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Archive December 2018 XIX, No. 12

Cool Cataract Surgery Advances

These innovations promise to take ophthalmology's tried-and-true procedure to the next level.

Daniel Cook

Daniel Cook, Editor-in-Chief


John Hovanesian, MD
LOOKING AHEAD John Hovanesian, MD, believes surgeons need to be open to trying innovative new products and willing to move cataract surgery forward.

If it ain’t broke, don’t fix it is a motto unimaginative cataract surgeons use to justify their inability to think outside the oculars about improving a procedure that has remained largely unchanged. However, exciting developments in device design and drug delivery could compel eye physicians to at least take a second look at cataract surgery’s clinical routines.

1 Reduced phaco energy

IanTech’s miLoop was introduced in 2017 with the aim of eliminating, or at least significantly reducing, the need for phacoemulsification energy to fragment cataracts before removal. Surgeons insert the pen-like miLoop through a 1.5 mm corneal incision, slide the device’s filament loop in the open position around the cataract’s nucleus and activate the device’s finger lever to halve the nucleus. Surgeons can remove the fragments of soft lenses with only aspiration, but often employ low levels of phaco energy to chop up the fragmented remains of denser cataracts.

Ophthalmic surgeon William Trattler, MD, uses the miLoop in only about 4% of his cases, but appreciates having it nearby to fragment very dense cataracts before dialing back the phaco energy to finish the job. “Less energy translates into lower risk of corneal edema and less inflammation in the anterior chamber,” points out Dr. Trattler, who operates at the Center for Excellence in Eye Care in Miami, Fla.

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