Breaking News from the ASCRS Meeting in Washington DC

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Eyewire reports on new products and breaking news live from the American Society of Cataract and Refractive Surgery meeting in Washington DC.  Learn more about your ad choices. Visit megaphone.fm/adchoices

Cataract Surgery in Patients with Corneal Opacities

When the view through the cornea is poor, adjustments in illumination, capsular staining, and pupil expansion can help.

Boris Malyugin, MD, PhD

Cataract and Refractive Surgery Today

KEY TAKEAWAYS Corneal opacities can compromise visualization during cataract surgery, but microscope illumination adjustments and supplemental light can improve the surgical view Transcorneal, intracameral, or pars plana chandelier illumination can enhance lens visualization by using reflected retinal light when coaxial light is insufficient Capsular staining, posterior capsule–safe phaco technique, and pupil expansion with a Malyugin Ring 2.0 or iris hooks can further improve control In eyes with corneal opacities, visualization of the capsule and lens can be challenging. The degree of difficulty depends on the density and location of the opacity. When cataract surgery alone, rather than a combined corneal and cataract procedure, is planned, several techniques can improve visualization. OPTIMIZING VISUALIZATION The first technique to improve visualization is to adjust the intensity of the operating microscope light and the balance between the coaxial and paraxial illumination. The second is to add supplemental illumination. A light pipe borrowed from a vitreoretinal setup can be positioned on the cornea near the limbus for transcorneal illumination or introduced into the anterior chamber through a paracentesis incision for intracameral illumination. Pars plana chandelier illumination can be useful in these cases. This technique was first described by Oshima et al in 2007.1 The approach is illustrated in Figures 1 and 2. When the coaxial microscope light is turned off and the chandelier illuminator is turned on, light reflects off the retina and improves visualization of the lens structures.

Ophthalmic Oncology Perspectives at ARDS

During the 54th annual meeting, Tara A. McCannel, MD, PhD, explored the utility of prognostic biopsy and the psychological ups and downs that come with a cancer diagnosis.

James Winebrake, MD

Retina Today

KEY TAKEAWAYS The 54th annual Aspen Retinal Detachment Society meeting included two talks by Tara A. McCannel, MD, PhD, providing comprehensive framework for managing uveal melanoma. Prognostic biopsy, while useful, is only one factor that can influence surveillance frequency. When counseling patients with a new cancer diagnosis, use precise language, favoring “vision change” over “vision loss,” and remember that a patient’s mindset is learned and can be intentionally revised. The 54th annual Aspen Retinal Detachment Society meeting, held February 28 – March 4, 2026, in Snowmass Village, Colorado, was a feat of education with lectures on everything from surgical delivery of gene therapy and AI to diagnosing uveitis and surgical approaches to schisis detachments. This year, Tara A. McCannel, MD, PhD, delivered two lectures that offered a comprehensive framework for managing uveal melanoma: one grounded in the molecular science of risk stratification, the other in the psychology behind the diagnosis (Figure). PROGNOSTIC BIOPSY IN UVEAL MELANOMA Dr. McCannel opened with a case of a 56-year-old man with choroidal melanoma whose cytogenetic biopsy results—monosomy 3, chromosome 1p loss, and 6p gain—suggested an approximately 50% 5-year metastatic mortality risk. Twenty years later, the patient is alive and metastasis-free.