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An Update on New Tools and Tactics in the OR

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An Update on New Tools and Tactics in the OR JANUARY/FEBRUARY 2020 VOL. 15, NO. 1 | RETINATODAY.COM Techniques and Technologies An update on new tools and tactics in the OR CLOSING A MACULAR HOLE WITH CAN OCTA REDUCE THE NEED FOR WHAT’S NEW FOR BILLING DROPS INSTEAD OF SURGERY FACEDOWN POSITIONING? AND CODING IN 2020? 0120rt_Cover.indd 1 1/30/20 2:20 PM This is Laser-ablated micro-surface is designed to support atraumatic ILM peel initiation1 Optimized grasping platform and angled tip closure to help mitigate membrane shredding2 GRIESHABER® DSP IMPORTANT PRODUCT INFORMATION Caution: Federal (USA) law restricts this device to sale by, or on the order of, a physician. Indications for Use: GRIESHABER® DSP instruments are a line of single-use vitreoretinal microinstruments which are used in ophthalmic surgery, for cases either in the anterior or the posterior segment. The GRIESHABER® Advanced Backflush Handles DSP are a family of instruments for fluid and gas handling in vitreoretinal surgery. Warnings and Precautions: • Potential risk from reuse or reprocessing GRIESHABER® DSP instruments include: foreign particle introduction to the eye; reduced cutting or grasping performance; path leaks or obstruction resulting in reduced fluidics performance. • Verify correct tip attachment, function and tip actuation before placing it into the eye for surgery. • For light fiber instruments: Minimize light intensity and duration of exposure to the retina to reduce risk of retinal photic injury. The light fiber instruments are designed for use with an ALCON® illumination source. • Good clinical practice dictates the testing for adequate irrigation and aspiration flow prior to entering the eye. If stream of fluid is weak or absent, good fluidics response will be jeopardized. • Use appropriate pressure supply to ensure a stable IOP. • If unwanted tissue gets engaged to the aspiration port, it should be released by interrupting aspiration before moving the instrument. Attention: Please refer to the product labeling for a complete listing of indications, warnings, and precautions. Reference: 1. Data on File. Alcon Laboratories Inc; May 2018. 2. Data on File. Alcon Laboratories Inc; September 2017. © 2018 Novartis 5/18 US-GUS-18-E-1175 US-GUS-18-E-1175 RT.indd 1 1/8/20 10:05 AM This is Designed to: Enhance stability with a continuously open port and CONSTELLATION® Vision System’s IOP compensation1 Reduce pulsatile traction with 20 000 cuts per minute using 25+® and 27+® gauge probes*, 2,3 Improve vitreous flow4 Enable closer access to tissue plane with beveled tip5 *At similar single-blade flow rates MIVS IMPORTANT PRODUCT INFORMATION Caution: Federal law restricts this device to sale by, or on the order of, a physician. Indications for Use: The CONSTELLATION® Vision System is an ophthalmic microsurgical system that is indicated for both anterior segment (i.e., phacoemulsification and removal of cataracts) and posterior segment (i.e., vitreoretinal) ophthalmic surgery. The ULTRAVIT® Vitrectomy Probe is indicated for vitreous cutting and aspiration, membrane cutting and aspiration, dissection of tissue and lens removal. The valved entry system is indicated for scleral incision, canulae for posterior instrument access and venting of valved cannulae. The infusion cannula is indicated for posterior segment infusion of liquid or gas. Warnings and Precautions: • The infusion cannula is contraindicated for use of oil infusion. • Attach only Alcon supplied products to console and cassette luer fittings. Improper usage or assembly could result in a potentially hazardous condition for the patient. Mismatch of surgical components and use of settings not specifically adjusted for a particular combination of surgical components may affect system performance and create a patient hazard. Do not connect surgical components to the patient’s intravenous connections. • Each surgical equipment/component combination may require specific surgical setting adjustments. Ensure that appropriate system settings are used with each product combination. Prior to initial use, contact your Alcon sales representative for in-service information. • Care should be taken when inserting sharp instruments through the valve of the Valved Trocar Cannula. Cutting instrument such as vitreous cutters should not be actuated during insertion or removal to avoid cutting the valve membrane. Use the Valved Cannula Vent to vent fluids or gases as needed during injection of viscous oils or heavy liquids. • Visually confirm that adequate air and liquid infusion flow occurs prior to attachment of infusion cannula to the eye. • Ensure proper placement of trocar cannulas to prevent sub-retinal infusion. • Leaking sclerotomies may lead to post operative hypotony. • Vitreous traction has been known to create retinal tears and retinal detachments. • Minimize light intensity and duration of exposure to the retina to reduce the risk of retinal photic injury. ATTENTION: Please refer to the CONSTELLATION® Vision System Operators Manual for a complete listing of indications, warnings and precautions. References: 1. Irannejad A, Tambat S, Abulon DJK. Retropulsion and mass flow of 27-gauge vitrectomy probes: comparison of dual-blade/flat-tipped probes and single-blade/beveled probes. Poster presented at: 18th Congress of the European Society of Retina Specialists; September 20–23, 2018; Vienna, Austria. 2. Alcon data on file. Alcon Laboratories, Inc; June 2018. 3. Alcon data on file. Alcon Laboratories, Inc; June 2018. 4. Alcon data on file. Alcon Laboratories, Inc; June 2018. 5. Alcon data on file. Alcon Laboratories, Inc; May 2017. ©2019 Alcon 5/19 US-GAU-19-E-0842 US-GAU-19-E-0842 RT.indd 1 1/8/20 10:05 AM EDITORIAL ADVISORY BOARD CHIEF MEDICAL ASSOCIATE Thomas Albini Pravin U. Dugel John W. Kitchens Elias Reichel EDITOR MEDICAL EDITOR Miami, FL Phoenix, AZ Lexington, KY Boston, MA Allen C. Ho Robert L. Avery J. Fernando Arevalo Jay S. Duker Derek Y. Kunimoto Carl D. Regillo Philadelphia, PA Santa Barbara, CA Baltimore, MD Boston, MA Phoenix, AZ Philadelphia, PA Carl C. Awh Jorge Fortun Baruch Kuppermann Kourous A. Rezaei Nashville, TN Miami, FL Irvine, CA Chicago, IL SECTION EDITORS G. William Aylward Thomas R. Friberg Rohit Ross Lakhanpal Philip J. Rosenfeld RETINA PEARLS GLOBAL PERSPECTIVES London, UK Pittsburgh, PA Owings Mills, MD Miami, FL Dean Eliott Albert J. Augustin Caroline R. Baumal Julia A. Haller Theodore Leng Steven D. Schwartz Boston, MA Karlsruhe, Germany Boston, MA Philadelphia, PA Palo Alto, CA Los Angeles, CA Ingrid U. Scott Ehab El Rayes Rubens Belfort Jr. Tarek S. Hassan Xiaoxin Li Carol L. Shields Hershey, PA Cairo, Egypt São Paulo, Brazil Royal Oak, MI Beijing, China Philadelphia, PA Audina M. Berrocal Stanislao Rizzo Miami, FL Jeffrey Heier Jordi M. Mones Richard F. Spaide BUSINESS MATTERS Boston, MA Barcelona, Spain New York, NY Florence, Italy María H. Berrocal Alan Ruby S.K. Steven Houston III Andrew A. Moshfeghi Ramin Tadayoni Royal Oak, MI San Juan, Puerto Rico Lihteh Wu Lake Mary, FL Los Angeles, CA Paris, France San José, Costa Rica David M. Brown MEDICAL RETINA Houston, TX Jason Hsu Timothy G. Murray Sjakon George Tahija Philadelphia, PA Miami, FL Jordana G. Fein FELLOWS’ FOCUS David S. Boyer Jakarta, Indonesia Fairfax, VA Thomas Jenkins Los Angeles, CA Michael Ip Anton Orlin Nadia Waheed Los Angeles, CA New York, NJ Boston, MA Heeral R. Shah Philadelphia, PA Robison V. Paul Chan Chicago, IL Glenn J. Jaffe Yusuke Oshima Joplin, MO George A. Williams Ravi Pandit Steve Charles Durham, NC Osaka, Japan Royal Oak, MI EYETUBE RETINA CHIEF Philadelphia, PA Memphis, TN Kazuaki Kadonosono Kirk H. Packo Charles C. Wykoff Michael A. Klufas David Xu Allen Chiang Yokohama City, Japan Chicago, IL Houston, TX Philadelphia, PA Philadelphia, PA Philadelphia, PA Peter K. Kaiser Jonathan L. Prenner Young Hee Yoon David R. Chow Cleveland, OH New Brunswick, NJ Seoul, South Korea VISUALLY SPEAKING Mississauga, Canada Richard S. Kaiser Aleksandra Rachitskaya Manish Nagpal Kim Drenser Philadelphia, PA Cleveland, OH Gujarat, India Royal Oak, MI Szilárd Kiss Ehsan Rahimy New York, NY Palo Alto, CA BUSINESS David Levine, Executive Vice President, Stephen Daily, Executive Editor, News Digital & Custom Media +1 484 581 1871; [email protected] David Cox, President/Cofounder +1 609 933 6799; [email protected] +1 484 581 1814; [email protected] Cara Deming, Director, Special Projects Laura O’Connor, Director, +1 484 581 1889; [email protected] Adam Krafczek Jr, Esq, Cofounder Market Analysis & Strategy +1 484 581 1815; [email protected] +1 484 581 1860; [email protected] ART/PRODUCTION Tamara Bogetti, MBA Alvin Fu, Senior Director, Analytics & Technology Executive Vice President/Group Publisher +1 484 581 1888; [email protected] John Follo, Creative/Production Director +1 714 878 0568; [email protected] +1 484 581 1811; [email protected] Janet Burk, Publisher Dominic Condo, Art/Production Director +1 214 394 3551; [email protected] EDITORIAL +1 484 581 1834; [email protected] Gaynor Morrison, Scott Krzywonos, Editor-in-Chief Joe Benincasa, Digital Art Director Vice President, Sales +1 484 581 1880; [email protected] +1 484 581 1822; [email protected] +1 484 581 1836; [email protected] Katie Herman, Associate Editor Rachel McHugh, Associate Art Director Barbara Bandomir, Vice President, Operations +1 484 581 1897; [email protected] +1 484 581 1853; [email protected] +1 484 581 1810; [email protected] Tim Donald, ELS, Consulting Editor Camela Pastorius, CMP, Vice President, [email protected] Meetings &
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