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Inside Eyetube.net | May 2010

Travel the Globe on Eyetube.net

A beautiful thing about the Internet is that doctors from around the world can easily communicate with each other. For example, Eyetube.net features excellent international videos that are relevant to US eye care professionals. This month’s column highlights a few of those videos, which present challenging cases, showcase new techniques, or preview technologies that are currently on the horizon.

COMPLICATED SURGERY IN ENGLAND
In a series of videos based on Cataract & Refractive Surgery Today’s sister publication’s, Cataract & Refractive Surgery Today Europe, annual cataract complications issue, Brian Little, MD, of London, presents a video titled “Completing Surgery With a Compromised Rhexis.” He focuses on intraoperative techniques used to complete surgery when a capsular tear develops before the nucleus is completely removed (Figure 1) (http://eyetube.net/v.asp?giweni).

NEW TECHNOLOGY IN GERMANY
Another interesting video from the previously mentioned series was submitted by George Waring III, MD, of Atlanta, and Wolfram Wehner, MD, of Nuremberg, Germany. Their video, “Capsular Cleaning to Remove Lens Epithelial Cells,” features the Dodick Nd:YAG laser photolysis instrument (not available in the United States; A.R.C. Laser, Nuremberg, Germany). It appears to be an effective device for cleaning out peripheral lens epithelial cells as well as polishing the central posterior capsule. This technology is just starting clinical trials in Europe (Figure 2) (http://eyetube.net/v.asp?fofege).

NEW TECHNIQUE IN THE NETHERLANDS
“Iatrogenic Zonular Disaster” by Khiun Tjia, MD, of Zwolle, the Netherlands, depicts a fun procedure that viewers are happy to watch and thankful not to perform. Dr. Tjia shares the case of a patient he suspected to have weak zonules. During the procedure, a 180° zonulolysis developed. Dr. Tjia explains his technique of shielding the vitreous from the anterior chamber and successfully removing the remaining nuclear material with torsional ultrasound (Figure 3) (http://eyetube.net/v.asp?kozade).

REFRACTIVE SURGERY IN BELGIUM
Eyetube.net also has numerous videos on the Refractive IOL Channel from international surgeons. For example, Frank Goes Jr, MD, of Antwerp, Belgium, shares a challenging case in which he has difficulty securing the haptics of an Artiflex IOL (not available in the United States; Ophtec BV, Groningen, The Netherlands/Abbott Medical Optics Inc., Santa Ana, CA) to the iris. By removing some excess viscoelastic, Dr. Goes is able to successfully complete the procedure. This video demonstrates how slight variations in one’s usual technique, like placing a small amount of extra viscoelastic, can dramatically influence the progress of a surgical procedure (Figure 4) (http://eyetube.net/v.asp?bichet).

NEW TECHNIQUE IN KOREA
Bong-Hyun Kim, MD, of Seoul, South Korea, provides a video in which he uses an intraocular mirror to aid the examination of areas behind the iris and confirm the final position of the IOL. The mirror also allows for direct visualization of corneal endothelial conditions (Figure 5) (http://eyetube.net/v.asp?misobe).

CONCLUSION
With the numerous international contributions on Eyetube.net, surgeons can get an idea of how doctors all over the globe handle various situations. Viewers can also get a sneak peek of technologies that may one day become available in the United States.

Section editor William B. Trattler, MD, is the director of cornea at the Center for Excellence in Eye Care in Miami and the chief medical editor of Eyetube.net. He is a consultant to Abbott Medical Optics Inc. Dr. Trattler may be reached at (305) 598-2020; wtrattler@earthlink.net.

Section editor Richard M. Awdeh, MD, is the director of technology transfer and innovation and assistant professor of ophthalmology at the Bascom Palmer Eye Institute in Miami. He acknowledged no financial interest in the products or companies mentioned herein. Dr. Awdeh may be reached at (305) 326-6000; rawdeh@med.miami.edu.

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May 2010