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The Latest in Cataract and Refractive Surgery
Let's go window shopping at the annual meeting of the American Society of Cataract and Refractive Surgery.
David George
Publish Date: August 7, 2008   |  Tags:   Ophthalmology

Here's a roundup of eight of the more interesting things that I saw during my stay in Chicago for the annual meeting of the American Society of Cataract and Refractive Surgery in early April.

1 Alcon Laboratories continues to add to its AcrySof ReStor presbyopia-correcting IOL line. The new apodized diffractive optics are similar to the technology used in microscopes and telescopes. Apodization, the gradual reduction of diffractive step heights, distributes the appropriate amount of light to near and distant focal points in various lighting situations. The new aspheric optic helps compensate for positive corneal spherical aberration. This may improve the overall quality of vision compared to the non-aspheric ReStor lens.

2 Carl Zeiss hopes its new Lumera surgical microscope will have ophthalmologists seeing red, but in a good way. With Zeiss' new stereo coaxial illumination technology, different tissues can be easily recognized with an improved red reflex, even with thick cataracts, thanks to the high-contrast detail recognition. The microscope also has a depth-of-field management system, a retinal protection device to protect the patient's eyes against phototoxic injuries and an automatic halogen bulb change feature. Teaching institutions may be interested in the Lumera T, which has an assistant's microscope and can be modified to include a video monitor so that the rest of the OR can see the progress of the surgery.

Zeiss also unveiled its Callisto Eye OR management software for ophthalmic surgery, which lets you capture all patient data, including video, before, during and after the procedure. Callisto runs on Mac and Windows platforms and should hit the U.S. market near the end of the year.

3 Dutch Ophthalmic (DORC) has addressed eye surgeons' concerns of photo-toxicity when using an illumination system close to the retina in vitreoretinal surgery. The Xenon BrightStar lets the surgeon control the illumination spectrum, depending on the clinical situation, through four cut-off filters that limit the ultraviolet light rays near the retina. The filters let the surgeon work close to the retina safely for a longer period of time. The unit also has a light-time indicator and uses Xenon bulbs that can be exchanged with little hassle.

4 MicroSurgical Technology's Malyugin Ring generated a lot of interest at the meeting. The pupil expander is designed to keep the pupil open and prevent it from billowing in cases involving intraoperative floppy iris syndrome (IFIS). There's been a lot of talk about IFIS among cataract surgeons since David Chang, MD, and John Campbell, MD, linked it to tamsulosin hydrochloride (Flomax) in 2005. Flomax and other alpha 1-adrenergic blocking agents are used for lower urinary tract symptoms in men caused by an enlarged prostate. These drugs relax the muscles that contract the prostate and the bladder neck. But they also appear to relax the eye's iris dilator smooth muscle. The Malyugin Ring is an alternative to using

J-hooks to keep the pupil dilated. Actually a square when it opens in the eye, the ring looks like the loop end of a safety pin at each corner. It is inserted with a disposable injector and removed from the iris with a Lester hook before it's drawn back into the injector. A box of six Malyugin Rings sells for about $700.

5 Optronics has added a recording feature to its Microcast HD microscope camera system. The camera lets the ophthalmologist create high-definition video at 60 frames per second with 1920 x 1080p resolution. The Microcast system is designed to create portable video images that can be saved in MPG4 format on a flash memory stick. The video files, with rich colors, can be played back on any PC. The system with the recording features costs about $20,000.

6 SciCan has added a larger model to its line of autoclaves. The Statim 7000, designed for high-volume facilities, boasts a 12-minute unwrapped cycle, a 15-minute wrapped cycle and a 12-minute steam-heat drying cycle with a full load, says the company. The unit holds 8-inch x 11-inch IMS cassettes and has a filter that lets it use tap water, eliminating the need to buy distilled water. Likewise, the condensation bottle can be plumbed directly to your facility's drain. The unit sells for about $7,700.

7 Sharpoint continues to grow its SharpGuard line of guarded knives. The company has introduced a safety scalpel with a guarded sheath to help prevent sharps injuries. The sheath features a textured grip that clicks once the blade is fully exposed. Slide the grip sheath forward and the guard clicks in the safety position. The knives are sold five to a box and are available in paracentesis, clear corneal and crescent blade designs. These guarded blades may help protect your OR staff and also help you comply with OSHA rules that require a bloodborne pathogens exposure control plan.

8 TrueVision Systems introduced an add-on for cataract surgeons who love making films of their work. (And there are many. ASCRS has to be one of the few medical conferences with its own film festival.) TrueVideo is a high-definition 3-D video recording and playback module for the TrueVision system, which captures a 3-D image through a module that replaces the eyepiece of a surgical microscope. The system lets surgeons work head-up and lets other team members follow the procedure and better anticipate each step. You can route real-time or recorded 3-D video images to a 19-inch flat panel display, a 40-inch rear projection cart or a 110-inch front projection system. The TrueVision system lists for about $60,000 and about $90,000 for the record and playback version. You can save video files in AVI format for easy compatibility. Maybe there'll be a 3-D category in the ASCRS film festival next year in San Francisco. I'll be watching, wearing my shades, of course. OSM

Also Seen and Heard at ASCRS 2008

  • ASCRS launched EyeSpaceMD.org, an educational Web portal that serves as a resource library and social media network for ASCRS members. The site features presentations from the Chicago meeting and other gatherings as well as discussion groups and a video and image library. Content is ranked by member reviews and most-viewed status. Consider it YouTube for eye surgeons.
  • Bausch & Lomb entered the growing premium IOL market earlier this year as a result of its acquisition of eyeonics, makers of the crystalens IOL. This is the first acquisition for B&L since it became a private company in the fall of 2007.
  • Fernando C. Trindade, MD, of Brazil, won the grand prize at the 2008 ASCRS Film Festival for his seven-minute film, "Watch the Haptic!" The film shows how best to deal with a displaced haptic that has become implanted outside the capsular bag or in the ciliary sulcus. See the film at ascrs2008.conferencefilms.com/atables.wcs?entryid=428084.
  • American Optisurgical showed off its yet-to-be-approved Vizual compact phaco machine that features a small, lightweight console, large touchscreen and IV pole interface.
  • Eyemaginations! introduced 3D-Eye Home, an educational software product that lets patients see images and animations of eye conditions and procedures from their home computer before or after their procedure. 3D-Eye Home can be integrated into the company's other animation products for ophthalmologists.

— Kent Steinriede