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Up Front | Jan 2011

‘Tis Better to Give Than to Receive

This holiday season, reward yourself with the gift of Eyetube.net. Ophthalmic surgeons across the globe have uploaded videos to present their surgical pearls to you. Here are some great additions to this growing video resource.

LASER-ASSISTED DESCEMET’S STRIPPING ENDOTHELIAL KERATOPLASTY AND GLUED IOLS
This month, Dr. Awdeh had the pleasure of spending time in the clinic with Adil Agarwal, FRCS; Ashvin Agarwal, FRCS; and Anosh Agarwal, FRCS, of Dr. Agarwal’s Eye Hospital in India. These three brilliant brothers embrace the future of our field. In their video offering, they demonstrate the use of the IntraLase FS Laser (Abbott Medical Optics Inc., Santa Ana, California) for the preparation of a donor corneal graft for Descemet’s stripping endothelial keratoplasty. They also combine the procedure with vitrectomy, pupilloplasty, and glued IOLs, which are inserted through a scleral tunnel. A challenging case, made to look simple, and three gifts for one are offered in this exciting video (Figure 1; available at http://eyetube.net/?v=fafel).

A separate video by Amar Agarwal, FRCS, demonstratesthe fibrin glue technique for the insertion of a multifocalIOL. This video begins with a smart animation demonstratingeach stage of the procedure (available athttp://eyetube.net/?v=hejem). Dr. Agarwal also presents a case of a lens coloboma in which he implants a glued IOLand performs a closed-globe refixation of a dislocated IOLwith glue (available at http://eyetube.net/?v=sifos).

REPOSITIONING AN IOL’S HAPTIC 1 YEAR AFTER SURGERY
Som Prasad, MS, FRCS(Ed), FRCOphth, FACS, of the United Kingdom, offers a nice case of a patient who had uneventful cataract surgery and was found to have recurrentuveitis with an area of inferotemporal iris thinning, suggestiveof a haptic placed in the sulcus rather than the capsular bag. He places a Malyugin Ring (MicroSurgicalTechnology, Redmond, Washington) to get good exposure, uses a forceps to reopen the bag, and performs bimanual maneuvers to place the haptic in the capsular bag (Figure 2;available at http://eyetube.net/?v=gubuw).

NEW PHACO TECHNIQUES
Marcos Gomez, MD, demonstrates his phaco tunnel technique for medium to hard cataracts (available at http://eyetube.net/?v=jojee). Eslam Ramadan,FRCS(Glasg), reviews his pearls for the surgicalmanagement of hard cataracts (available athttp://eyetube.net/?v=pihoh). Jason Jones, MD, shares his methods for polishing the posterior capsule and creating the primary posterior capsulorrhexis, which he demonstrates for the removal of a posterior capsularplaque from a posterior subcapsular cataract(Figure 3; available at http://eyetube.net/?v=tehur).

PRESSURE MANAGEMENT
Steven Vold, MD, presents his technique for implantingthe P50 model of the Ex-Press mini glaucoma shunt (Alcon Laboratories, Inc., Fort Worth, Texas) followed by the insertionof the Ologen Collagen Matrix Implant (Optous, Roseville, California), a biodegradable scaffolding matrix that induces a regenerative wound healing process without theneed for antifibrotic agents. Dr. Vold uses the collagenmatrix to help maintain the subconjunctival space of thebleb and prevent postoperative fibrosis (Figure 4; available athttp://eyetube.net/?v=hocri).

CONCLUSION
We hope that you explore these and the other giftsthat are available to you on Eyetube.net. We look forwardto directing you to interesting videos in 2011. Wewould also like to introduce you to our European colleague,Elena Albé, MD, who will be joining us as a cosectioneditor of this column. She will no doubt helpus maintain a worldview. Please join us in welcomingDr. Albé.

Elena Albé, MD, is a consultant in theDepartment of Ophthalmology, Cornea Service,Istituto Clinico Humanitas OphthalmologyClinic, Milan, Italy. She states that she has nofinancial interest in the products or companiesmentioned. Dr. Albé may be reached at tel: +39 0331441721; e-mail: elena.albe@gmail.com.
Richard M. Awdeh, MD, is the Director ofTechnology Transfer and Innovation and anAssistant Professor of Ophthalmology at theBascom Palmer Eye Institute, Miami. He statesthat he has no financial interest in the productsor companies mentioned. Dr. Awdeh may be reached at tel:+1 305 326 6000; e-mail: rawdeh@med.miami.edu.
William B. Trattler, MD, is the Director of Corneaat the Center for Excellence in Eye Care, Miami andthe Chief Medical Editor of Eyetube.net. He statesthat he is a consultant to Abbott Medical OpticsInc. Dr. Trattler may be reached at tel: +1 305 5982020; e-mail: wtrattler@earthlink.net.

Jan 2011