decreases or even eliminates the risk of false track creation. For their early, 3-month results, including 90 eyes, 100% had 20/20 or better best-corrected visual acuity and 98% 20/20 or better uncorrected distance visual acuity. At the same session, Jodhbir S. Mehta, BSc(Hons.), MBBS, PhD, FRCOphth, FRCS(Ed), FAMS, Singapore, talked about “Cornea Nerve Regeneration Following Lenticule Extraction.” Dr. Mehta said that in both animal and clinical studies, postop re-innervation has been shown to be superior in terms of corneal nerve fiber area, length, density, and branch density in SMILE compared to LASIK from 6 to 12 months. But what happens after that time period? Dr. Mehta and his colleagues performed a contralateral RCT with each patient having one eye undergoing LASIK, the other undergoing SMILE—essentially providing a matched patient cohort. At a mean average follow-up of 4.1 years, they found that all mean fiber parameters, there was a significant advantage in the SMILE group. Qualitatively, the SMILE group also had significantly less beading response to nerve damage. Note however that these postop eyes still have lower parameters than age-matched, unoperated eyes even after 5.5 years of follow-up. Also, these did not translate to significant differences in clinical parameters between SMILE and LASIK; the differences were seen via in-vivo confocal microscopy. Taekwondo Masters–Top Cataract Surgery Tips Fifteen cataract surgeons shared their top cataract surgery tips through a series of patient case videos in the last session of the 34th APACRS Annual Meeting. At the end of the session, audience members voted on the best surgery tip and winners were presented directly at the end of the session. Highlights from this session included Jong Suk Song, MD, PhD, South Korea, who demonstrated the advantage of intracameral triamcinolone (TA) injections in reaching the macula sufficiently in pseudophakic eyes to treat macular edema. “It is easier to irrigate TA powder when IOP is increased,” said Dr. Song. Chee Soon Phaik, MD, Singapore, presented her tip to surgeons who have struggled with rotating a nucleus despite cortical cleaving hydrodissection. In viscocleaving the cortical adhesion site, surgeons inject viscoelastic in the subcapsular plane to reach the equator in order to avoid rotational issues. Doing this can preserve zonules while enabling consistent nucleus rotation. Francis Mah, MD, USA shared his tip on reducing IOP as much as possible when faced with iris prolapse, a difficult situation. “The key is to get the viscoat out and decrease pressure,” he said. Hyun Seung Kim, MD, South Korea, provided tips for small pupil cataract surgery without using pupil expansion devices. Dr. Kim demonstrated the hidden capsulorhexis technique as well as a procedure using a 2nd instrument in performing successful surgery on small pupils. Thomas Kohnen, MD, PhD, FEBO, Germany, explained that a posterior capsule rupture with premium IOL implantation is not the end of the world. By utilizing proper cortex aspiration, vitrectomy, and implanting the IOL in the capsular bag on the remaining posterior leaflet, one can still be quite successful in the procedure. Chopping is one technique in which cataract surgeons may benefit from advice. In a minimal power chop, Joon Young Hyon, MD, South Korea, explained that less energy can be delivered to the anterior chamber with this technique, and it can even be used in small pupils. Angling the chopper in the direction towards the phaco tip will allow for surgeons to succeed in splitting the nucleus. Many other surgeons provided useful tips and tricks during this session to demonstrate how to perform cataract surgeries with ease while managing any arising challenges. As for the winning tip? Dr. Joon Young Hyon took the win for his tip on chopper alignment. The runner-up was awarded to Dr. Chee Soon Phaik for her tip on viscocleaving. Congratulations to the winners! “Taekwondo Masters” was an incredibly instructive and knowledgeable session, providing delegates with useful tips to bring to their surgery room. EWAP EWAP meeting reporter banner.indd 1 27/07/2022 10:22 AM
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