The field of ophthalmology is always on the leading edge of innovation, but residents and fellows may not be exposed to all the latest developments in eye care. To provide insights into some of the recent advances, YoungMD Connect hosted a workshop on this topic. The program—Innovations You May Not Learn About in Training—brought together three anterior segment experts to guide attendees through the importance of innovating and embracing new technologies early in a young surgeon's career.

The workshop started with a brief panel discussion among the mentoring faculty members about the importance of embracing innovations early in practice. William F. Wiley, MD, pointed out that ophthalmology is churning out new technologies regularly. He advised the attendees to put themselves out there and engage with other colleagues and industry representatives to get access to these technologies. In addition, Dr. Wiley stressed the importance of capturing data and clinical experience and presenting them to industry partners looking for this information. Reena Garg, MD, pointed out that it can be scary to try out new technologies as a resident or fellow. She suggested working with industry representatives to set up a wet lab that allows trainees to experience new technologies in a more comfortable environment.

Phacoemulsification Tips

Cataract surgery is one of the most common procedures performed by anterior segment surgeons, and surgeons can choose from a plethora of devices and tools to use in each case. Dr. Garg encouraged the attendees who are learning cataract surgery to think about fluidics and phaco dynamics. These concepts may not be at the forefront of a trainee's mind; however, understanding the phaco equipment and the nuances that affect efficiency will improve one’s overall surgical performance. As an example, Dr. Garg highlighted the importance of knowing whether one’s phaco platform features a venturi or peristaltic pump and how to balance phaco and vacuum energy during surgery. These factors play a critical part in the efficiency of lens removal and anterior chamber stability.

Benefits of Office-Based Surgery Suites

I. Paul Singh, MD, explained the benefits of performing ocular surgeries in an office setting. On a long list of benefits, the positive patient experience ranks the highest, Dr. Singh said. Patients are comfortable in the office and familiar with the staff, often requiring no IV sedation or need for fasting. Additionally, operating in an office-based surgery suite (OBS) can help save costs and bundle them for the patient. A variety of procedures can be performed in an OBS, ranging from cataract, to glaucoma, to cornea, to eyelid surgeries. An OBS also allows the physician to have control over surgery scheduling, OR technology, and overall surgical flow. OBS also optimizes collaboration with industry partners on research projects without the need for multiple local committee approvals. Finally, surgeries performed in an OBS have the same safety profile as procedures done at hospitals or ambulatory surgery centers.

Updates in Corneal and Cataract Surgery

During his presentation, Dr. Wiley reviewed three new technologies and their potential in anterior segment surgery.

Cornea tissue addition for keratoconus, or CTAK (CorneaGen), is a corneal tissue implant designed to reshape ectatic corneas. Each implant is specifically customized to the patient’s cornea to improve visual acuity and quality.

Dr. Wiley also described a modified IOL explantation technique in which a pair of ICL loading forceps (Zaldivar-Kraff ICL Pacman Cartridge Loading Forceps, Titan Medical) are inserted through the back of a cartridge into the eye. To fit the forceps in the cartridge, the back part of the cartridge is cut off. After the incision is made and the lens is dissected, the forceps are inserted and the IOL can be pulled out as it is folding into the cartridge.

Last, Dr. Wiley discussed the IC-8 Apthera small-aperture IOL (Bausch + Lomb). The lens’ pinhole optic helps to block irregular light, making the IC-8 a great tool for patients with irregular astigmatism, Dr. Wiley said.