One of the main attractions of the ASCRS annual meeting is the film festival. A multitude of educational videos are submitted by the international ophthalmic community for this competition. The films highlight surgical techniques, new technology, and procedures. These are my 5 favorite films from this year’s entries:
Hydrogel Sealant – Best Practices for Watertight Closure of Cataract Wounds by John Hovanesian
Dr. Hovanesian describes and demonstrates the use of ReSure sealant from Ocular Therapeutix with several case examples. He reviews the advantages of a sealant over a suture—comfort, no removal, and no nidus for infection—and discusses the FDA trial that demonstrated the superiority of the sealant to a suture. He also provides instructions for preparing and applying the sealant, and he offers tips for optimal success with this product.
Sleeved Hydrodissection by Naohisa Nezu
Dr. Nezu shares a novel technique for hydrodissection that avoids the potential complications associated with this important step of cataract surgery. With traditional hydrodissection, there is a risk of increased IOP, over inflation of the capsule, vitreous hydration, and iris prolapse. By using a silicone sleeve over the hydrodissection cannula, these complications are avoided because the fluid in the anterior chamber has a path of egress through the sleeve. This is a simple and elegant technique that improves the safety of the procedure.
Phaco with Zonular Dialysis: Seven Pearls by David Chang
Dr. Chang shows us how to perform cataract surgery in an eye that lacks capsular support. He shares seven pearls for success in these cases: 1. Inject a dispersive OVD to tamponade the vitreous in the area of the zonular dialysis; 2. Use capsule retractors to support the capsular bag in the area of the zonular dialysis; 3. Consider bimanual I/A to dissociate the aspiration from the irrigation; 4. Delay inserting a CTR until after cortical removal; 5. If necessary, place a 3-piece IOL in the sulcus and capture the optic in the capsulorhexis; 6. Use triamcinolone if vitreous prolapse is suspected; and 7. A pars plana anterior vitrectomy is the preferred approach in the presence of zonular dialysis.
A Tale of Two Tools by Robert Osher
Dr. Osher discusses two ophthalmic instruments he has developed. The first, a modified Malyugin ring injector device, allows easier insertion and removal of a Malyugin ring because the retractable finger is narrower and reshaped to facilitate release and capture of the Malyugin ring scroll. The second instrument, a modified muscle hook to conform to the shape of the globe, is used to reduce conjunctival chemosis from hydration during phacoemulsification surgery.
Tips and Tricks in Converting to Relex Smile Laser Surgery by Frank Goes
Dr. Goes discusses Relex Smile surgery: the new minimally invasive, flapless, laser vision correction procedure. The video reviews the procedure, patient selection, and advantages over LASIK. Dr. Goes details his technique for dissecting the stromal lenticule so it can be removed in one piece. It is important to determine the proper plane of dissection and fully dissect both the roof and the floor of the lenticule before attempting removal. He also demonstrates how to remove a small remnant at the periphery and suggests using a topical steroid drop to enhance visualization of such remnants.
If you attended the meeting, or even just registered, you can still view the films by logging in using your badge number here. There were many other impressive films demonstrating novel ophthalmic technologies, techniques and procedures, so be sure to make some time to watch and learn something from these engaging short videos.