The film festival is one of the highlights of the annual American Society of Cataract and Refractive Surgery (ASCRS) Annual Meeting. Ophthalmologists from around the world submit short educational videos on surgical techniques, new procedures and technology. Here are my 5 favorite films from this year’s entries:
1. Managing Iris Prolapse When Sealing the Wound During Cataract Surgery by Dr. Daniel Chang
Dr. Chang describes and demonstrates four simple maneuvers for treating iris prolapse at the conclusion of cataract surgery: 1. Soften the eye by stopping irrigation prior to removing the I/A probe. 2. Tap the sideport incision to lower the IOP. 3. Massage the wound with gentle pressure on the anterior lip to move the iris back into the eye. 4. Tangential stromal hydration of the corneal incision to seal the wound prior to repressurizing the eye. These maneuvers can be performed alone or in combination depending on the iris response.
2. How to Obtain High-Quality iPhone Slitlamp Photographs, Slitlamp Videos, and Surgical Microscope Videos by Dr. Mitchell Weikert
Drs. Weikert’s and Hester’s film is a step-by-step guide that explains how to capture excellent quality slitlamp and surgical images and videos. The three necessary components are a slitlamp adaptor (i.e., EyePhotoDoc), an iPhone camera app that allows separation of focus and exposure controls (i.e., ProCamera), and an external illumination source for the slitlamp such as a transilluminator or clip-on light with intensity and color controls. More information can be obtained at http://eyewiki.aao.org/Smart_Phoneography_-_How_to_take_slit_lamp_photographs_with_an_iPhone.
3. Pars Plana Safety Basket Suture for Intraoperative Management of Malpositioned Posterior Chamber IOLs by Dr. Samuel Masket
Dr. Masket elegantly depicts how to stabilize an IOL that lacks capsular support. His technique is to create a support scaffold below the lens implant with two perpendicular mattress sutures placed through the pars plana. During one of the cases in the film, Dr. Masket also demonstrates the use of the Hoffman pocket, another valuable technique to facilitate scleral suture fixation of an IOL.
4. Femtosecond Laser Capsulotomy—The Napkin Versus the Postage Stamp by Dr. Robert Rivera
Dr. Rivera discusses his experience with two femtosecond laser systems for cataract surgery: Alcon Surgical’s LenSx and OptiMedica’s Catalys. He explains and demonstrates how the different patient interface designs affect the capsulotomy resulting in a perforated edge with multiple small adhesions with the LenSx laser versus a smooth edge without adhesions with the Catalys device. Thus, Dr. Rivera’s analogy for removal of the central capsule disc is that of disconnecting a postage stamp versus lifting a napkin off a table.
5. Central Microphaco-Capsulorhexis in Hypermature Cataracts by Dr. Fernando Rodriquez Sixtos
Dr. Sixtos very nicely demonstrates a previously described technique for avoiding radial anterior capsular tear extension (i.e., the “Argentinean flag” sign) in intumescent hypermature cataracts. After Trypan blue staining of the anterior capsule, the phaco needle is used to puncture the capsule making a small round complete capsulotomy, and the liquid cortex is aspirated to decompress the bag. Capsulorhexis forceps are then introduced to enlarge the anterior capsular opening to the desired size.