37th APACRS Annual Meeting Final Program

FILM FESTIVAL

FF2-53 Ultrasonic Prechopping for Hard Cataracts

Pankaj LANDE India

Hard cataract is a challenge for any surgeon, best surgeons with best possible machine are also at risk of causing endothelial damage. We introduce a Ultra sonic power for pre chopping the hard nuclei into multiple small pieces as in femtosecond. This tool/technique make phaco in hard cataract easy with increased patient safety, and is surgeon friendly. In addition, it can cut hard to super hard cataract with ease, even in situation where even femtosecond laser may not work. This is a much cheaper alternative, no major financial burden to surgeon for upgrading, help patient to undergo safer surgery. FF2-54 Toric IOL Implantation Post Posterior Continueous Curvilinear Capsulorhexis in a Posterior Polar Cataract Dhananjay PRAJAPATI India Posterior polar cataract (PPC) amongst all types of cataracts is unique as it poses great challenges to the surgeon. In PPC the posterior capsule is very thin then usual and may have pre-existing capsular dehiscence. Posterior capsular dehiscence may also occur during hydrodissection or during phacoemulsification rendering the bag not an ideal place for IOL implantation. We are showcasing a PPC case with pre-existing posterior capsular dehiscence, managed with PCCC and anterior vitrectomy with toric IOL implantation in the bag. This video gives valuable insight into how the refractive outcomes can be optimized by planning a toric IOL even in a PPC with posterior capsular dehiscence provided timely detection with appropriate steps. FF2-55 Phacoemulsification in Polar Cataract Rakhi DCRUZ India We use the technique of step-by-step chop in situ and lateral separation12 with 40–50% ultrasound, vacuum of 150– 250 mm Hg, an aspiration flow rate of 16 mL/min, and a bottle height of 50–60 cm. We used some mix of tips for dealing with PPC in this case which included multiquadrant low volume hydrodilenation, no rotation, central V shaped trenching and multiqudrant low vaccum lowspiration quadrant removal and multilayered nucleus and epinucleus removal. We also used low vacuum, low aspiration, and low inflow parameters to ensure a more stable anterior chamber; bottle

height was at 50 cm, vacuum at 100 mm Hg, and aspiration flow rate at 20 ml per minute. FF2-56 Bridging the Gap: Effective management of cataracts in colobomatous eyes

Prashanth R India

Coloboma of the iris, choroid, and retina is a rare congenital anomaly which results from failure of closure of embryonic fissure. These patients develop cataract at a much earlier age and also associated pathologies like microcornea, small pupil, absence of zonules or lens coloboma, and other structural anomalies make cataract surgery more challenging and fraught with complications in these eyes. In this video, through a step wise manner, we will demonstrate planning and executing cataract surgery along with counselling patients with cataract in a colobomatous eyes. This video will help you understand the nuances of IOL biometry and tips and tricks for surgery which help prepare a surgeon better for

any surprises on the operating table as well as handling patient expectation post surgery. FF2-57 Lo(o)se Zonules, Not Your Confidence - Capsular tension ring to the rescue (my first implantation experience)

Himani MANRAL India

Capsular Tension Rings (CTRs) are a handy tool that help stabilise a loose capsular bag with zonular weakness/ dialysis, whether pre-existing or iatrogenic. The video shows a patient having nuclear sclerosis grade 2 cataract with pseudoexfoliation undergoing phacoemulsification surgery. While dislodging the epinucleus from the capsular fornix, significant zonular dialysis was noted and decision was taken to implant a standard CTR so that the patient would not be rendered aphakic. The video highlights the challenges I faced as this was my first independent CTR implantation (as a consultant posted at a high-volume surgical centre), ending with a successful intraocular lens implantation. The video serves to educate all, especially beginner surgeons, to make use of CTR device whenever needed for optimal results.

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