37th APACRS Annual Meeting Final Program

FILM FESTIVAL

FF4-16 Intraoperative Hard Eye - A wolf in a sheep's clothing

Deepak MEGUR India

Intra operative Hard eye during cataract surgery is a serious condition which is distressing for the surgeon and the patients. Fluid Misdirection and Supra Choroidal haemorrhage are the 2 serious causes of Intra-operative hard eye and differentiating them is critical as management is different. In this film we share our experience with these dreaded entities. Intraoperative differntiaiton between these 2 entities can be challenging. Assuming every intraoperative hard eye as having Fluid Misdirection and performing pars plana anterior vitrectomy can be disastrous since Suprachoroidal hemorrhage is not very rare. A step by step approach will be demonstrated in this film which ensures safe management of intra operative hard eye. FF4-17 Intraoperative OCT for Real-time Assessment of Structural Changes in Cataract Surgery With Minimally Invasive Glaucoma Surgery (MIGS) Ankith NAIR India OCT imaging provides high-resolution cross-sectional images, allowing real-time objective evaluation of structural changes induced by a surgical procedure. In this study, a portable OCT is modified to integrate with an operating microscope, enabling precise assessment of each step of combined cataract surgery with MIGS. Accurate assessment of successful placement of Kahook Dual Blade in the Schlemm’s canal and the adequacy of removal of trabecular meshwork strip and the inner wall of the Schlemm’s canal was possible. Intraoperative OCT was effective in confirming the thoroughness of each step, which could lead to better results and fewer complications. This approach also facilitates visualisation of microstructural changes and residual tissue that might need further intervention. FF4-18 Ophthalmic Examination of Pediatric Patient in a Nutshell Venu MURALIDHAR India Examination of a pediatric patient can be daunting for any ophthalmologist. Hence, having a proper protocol can prove helpful. This video illustrates essential, practical steps for examining a child with ocular complaints. It describes techniques to assess visual acuity, overall visual function and how to perform a quick evaluation of commonly encountered pediatric ocular conditions such as squint and congenital cataract. It includes some tips and tricks that can come in handy for a fruitful examination. Although a rather basic concept, the video provides a structured protocol allowing for a swift and seamless assessment of a child. FF4-19 A True Dysfunctional Lens Bruno TRINDADE Brazil Anterior lenticonus causes significant internal aberrations that degrade vision. This film will show the management of anterior lenticonus in Alport's Syndrome patients. From the pre-operative challenges to the post-operative results. These young patients can have a significant visual improvement with proper surgery and elimination of their causative problem. FF4-20 Gonioscopy to the Rescue - External cyclopexy in post traumatic chronic hypotony Annu JOON India A 20-year-old male presented 4 months after RTA with chronic hypotony maculopathy. Examination revealed large cyclodialysis on gonioscopy. A decision for external cyclopexy was taken due to non-resolution with cycloplegics. Intraoperative gonioscopy revealed even larger cleft upon inflation with OVD. An external full-thickness scleral flap was created to expose uveal tissue and detached fibrous ciliarybody band, which was sutured to scleral spur using multiple 10-0 monofilament mattress sutures. Trypan blue was injected into anterior chamber to confirm closure by assessing (lack of) flow through the repaired area; followed by scleral flap closure. Post-operative,the cleft remained closed, with improvement in hypotony (13mmHg). This case underscores the importance of critical yet underutilized skill of gonioscopy in detecting conditions like cyclodialysis. Imaging techniques like ASOCT, may serve as supportive tool when necessary, if available.

114