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Evaluation of a complete 1.8 mm coaxial microincision cataract (C-MICS 1.8) procedure

J. E. “Jay” McDonald, II M.D. McDonald Eye Associates Fayetteville, Arkansas www.mcdonaldeye.com. Evaluation of a complete 1.8 mm coaxial microincision cataract (C-MICS 1.8) procedure.

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Evaluation of a complete 1.8 mm coaxial microincision cataract (C-MICS 1.8) procedure

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  1. J. E. “Jay” McDonald, II M.D. McDonald Eye Associates Fayetteville, Arkansas www.mcdonaldeye.com Evaluation of a complete 1.8 mm coaxial microincision cataract (C-MICS 1.8) procedure Financial disclosure: Bausch and Lomb – Consultant; Addition Technology - Advisory Board; Santen - Research Support; Acufocus - Research Support; Alcon Pharmacology - Speaker Bureau; Wave Tec – Research Support; Inspire – Consultant; Revitalvision, Inc. - Advisory Board

  2. Coaxial Microincision Cataract Surgery (MICS) • The trend in cataract surgery is toward smaller incisions • Coaxial MICS (C-MICS) • Use current phaco technique • Reduce surgically induced astigmatism (SIA)1-3 • Increase wound sealability4 • Reduce endothelial cell loss5 • Heg Wee Jin. WOC 2008, Hong Kong. • Braga-Mele R. ASCRS in San Francisco, CA, April, 2009. • Barrett GD. APAO Congress. Bali, Indonesia, May, 2009. • Barrett GD, Carlsson A. Canadian Ophthalmological Society, Montreal, Canada, June, 2007. • Zafirakis P. ASCRS in San Francisco, CA, April, 2009.

  3. Complete MICS System • Stellaris system for 1.8 mm phaco • Akreos MICS IOL implantable through 1.8 mm incision

  4. Stellaris 1.8 Coaxial MICS • Only system designed for coaxial 1.8 mm microincision cataract surgery (C-MICS) • Easy transition from small-incision to microincision surgery • StableChamber fluidics enhances followability, holdability and chamber stability 1.8 mm C-MICS(22 gauge) 2.8 mm SICS(19 gauge)

  5. Akreos MICS IOL • Akreos MICS lens inserts through 1.8 mm phaco incision • 30% thinner than Akreos AO lens • Aspheric aberration-free optic • Moderate refractive index • 360° posterior square-edge design

  6. Study • Retrospective chart review • All procedures by same surgeon in same OR • Millenium small incision cataract surgery (SICS) 2.8 mm (n=45) • Eyes implanted with SofPort AO or Crystalens IOL • Stellaris 1.8 mm MICS (n=63) • Eyes implanted with Akreos MICS IOL • EPT, cataract density assessed perioperatively • Flare/cells assessed 3.5-5.0 hours postop • Trace=0.5, 1=1.0, 1+-1.5, 2=2.0, 2+=2.5 • Uncorrected and best-corrected distance visual acuity at 3 and 6 months • Some eyes targeted for monovision; measured uncorrected and best-corrected near VA at 3 and 6 months

  7. Results

  8. Mean Distance Visual Acuity

  9. 3 Month Distance Visual Acuity

  10. 6 Month Distance Visual Acuity

  11. Conclusion • Microincision cataract surgery results in a quieter postoperative eye than small incision cataract surgery • Minimizing incision size in cataract surgery may also: • Decrease surgically induced astigmatism • Improves wound strength and integrity • Reduces endothelial cell loss • Reduce postoperative endophthalmitis • Reduce patient recovery time

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