Go-to Techniques for Complex Cataract Cases

Three surgeons share the maneuvers they rely on to improve control, safety, and efficiency in eyes with soft or dense nuclei, during IOL exchange, and in eyes with intumescent white cataracts.

Rosa Braga-Mele, MD, MEd, FRCSC; Uday Devgan, MD, FACS; and H. Burkhard Dick, MD, PhD, FEBOS-CR

Cataract and Refractive Surgery Today

KEY TAKEAWAYS Pocket chop creates a central groove that improves visualization and lets surgeons control soft or dense nuclei without advancing a chopper blindly toward the equator The twist-and-out technique removes a foldable IOL through the original phaco incision by rolling the optic, avoiding intraocular cutting and incision enlargement For intumescent white cataracts, a two-OVD strategy indents the anterior capsule, lowers the pressure gradient, and supports controlled capsulorhexis formation Pocket Chop for Soft and Dense Cataracts Rosa Braga-Mele, MD, MEd, FRCSC Many new tools and phaco technologies have made cataract surgery easier to manage, particularly in challenging situations. One technique that works reliably well with newer technologies is pocket chop, which can improve efficiency and safety in eyes with a soft or dense cataract.1 The beginning of a central groove, or pocket, is created in the center of the lens. The phaco needle is then embedded in the pocket with no vacuum for soft nuclei or with high vacuum for dense nuclei (Figure 1). A chopper is advanced from the distal edge of the capsulorhexis toward the pocket to create a horizontal chop (Figure 2).

Rethinking the Drop with iDose TR: Patient Access

I. Paul Singh, MD; Deborah Ristvedt, DO; and Kevin Talbot, MD

Eyetube

In this special podcast episode, I. Paul Singh, MD, speaks with Deborah Ristvedt, DO, and Kevin Talbot, MD, regarding the use of iDose TR (Glaukos), a procedural pharmaceutical, as an interventional glaucoma approach. They outline who the optimal patients are for this procedure, how to educate patients about drug delivery technology, and share pearls on reimbursement.

PBM for AMD: Mechanisms, Evidence, and Clinical Integration

Photobiomodulation shows promise, but long-term data are needed.

Luis Acabá-Berrocal, MD, and Anton Orlin, MD

Retina Today

KEY TAKEAWAYS Photobiomodulation (PBM) has been applied across many medical fields, including dermatology, neurology, and dentistry, where it has been shown to improve tissue repair, reduce neuropathic pain, and enhance bone remodeling. Ideal candidates for PBM include patients with intermediate dry AMD who are motivated to pursue a noninvasive treatment option. Patients typically undergo an initial series of nine treatment sessions over 3 to 5 weeks, followed by maintenance treatments every 4 to 6 months based on clinical response and patient preference. While PBM may improve visual function and slow disease progression, it is not curative. Outcomes may vary, and treatment benefits are generally more pronounced in earlier stages of disease. The prevalence of AMD is projected to increase from approximately 200 million to more than 300 million individuals worldwide as global life expectancy rises.1,2 Accordingly, the development of therapies that can prevent, slow, or treat AMD has become critical (Figure). The treatment landscape for AMD has evolved substantially, from AREDS supplementation to anti-VEGF therapies and complement inhibitors, and, most recently, photobiomodulation (PBM). Currently, PBM offers a noninvasive therapeutic option for patients with dry AMD. Figure. Patients such as this 68-year-old woman who has intermediate AMD, with the OCT of the left eye demonstrating drusen, may benefit from early treatment.