Final program | 33rd APACRS – SNEC 30th Anninversary Virtual Meeting

FILM FESTIVAL TITLE PRODUCER FF1-06 Don’t Just Be an Akahoshi! Be a Prechop Samurai Sohel Irfan Mohammed KHAN India 1) The quest of every dedicated phaco surgeon is to develop skills to emulsify all forms of hard nuclei efficiently with minimal damage to endothelium and reducing the risk of wound burn. Obtaining a pristine cornea the very next day in a hard cataract is a dream far from reality. 2) There are many techniques for prechopping aimed at reducing the use of total phaco energy. Nagahar’s Horizontal chopping or Vladimir Pfifer’s technique of vertical chopping were especially noteworthy. But Dr. Takayuki Akahoshi, Japan, stunned the world by presenting his technique of prechopping the cataract wherein the nuclei were broken into pie shaped fragments without the use of phaco energy. The fragments were subsequently emulsified by phaco thereby substantially reducing the use of ultrasound. This drastically reduced the effective phaco time and achieved clear and pristine corneas the very next day of cataract surgery. It is a delight observing Dr. Akahoshi performing prechops with his prechop forceps in all cataracts. But for the majority of us, the learning curve for this technique is very steep and frustrating. We in this video describe a new Universal Sickle-shaped Prechopper (Dr. Sohel Irfan Khan’s technique of sickle prechop) which is very easy and efficient in producing nuclear disassembly in all forms of cataracts. All maneuvers of prechop are performed in the bag away from endothelium. Here a Chang’s Horizontal Chopper is used to hook the equator of nucleus and the newly designed Dr. Sohel Irfan Khan’s Prechopper is inserted through a 2.8-mm clear corneal incision and both instruments are brought together to produce a full thickness nuclear crack. The nucleus is rotated again and prechopped repeatedly to obtain pie-shaped nuclear fragments to be emulsified subsequently. The division produced by this prechopper almost imitates the division produced by femto cataract surgery. Once you break the hard nucleus into multiple fragments by this technique you tame a hard cataract. The message is clear: “Be a Prechop Samurai” by using Dr. Sohel Khan’s Prechopper rather than Akahoshi. FF1-07 Phacoemulsification in Soft Cataract Nikita MASHRU India Purpose: To describe multiple techniques for managing soft cataract to improve the surgical safety. Materials and Method: Capsulorhexis is performed as usual with a 26-gauge needle and preferably larger. A trench is fashioned using low ultrasonic power. Hydrodelineation is performed by a cannula introducing directly in central lens substance. Hydrodissection follows next, and precise hydroprocedure is achieved. Nucleus is emulsified using ultrasound power, and intraocular lens is implanted. Results: This technique results in easy rotation and removal of nucleus and epinucleus using low phaco power. Conclusions: These phacoemulsification techniques for soft cataract are safe and very effective. FF1-08 Intraoperative Floppy Iris Syndrome: Combating the Challenge Rohit OM PARKASH India Patients using alpha1 antagonist drugs have a high incidence of varied degree of intraoperative floppy iris syndrome (IFIS). This video demonstrates the understanding of the dynamics involved in the pathogenesis of IFIS, the prevalent surgical strategies employed to prevent IFIS, and how our understanding of IFIS development helps in incorporating new modifications and improving outcomes in patients. FF1-09 Evolution of Fluid System in Cataract Surgery Hisaharu SUZUKI Japan The evolution of the fluid system in cataract surgery is remarkable. We have presented a novel method for observing the anterior chamber using slitlamp “slit side view” in 2017 and 2019. At this time, we have visualized the relationship between changes in intraocular pressure and the anterior chamber depth. Usefulness of the new handpiece was also verified. FF1-10 Ins and Outs of IOL management LEE Mun Wai Malaysia Phacoemulsification is the most commonly performed surgery in ophthalmology and excellent visual rehabilitation is achieved rapidly with intraocular lens (IOL) implantation. This very important step in cataract surgery may not always be straightforward due to inadvertent capsular complications and IOL damage (or defects). Sometimes, less than ideal postoperative outcomes may necessitate IOL repositioning or even exchange. This video highlights the pitfalls a surgeon may encounter during IOL implantation and shares pearls on the management of difficult situations. It also illustrates techniques of IOL manipulation, explantation as well as fixation. The principles of management in difficult scenarios serve as the key take- home message from this video and would be an important addition to the armamentarium of the cataract surgeon. 74