Bimanual Microincision Cataract Surgery with Stellaris Advanced Flow Module

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Bimanual Microincision Cataract Surgery with
Stellaris Advanced Flow Module

• Mark Packer, MD, FACS
• Clinical Associate Professor
• Oregon Health Science University

Financial Interest Consultant-Advanced Medical
Optics, Inc. Advanced Vision Science, Inc.
Bausch Lomb, Inc. Carl Zeiss Meditec, Inc.
Carl Zeiss Surgical GmbH Celgene Corporation
Gerson Lehman Group, Inc. Ista Pharmaceuticals,
Inc.i-Therapeutix, Inc. Johnson Johnson
Vision Care, Inc. Leerink Swann Company
Sirion Therapeutics, Inc. Transcend Medical,
Inc. Visiogen, Inc. VisionCare, Inc. WaveTec
Vision Systems. Travel Honoraria Endo Optiks,
Inc
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Purpose

• To assess facility of use, safety and efficacy of
  the Stellaris Vision Enhancement System for
  bimanual microincision cataract surgery

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Method

• 30 unselected eyes of 26 patients presented for
  cataract surgery
• Pre-existing pathology other than cataract
• Pseudoexfoliation glaucoma 1
• Strabismus/amblyopia 2
• Epiretinal membrane 2
• Pigment dispersion syndrome 1
• Previous ocular surgery
• S/P LASIK 4

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Patient Profile

• 13 women, 13 men
• Mean age 64.2 8.3 years
• Mean nucleus 1.4 NS

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Technique

• Bimanual microincision cataract surgery
• Temporal clear corneal incisions, 1.4 mm
• Trapezoidal diamond blade
• 20 g irrigating chopper, 30º straight phaco tip
• LRIs performed prior to IOL insertion
• 90 depth, 10 mm OZ, Nichamin nomogram
• IOL implanted via 3rd incision, 2.2 2.8 mm

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IOL Selection Astigmatism

• 40 Presbyopia correcting IOLs
• 45 ReZoom
• 36 crystalens
• 18 ReStor
• 53 Cornea customized aspheric IOLs
• 56Tecnis
• 25 IQ
• 19 AO
• 30 Limbal relaxing incisions

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Intra-Op Outcomes

• Mean surgery time start to end 19.7 5.5 min
• Mean effective phaco time 0.77 1.58 sec
• Average phaco power 2.04 2.25

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Post-Op Outcomes

• 20/30 mean uncorrected acuity 2 24 hours
  post-op
• Excluding eyes with pre-existing pathology and
  prior surgery
• 75 20/40 or better 63 20/30 or better
  
  53 20/25 or better 32 20/20
  or better
• No complications 

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Summary

• 30 consecutive eyes operated with the
  Stellaris,10/4/07 to 2/14/08.
• Mean age 64 years.
• Average nucleus 1.4 NS. 
• 40 had presbyopia correcting IOLs (45 ReZoom,
  36 crystalens, 18 ReStor)
• 30 had LRIs
• 53 has corneal-customized aspheric IOLs
  (56Tecnis, 25 IQ, 19 AO)      

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Conclusion

• Stellaris with advanced flow module is efficient,
  safe and effective for bimanual microincision
  cataract surgery