does 80-micron flaps for high myopes or thin corneas. The laser allows him to leave a 280- to 300-micron bed even in –10-D myopes. In almost 500 cases, he has had no haze, gas bubbles, anterior chamber bubbles, opaque bubble layer, or canthotomy. Dr. Chang said they have found a significant improvement in SMILE complications. Out of 419 eyes, only one had an incision tear, one had incomplete bubble separation, and one a lenticule adherent to the cap. One thing that does happen more often with the new laser is going deep first—it is easier to go to the deeper layer, but very easy to find and separate the cap layer. However, this, Dr. Chang noted, is no longer a complication as the ease with which the cap can be separated EWAP meeting reporter banner.indd 1 27/07/2022 10:22 AM

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