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

FILM FESTIVAL Film Festival FF2 – Cataract Complications/Challenging Cases TITLE PRODUCER FF2-01 Tips on Damage Control and Optimizing Outcomes: Keeping a small posterior capsular rupture Bryan Hung-Yuan LIN Chinese Taipei Although several factors can contribute to posterior capsule rupture during phacoemulsification, one of the crucial factors is the surgeon’s experience. In this video, our junior surgeon encountered a small posterior capsule rupture with nuclear fragments still present in the eye while doing phacoemulsification. Several surgical tips are described in this video regarding how to manage posterior capsule rupture (PCR) and optimize best outcome. Step by step strategies include the way to continue phacoemulsification, the procedure of removing the remaining cortex, and to perform toric IOL implantation without stretching the ruptured hole. In our training center, this is to help junior surgeons learn without compromising patient safety. FF2-02 Tackling the Great White Cataracts (SHARKS) Dennis Ket Ming KONG Malaysia Tackling the great white cataracts can be fraught with hidden risks and challenges. Opacified cortex may be hiding fibrotic capsule, dense nucleus, and even a polar cataract. Other possible challenges are small pupils, weak zonules, high intracapsular pressure, and absence of cortex to protect posterior capsule during nuclear disassembly. This video presentation will highlight the many challenges and two (2) key surgical techniques. Capsular management techniques with capsular dye, puncture, and immediate decompression before initiating capsulorhexis. Nuclear disassembly of segmental chops and scaffold techniques of emulsifying a nuclear segment anterior to another segment (later acting as a scaffold) and the last few segments emulsified after insertion of IOL scaffold. A brief retrospective analysis of 101 cases. FF2-03 Double Step Capsulorhexis in Hypermature White Intumescent Cataract Abul Bashar SHEIKH Bangladesh Without capsulorhexis, phaco surgery cannot be possible. I did double step capsulorhexis to overcome this problem. I did double step capsulorhexis in 669 patients with hypermature white intumescent cataract with high intralenticular pressure. Study was done from 1 January 2005 to 30 December 2019. Anterior capsule was stained with tryphan blue in all cases. Very small (mini) capsulorhexis was performed first. Then intracapsular loose cortical matter was pressed out. For the second step, anterior margin of capsule was cut by vanas scissor. Capsulorhexis of adequate size was completed using capsulorhexis forceps. Result: Out of 669 cases, successful capsulorhexis was performed in 665 eyes and phaco surgery was uneventful (99.40%). Conclusion: Double step capsulorhexis was very effective. FF2-04 Small is Tough – Challenging the Challenge Kumar DOCTOR India The purpose of this video is to demonstrate challenges in IOL implantation in small eyes and management of the same. Case 1: Largest ever IOL power implanted in human eye (65 D). Case 2: Video demonstration of the only optic of IOL implantation in micro cornea eye for refractive correction. It is advisable to do UBM preoperatively. Study various IOL formulas. Use customized IOL to achieve desired postoperative results. Once postoperative results analyzed, further bioptics can be managed. A comprehensive approach towards such small eyes is essential to achieve the desired refraction. Proper planning and thorough investigations are essential for a good outcome and patient satisfaction. FF2-05 Intraoperative Optical Coherence Tomography Guided Management of Intumescent White Cataract Jeewan TITIYAL India We describe intraoperative optical coherence tomography (iOCT) guided management of intumescent white cataract. Two types of intumescent white cataracts were observed on iOCT. Type A had swollen hyperreflective stromal fibers beneath the anterior capsule with multiple intralenticular clefts in underlying cortex. On initiation of capsulorhexis, a cortical bulge was visualized in AC through the capsular opening without any fluid release, with an imminent risk of capsulorhexis extension. iOCT guided bimanual cortical aspiration was performed till intralenticular pressure (ILP) decreased and cortical bulge recessed. Type B cataract had large hyporeflective vacuoles beneath anterior capsule. Spontaneous slow release of turbid fluid was observed on initiation of capsulorhexis with decrease of ILP. iOCT aids in creation of adequate- sized capsulorhexis in intumescent cataract without complications. 76