35th APACRS Annual Meeting Final Program

FILM FESTIVAL FF2-20 Phacoemulsification in Complicated Cataract with Glaucoma Drainage Implants Dewi ROSARINA Indonesia Glaucoma implant surgery is increasingly being performed. Cataract after glaucoma implant surgery can usually occur several months later. Phacoemulsification in the complicated cataract with a tube inside the anterior chamber presents a challenge. This video will demonstrate phacoemulsification surgery in complicated cataract patients with glaucoma drainage implants. Posterior synechia due to chronic inflammation made the pupil not wide enough. The surgical difficulties encountered in this patient were the presence of posterior synechia and the presence of the tube inside the anterior chamber. FF2-21 Expert Insights on Managing Rhexis in Hyper-mature Cataract (HMSC) in SICS Rohit RAO India The video aims to address common challenges faced during rhexis and offer practical solutions to improve outcomes and minimize risks. The goal is to equip ophthalmologists and surgical teams with the knowledge and tools they need to perform rhexis with confidence and achieve optimal results. During cataract surgery, it is important to be mindful of the high intralenticular pressure in HMSC cases, as this can increase the risk of rhexis extension and the appearance of the Argentinian flag sign. Having a good understanding and proficient use of various techniques is essential in managing rhexis in HMSC cases. The key consideration in all cases is to reduce intralenticular pressure, which can help prevent the rhexis from extending and the appearance of the Argentinian flag sign. FF2-22 Zonules Why Have You Forsaken Me? Alexander Gerard Nino GUNGAB Philippines We present a case of phacodonesis and a macula off retina detachment. The patient underwent scleral buckling surgery followed by elective cataract surgery. Unfortunately, prior to the cataract surgery, the patient developed an angle closure attack due to phacodonesis which was managed with iridoplasty and laser peripheral iridotomy. During preoperative planning for cataract surgery, the following issues were identified: small corectopic pupils, contracted capsular bag, gross phacodonesis. We demonstrate our surgical technique in dealing with such cases by utilizing the capsular tension segments to stabilize the bag before the phacoemulsification and to replace the weakened zonules. Suture fixation utilizes a double-flanged polypropylene suture which should have greater longevity as the thick suture and absence of a knot theoretically reduces the risk of long-term suture breakage. FF2-23 8 Knock Out Tips for Champion Cataract Surgeons Ashok Kumar MOOLANI India Cataract surgery has advanced from being a sight-giving procedure to a highly demanding refractive technique. With evolving technology and techniques, we are closer to achieving perfect surgeries. However, when unexpected situations occur, managing these complications is where champions shine. This video shows eight knock-out scenarios where the surgery was expected to be uneventful, but a sudden turn changed the potential consequences. Complications such as total zonular dehiscence, intraoperative hard eye, sunset intraocular lens, cracked lens during implantation, aqueous misdirection create stress and get the surgeon’s heart racing. The video will show a quick analysis and approach to managing the case with the best possible outcomes, and can help every surgeon excel under high pressure. FF2-24 Cracking Without a Crack Alexander Gerard Nino GUNGAB Philippines Dense brown cataracts are notoriously hard to obtain an initial split and has high risk of intraoperative zonulysis. We demonstrate our “flower-petal” technique to remove a dense brown cataract. We do not attempt to complete the initial crack to reduce the risk of stressing the zonules due to the excessive lateral division force needed to fully separate the two halves of the lens. Instead, we do multiple vertical chops to form multiple “flower petals” and remove each petal individually, leaving the base behind. Once all petals are removed and the lens effectively debulked, the base is flipped up and splits in half at the last step. In our opinion, this technique reduces zonular stress (as well as surgeon stress) as the hardest step of the surgery i.e. obtaining a full crack is bypassed. 99