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                 20-23 May
               Dear Colleagues,
               the 7th SOI International Congress, which is taking place these days in Rome, from May 20th to 23rd at the
               Rome Cavalieri Hotel, fulfils an intuition which has gradually developed during the previous editions.
               The SOI Congress which takes place in May is, par excellence, dedicated to a specialized in-depth
               analysis and to a debate with overseas countries.
               The first day of the Congress, Wednesday, starts with the Subspecialty Day, specialized sessions entirely dedi-
               cated to Glaucoma, Retina and Cornea, fundamental issues for an updating of the profession. Dealt with

               during the whole day and with the most thorough update, they represent a moment of study, of in-depth
               analysis, of confrontation on the new frontiers in this field. Furthermore, two poster as well as dedicated com-
               munications sessions have been included. The following days are characterized both by moments of
               International confrontation with Symposia and Sessions – just to highlight a couple, the SOI-OSN-AICCER Joint
               Meeting and the connection with live surgery – as well as by institutional seminars presented by SOI and by
               other significant associations in the oculistic field.
               On the occasion of this international edition of the Soi Congress, for the first time the Association opens a
    2          debate on two of the most important issues in the Italian ophthalmological field: Note 78 and Anti
               Angiogenetics drugs. These topics will be tackled by a panel of speakers during the SOI Round Table, on
               Thursday 21 May 2009 at 16.15 in Sala Cavalieri. The meeting will be attended by Sen. Cesare Cursi, Sen.
               Luigi D’Ambrosio Lettieri, Hon. Giuseppe Palumbo and Dr. Carlo Tomino, on behalf of Government as well as
               reference bodies.
               The SOI International Congress presents a rich scientific programme, which also includes 20 Educational
               Courses, 19 Symposia and 3 Sessions completely dedicated to Posters and oral Papers on more general inte-
               rest topics.
               This Congress offers a highly specialized training. Accredited with CMEs, it is a place where interaction and
               debate between the Italian ophthalmological specialists takes place, together with the greatest Italian and
               international experts.
               To this end, we would like to remind the masterly lectures that two among the most important ophthalmo-
               logists in the world will hold on Friday. Stanley Chang and Roger Steinert - respectively awarded the Gian
               Battista Bietti Medal Lecture “Optic Nerve Anomalies and Retinal Detachment” and the Benedetto Strampelli
               Medal Lecture “The Pursuit of Implants to Correct Presbyopia”. For the first time in Italy, these two eminent
               professors will honour the Soi Congress with their presence.
               Absolute 2009 novelty: the consultation of the posters in programme in an electronic format. As a matter of
               fact, there will be a dedicated room with PCs to view and analyse over 30 Posters, together with photos and
               This year, in order to favour a greater adhesion, the Congress will be completely free for the SOI mem-
               bers with the 2009 paid-in dues. There will be no further costs, neither for the registration to the
               events, nor for the participation to the Subspecialty days and all the educational courses.
               The SOI Members are invited to remember an important appointment: the General Meeting of Members
               at 18.00, on Thursday 22 May in Sala Cavalieri. Among others, it will make a decision on a fundamental
               issue on the agenda: the proclamation of the 2008 SOI electoral results or the annulment of the 2008 SOI
               electoral results, with the consequent summoning of new elections.
               As usual, ample space will be given to the exhibition area, for an updating and a useful confrontation on
               the latest news in terms of design, equipment and pharmacological therapy.
                                                                                           The SOI – AMOI Board of Directors
                                                                SOI BOARD OF DIRECTORS AND SCIENTIFIC CONSULTANTS
SOI Board of Directors
Scientific Committee
Prof. Corrado Balacco Gabrieli
Deputy Vice-President
Dott. Antonello Rapisarda
Dott. Antonio Mocellin
Treasurer Secretary
Dott. Matteo Piovella
Dott. Alberto Montericcio
Dott. Marco Borgioli
Dott. Roberto Dossi
Prof. Leonardo Mastropasqua
Dott. Vincenzo Sarnicola
Dott. Sergio Zaccaria Scalinci
Prof. Giovanni Scorcia
Dott. Giorgio Tassinari
Dott. Sandro Vergani
Dott. Carlo Maria Villani                                                  3
Dott. Lucio Zeppa
Auditors of Effective Accounts
Dott. Sen. Rosario Giorgio Costa
Prof. Gian Primo Quagliano
Dott. Luca Capoano
Auditor of Temporary Accounts
Dott. Danilo Mazzacane

                                   SOI Scientific Consultants
                                   Dott. Fabrizio Camesasca
                                   Dott. Luigi Conti
                                   Dott. Luigi Fontana
                                   Dott. Rosangela Lattanzio
                                   Prof. Giorgio Marchini
                                   Dott. Antonio Marino
                                   Dott. Vincenzo Maurino
                                   Prof. Edoardo Midena
                                   Dott. Mario Nubile
                                    A.D.M.O.I.                                      A.S.M.O.O.I.
                                    Association of Italian Ophthalmic Medical       Italian Ophthalmologist and Orthoptist
                                    Directors                                       Association
                                    President: G. Tassinari                         President: C.M. Villani
                                    Secretary: P. Troiano                           Secretary: M. Piovella

                                    Ophthalmic Foundation of Polyclinic             Via dei Mille, 35 – 00185 Roma
                                    of Milan IRCCS                                  Tel./Fax +39 06 4434015
                                    Via M. Fanti, 6 – 20122 Milano
                                    e-mail:              G.I.S.I.
                                                                                    Italian Study Group of Limited Eyesight
                                    A.I.C.C.E.R.                                    President: L. Cerulli
                                    Italian Cataract and Refractive Surgery         Secretary: P. Iorio
                                    Association                                     San Salvatore Ophthalmic Clinical Hospital
                                    President: A. Caporossi                         67018 L’Aquila
                                    Scientific Secretary: P. Vinciguerra
                                    Administrative Secretary: V. Orfeo              O.P.I.
                                    Via S. Lucia, 143 – 80132 Napoli                Oculists of Private Italian Hospitals
                                    Tel. +39 081 7640029 – Fax +39 081 7644843      President: G. Lesnoni
                                    e–mail:                     Secretary: F. D’Arrigo
                                                                                    Via Ugo Bassi Is. 157, n. 91 – 98122 Messina
                                    A.I.E.R.V.                                      Tel. +39 090-2922926 – Fax +39 090-2923890
                                    Association International pour l’Enfance        e–mail:
                                    et la Réhabilitation Visuelle
            4                       22, ch. Beau-Soleil – CH 1206 Genève (Suisse)   S.I.Co.M.
                                    President: I. Molnar                            Italian Society of Medical Contact Lenses
                                    Secretary: M. Fortunato                         President: P. Troiano
                                    Viale Medaglie d’Oro, 40 – 00136 Roma           Secretary: E. Bonci
                                    Tel./Fax +39 06 39742614                        Ophthalmic Foundation of Polyclinic
                                    e-mail: –            of Milan IRCCS
                                                                                    Via M. Fanti, 6 – 20122 Milano
                                    A.I.La.R.P.O.                                   e-mail:
                                    Italian Association of Laser and      
                                    Radiofrequency in Ophthalmic Plastic Surgery
                                    President: F. Dossi                             S.I.C.O.P.
                                    Secretary: G. Aimino                            Italian Society of Ophthalmic Plastic Surgery
                                    Corso Vittorio Emanuele II, 14 – 10123 Torino   President: G.B. Frongia
                                    Tel. +39 011 88400 – Fax +39 011 888028         Secretary: F. Quaranta Leoni
                                    e-mail:                       Via Archimede, 201 – 00197 Roma
                                                                                    Fax +39 06 8082196
                                    A.I.O.L.                                        e-mail:
                                    Italian Academy of Legal Ophthalmology
                                    President: D. Siravo
                                    Secretary: P. Troiano                           S.I.E.T.O.
                                    Ophthalmic Foundation of Polyclinic             Italian Society of Ergo-ophthalmology and
                                    of Milan IRCCS                                  Ocular Traumatology
                                    Via M. Fanti, 6 – 20122 Milano                  President: V. De Molfetta
                                    e-mail:              Ergo-ophthalmology Secretary: V. Bongiorno
                                                                                    Traumatology Secretary: M. Borgioli
                                                                                    Viale Martiri della Libertà, 57 – 62100 Macerata
                                                                                    Tel. +39 0733 236493 – Fax +39 0733 237977
Benedetto Strampelli Medal Lecture 2005
History of Intra Ocular Implant: the Role of an Italian Genius
Pier Enrico Gallenga

Benedetto Strampelli Medal Lecture 2006
Cataract Surgery in the Glaucoma Patient
Richard L. Lindstrom

                                                                                                                     MEDAL LECTURES
Benedetto Strampelli Medal Lecture 2007
Intraoperative Floppy Iris Syndrome
David F. Chang

Benedetto Strampelli Medal Lecture 2008
Phacoemulsification in Difficult and Challenging Cataract Cases
I. Howard Fine

Benedetto Strampelli Medal Lecture 2009
The Pursuit of Implants to Correct Presbyopia
Roger F. Steinert
Dr Steinert is currently Chair of the department and Director of the Gavin Herbert Eye Institute at the
University of California, Irvine, where he holds joint appointments as Professor of Ophthalmology and
Professor of Biomedical Engineering. He combines a consultative practice in cataract, refractive, and corneal
surgery with teaching and translational laboratory research in these fields. He has authored or co-authored
four textbooks, including the definitive text, Cataract Surgery, which is in its third edition. He has published
over 120 peer-review journal scientific articles and over 70 book chapters. Dr. Steinert is a member of the
Executive Committee of the American Society of Cataract and Refractive Surgery (ASCRS) and became
President of that society in April 2005, as well as Chair of the Annual Program, a position is currently fills. He
serves as Associate Editor of Ophthalmology, the journal of the American Academy of Ophthalmology
(AAO), and serves on the editorial boards of the Journal of Cataract and Refractive Surgery and Ophthalmic
Surgery, Lasers, and Imaging. He has presented 10 named lectureships, including the 2004 Binkhorst Lecture
at ASCRS and the 2008 Barraquer Lecture at AAO. Dr. Steinert serves as medical monitor of several FDA
trials. He holds seven U.S. and numerous international patents. He has received the Senior Honor Award of
the American Academy of Ophthalmology and has been selected by his peers for inclusion in every edition
of Best Doctors in America and America’s Top Doctors. Ophthalmology Times named him one of the top 100
ophthalmologists in North America.
Dr. Steinert earned his medical degree from Harvard Medical School, having graduated summa cum laude
from Harvard College. He served his residency at Harvard Medical School’s Massachusetts Eye and Ear
Infirmary and rose through the ranks of the Harvard faculty until being recruited to UCIrvine.
                 Gian Battista Bietti Medal Lecture 2006
                 Congenital Glaucoma Management
                 Roberto Sampaolesi

                 Gian Battista Bietti Medal Lecture 2007
                 Advances in Ultrasound Evaluation of the Eye for the Vitro-Retinal Surgeon
                 D. Jackson Coleman

                 Gian Battista Bietti Medal Lecture 2008
                 Surgical Technique for Suture Fixation of an Acrylic Intraocular Lens
                 in the Absence of Capsule Support
                 Walter J. Stark

                 Gian Battista Bietti Medal Lecture 2009
                 Optic Nerve Anomalies and Retinal Detachment
                 Stanley Chang
                 Stanley Chang, MD, is the Edward S. Harkness Professor and Chairman of Ophthalmology at Columbia
                 University. He is also the K.K. Tse and Ku Teh Ying Professor of Ophthalmology. Dr. Chang obtained a
                 bachelor of science in electrical engineering from Massachusetts Institute of Technology. After a Masters
                 degree in Biomedical Electronic Engineering at the University of Pennsylvania, he completed his medical
                 education at the College of Physicians & Surgeons of Columbia University. After ophthalmology residency at
                 Massachusetts Eye and Ear Infirmary, he was a vitreoretinal fellow at the Bascom Palmer Eye Institute. Dr.
                 Chang joined the faculty of Department of Ophthalmology at Cornell University Medical School in 1979,
                 where he became Professor of Ophthalmology in 1994. Appointed the Edward S. Harkness Professor and
                 Chairman of the Department of Ophthalmology in 1995, he also serves as director of the Edward S. Harkness
                 Eye Institute.
                 Dr. Chang has developed and pioneered several revolutionary surgical approaches to treat complicated forms
                 of retinal detachment, improving outcomes for patients worldwide. He was the first to use perfluoropropane
                 gas in the management of retinal detachments caused by scar tissue proliferation (PVR) on the retina. This
                 gas is the most frequently used gas in vitreoretinal surgery. He developed perfluorocarbon liquids, a ‘heavy
                 liquid’ used in flattening retinal detachment, and the related surgical techniques for vitreoretinal surgery. In
                 collaboration with Avi Grinblat, he developed a panoramic viewing system and led in the worldwide
                 adaptation by retina surgeons to this technique. He is the recipient of several honors including the Hermann
                 Wacker Prize from the Club Jules Gonin, Helmerich Prize from the American Society of Retinal Specialists, the
                 Senior Honor Award and the Secretariat Award from the American Academy of Ophthalmology, the Jackson
                 Lecture and the Alcon Research Institute Award. Consistently named as one of America’s best doctors, Dr.
                 Chang was recently recognized as one of three physicians selected as National Physician of the Year by the
                 Castle Connolly Guides (2008).
                                                                                                                         SOI AWARD "A LIFE SPENT SERVING OPHTHALMOLOGY"
SOI Award “A life spent serving ophthalmology” 2006
Bruno Monfrini

SOI Award “A life spent serving ophthalmology” 2007
Victor Manuel Dias Ferreira

SOI Award “A life spent serving ophthalmology” 2008
James V. Mazzo

SOI Award “A life spent serving ophthalmology” 2009                                                                                 7
Giuseppe Benanti
Chairman and CEO of SIFI SpA
After obtaining a degree in pharmacology, Giuseppe Benanti was hired by SIFI, founded in 1935 by his father,
Antonino Benanti as well as by Carmelo Chines. Since then, with commitment, passion, obstinacy and far-
sightedness, he has promoted and guided the growth of the company from being a simple lab to an
international level firm. He started his career as a pharmaceuticals representative, then for 7 years he was
Marketing and Sales Director. In 1977 he became a member of the Board of Directors and, in 1984, he
started chairing it. His ongoing aspiration towards excellence is reflected in the developing successes which
has marked the growth of the company, that is today a leader on the Italian market and present in 15
countries round the world.
At present SIFI displays an evolved industrial production and is the first firm in Europe offering an integrated
approach in the EyeCare field: from the research to the production and marketing of drugs, to the definition
of new diagnosis and surgery tools for the most widespread ocular pathologies.
SIFI can boast of being among the most advanced production plants in Europe. The company invests nearly
14% of its turnover in Research & Development and in the last few years it has promoted some projects with
a high scientific value. The first result is a newly-build plant for the production of intraocular lenses for
cataract surgery, which is the outcome of a research project called ‘Waterfall’, in which SIFI cooperates with
INAF (Astrophysics Italian Institute) as well as with LAMSUN (Laboratory for molecular surfaces and
nanotechnologies of the University in Catania). SIFI Diagnostics SpA, a company of the Group dedicated to
the development and marketing of ocular diagnostics tools can be placed in the same framework.
In 2006, on the occasion of the hundredth birthday of the SIFI Founders the Fondazione SIFI – Benanti e
Chines was created: it promotes initiatives in the cultural, ethical as well as social fields. Its first and important
initiative was the foundation of an advanced ophthalmic surgery ward in Madagascar. A publishing company
was also created, which is specialized in scientific texts focused on ophthalmology. For 40 years, it has been
publishing the magazine “L’Oculista Italiano” (The Italian Ophthalmologist), which is a reference point for all
the EyeCare specialists in Italy.
                            Mario Gelsomino SOI Award 2006
                            Bruno Michelone
                                                                                                                      Mario Gelsomino

                            Mario Gelsomino SOI Award 2007

                            Luigi Colangelo

                            Mario Gelsomino SOI Award 2008
                            Michele Illiano

         8                  Mario Gelsomino SOI Award 2009
                            Sonia De Francesco
                            Sonia De Francesco was born in San Lucido (CS) on 20 October 1975. She earned her MD degree from the
                            University of Siena where she completed her ophthalmology residency. Her main topic is retinoblastoma. She
                            has contributed to more than 40 articles published mainly in the area of ocular tumors. Her current main
                            area of both laboratory research and clinical is focusing on the diagnosis and treatment of retinoblastoma.
                            Dr. De Francesco is a member of the Italian Society of Ophthalmology (SOI), the Italian Society of Pediatric
                            Ophthalmology (SIOP), the Italian Society of Ocular Oncology (SIOO), the Italian Association of the Pediatric
                            Oncology - Hematoly (AIEOP), the European Society of Ophthalmology (SOE), the European Association for
                            Vision and Eye Research (EVER), the European Scientific Institution (ISE), International Society of Ocular
                            Oncology (ISOO). She is a scientific member of the Italian Association of Retinoblastoma parents (AIGR).
                            Diplomas and certificates: 1994-2000: Medical student, University of Siena; 2001-2005: Resident in
                            Ophthalmology, University of Siena; 2005-2006: National Course of Ocular Ultrasonography; 2006: Ocular
                            Oncology Master, University of Sacro Cuore, Rome; 2005-2008: Doctor’s degree in degenerative, involutive
                            and neoplastic ocular and orbital diseases, University of Siena; 2008: Annual Scientific Project about “Orbital
                            implants in patients enucleated for Retinoblastoma” the Department of Ophthalmology, University of Siena
                            She completed her medical fellowship at Bejing University (CHINA, 2007), at the Sloan Kettering and at Weil
                            Cornell Hospitals di New York (2008).
                            Scientific projects (2000-2009): 2000: Web site creation for retinoblastoma (C.R.I.S.A.T.O.); 2001:
                            Therapeutic conservative strategies in retinoblastoma; 2002: Genetics in ocular tumors; 2003: Therapeutic
                            protocols in retinoblastoma: guide-lines; 2004: Benign and malignant retinal tumors in childhood; 2005:
                            Retinal tumors in childhood; 2006: Retinoblastoma risk factors for metastatic disease; 2006: Genetic
                            modifiers in varying retinoblastoma expressivity; 2007: Shape and size of corioretinal scar after Trans-pupillary
                            termotherapy (TTT) in retinoblastoma; 2008: Risk factors identification of complications after enucleation for
                            intraocular tumors; 2008: New conservative treatment for retinoblastoma: local Chemotherapy; 2009: New
                            conservative therapies in retinoblastoma: Direct intraarterial (ophthalmic artery); chemotherapy with
                            melphalan for intraocular tumors.
                            Publications: 45 papers in major international journals, 5 papers in Italian language.
                            Several oral communications or posters in Italian or international meetings (many as first author).
                            Prizes and grants: 2001: prize SIOP (Italian Society of Pediatric Ophthalmology) for the best poster; 2007:
                            First Medal: Pioneer in Ocular Oncology, ISOO (International Society of Ocular Oncology).
SOI Outstanding Humanitarian Service Award 2008

                                                                                                               SOI OUTSTANDING HUMANITARIAN SERVICE AWARD
Alessandro Pezzola

                                                                                                                     SOI HONORARY AWARD IN OPHTHALMOLOGY
SOI Outstanding Humanitarian Service Award 2009
The SOI Board of Directors has decided to devolve the prize money
to contribute towards an ophthalmic support in favour of the victims
of the earthquake in Abruzzo.

SOI Honorary Award in Ophthalmology 2008
H. Dunbar Hoskins, Jr.

SOI Honorary Award in Ophthalmology 2009
Mary D’Ardis
Mary D’Ardis is Chief Executive Officer of the European Society of Cataract and Refractive Surgeons. She has
held this position since 1998. Prior to that Mary was Managing Director of Agenda Communications, a
professional congress organising company, which took over the Managements of the ESCRS in 1991.
For the previous ten years, Mary held the position of Public Relations Executive at the Health Education
Bureau, the national agency with responsibility for Health Education in Ireland.
                      Congress Venue
                      Hotel Rome Cavalieri Congress Centre
                      Via Cadlolo, 101 – 00136 Rome – Tel. +39 06 35091
                      Scientific Secretariat
                      S.O.I. Board of Directors
                      Via dei Mille, 35 – 00185 Roma – Tel. +39 06 4464514 – 06 44702826 – Fax +39 06 4468403
                      Organizing Secretariat
                      Congressi Medici Oculisti Srl
                      Via dei Mille, 35 – 00185 Roma – Tel. +39 06 4464514 – Fax +39 06 4468403
                      Hotel booking
                      Studio Schiavo
                      Via Tiburtina, 325 – 03100 Frosinone – Tel./Fax +39 0775 871538

                      Press Office
                      Monica Assanta

                      In order to participate in the 7th SOI International Congress, in the exhibition area as well as in all the
                      congress events, it is necessary to be a member of the Society, up to date with the annual dues.
                      The registration desk is open at the following hours:
                      • Tuesday 19 May                        hours 6.00 pm - 8.00 pm
                      • Wednesday 20 May                      hours 8.00 am - 7.00 pm
10                    • Thursday 21 and Friday 22 May         hours 7.30 am - 7.00 pm
                      • Saturday 23 May                       hours 7.30 am - 1.00 pm

                                                           PARTICIPATION REGISTRATION FEE
                      • SOI members (up to date with the 2009 annual dues)                                                    d     0,00
                      • Non-Ophthalmologist medical specialists (upon presentation of specialization certificate)             d   250,00
                      • Non-SOI members Ophthalmologists (upon presentation of specialization certificate)                    d   550,00
                      • Students in medicine and orthoptics (upon presentation of a certificate proving their student status) d     0,00
                      • Biologists, Orthoptists, Operating Room Assistants
                        (upon presentation of a certificate proving their qualification)                                      d   100,00
                      • Non-SOI members foreign Ophthalmologists                                                              d   180,00

                      Subspecialty Day
                      Retina Day             Glaucoma Day                Cornea Day
                      • SOI Members (up to date with the 2009 annual due)                                                   d       0,00
                      • Ophthalmologists, not SOI Members (upon presentation of specialization certificate)                 d       0,00
                      • Non-SOI members foreign Ophthalmologists                                                            d       0,00

                      • SOI institutional courses (for members only)                                                        d       0,00
                      • Educational courses                                                                                 d       0,00
                      • ASOC Course                                                                                         d      60,00
                      • N. 1 daily buffet lunch coupon (subject to availability)                                            d      35,00
                      • N. 2 daily buffet lunch coupon (for 2 congress days, subject to availability)                       d      63,00
                      • N. 3 daily buffet lunch coupon (for 3 congress days, subject to availability)                       d      95,00
                                                PAY M E N T
The above-mentioned fees should be paid to Congressi Medici Oculisti Srl as follows:
• Current account check made out to Congressi Medici Oculisti Srl
• Cash
• Bancomat card
• Credit cards: Visa, Master Card, American Express

• Ordinary Member (by 31st January of the current year)*                                             d     500,00
• Meritorious Supporting Member                                                                      d     700,00
• Postgraduate Students and Attending Doctors                                                        d     200,00

                                                                                                                          GENERAL INFORMATION
• Foreign Ophthalmologists (with residence and professional activity abroad)                         d     200,00

* After 31 January only the Meritorious Supporting Members will keep on paying the amount of 700
New members and members who have not paid the annual due for 2 years will pay 500 Euros.
The Meritorious Supporting Member fee includes the following benefits:
• accident policy (limited to the participation to the two annual congresses)
• policy in the driving field, offering a contribution for updating courses as well as for the reacquisition of driving
  license points
• suitable legal tutelage in case of car accidents.
In all the SOI Congresses, Meritorious Supporting Members can collect their badge as well as their congress bag at            11
the dedicated desk.

How to register with SOI
Documents to attach to the application form for the Italian Society of Ophthalmology
1. Certificate of Specialization or registration at the School of Specialization in Ophthalmology.
   Declaration of equivalence of degree as well as of professional qualification in Italy for foreign ophthalmolo-
   The “Expert in Ophthalmology” should attach a personal CV.
2. Settlement of registration fee.
The payment of the 2009 annual due can be settled as follows:
• Current account check made out to SOI
• Cash
• Bancomat card
• Credit cards: Visa, Master Card.

Continuing medical education programme – Acquiring credits
Participation to the 7th SOI International Congress entitles participants to acquire the credits established by the
Ministry of Health. All planned courses are considered part of the official programme and therefore complete the
Continuing Medical Education programme in ophthalmology. Credits will be assigned on the basis of the effective
presence, controlled by electronic bar code check of the badge.
EACCME credits (which can be converted to AMA PRA credit by contacting AMA) have been requested.

The speakers will have 7 minutes available for their presentation.

This edition of the Congress includes a great novelty: the accepted posters can be consulted only in elec-
tronic format. In Sala S. Giorgio a computer will be available for the congress participants who wish to
view and analyse the posters.
                      Poster presentations for the electronic consultation will be taken care of by the authors. They can contain photos
                      as well as explanations (1 slide, 3 minutes maximum).
                      Technical characteristics
                      • the electronic Posters presentations must be created in Power Point office 2003 or 2007 for Window (including
                         all the attached images, with audio and films);
                      • maximum of 12 slides;
                      • every slide can contain a maximum of 4 photo slides + 1 3-minute film;
                      • limited weight of the entire file, for a correct vision on a 17” monitor.
                      Posters will be discussed during the dedicated sessions. Their authors will have 3 minutes to present their work.

                      Once the congress registration fee has been settled, each participant will receive a personal name badge with

                      photo*. The badge is not transferrable (otherwise annulled) and it must be worn in a visible way. The badge will
                      enable the participant to access the exhibition and congress area, through the reading of its bar code. Any badge
                      duplication will automatically entail its annulment and will cost 25,00 Euros.
                      The badges will be marked as follows:
                      R RETINA DAY                             Participants                      Staff
                      G GLAUCOMA DAY                       E Exhibitors                          Board of Directors
                      C CORNEA DAY

                      * Photo desk: participants who have not received the new badge with photo are invited to go to the photo desk.

                      Booking the Sessions
                      Registered participants have the right of way to access the conference rooms by arriving 10 minutes before the
12                    beginning of the session with the coupon they will receive together with the nominative badge. After this deadli-
                      ne, the access to the rooms will be free, till the maximum capacity allowed by security rules.

                      Congress kit
                      All registered participants in the congress will be given:
                      • A badge, indispensible to enter and circulate in the exhibition and congress area
                      • The book “Quaderno di Oftalmologia”
                      • Certificate of participation
                      • Congress bag
                      • CME documentation.

                      Certificate of Participation
                      The certificate of participation is only valid for fiscal reasons. It will be issued upon personal request and only for
                      the effective days of attendance.

                      A technical-scientific exhibition will be set up in the congress area. It can be visited by all the registered participants
                      with a badge. Exhibitors can collect their badge at the exhibitor’s desk.

                      All the congress participants who have adhered to the “buffet lunch package” will receive their coupons together
                      with their badge. Furthermore, it will be possible to purchase single-meal coupons at the registration desk. Each
                      meal will cost 35,00 Euros. A 10% discount will be applied to those who purchase at least two lunches.

                      There is a free cloakroom service provided by the Rome Cavalieri Hotel at the entrance of the exhibition area.

                      Hotel Booking
                      Studio Schiavo has been assigned the task of preempting a certain number of rooms for participants and exhibi-
                      tors. At the Congress venue Studio Schiavo can be contacted at its desk.

                      Shuttle Service
                      Hotels booked through the Secretariat office will be linked to the Congress centre, in the morning for the begin-
                      ning of the sessions and in the evening at the end of the scheduled meetings.
                                       I N F O R M AT I O N F O R S P E A K E R S
  • All the Congress rooms will have a 1024x768 (XGA resolution) computer-projector, as well as a DVD video
    projector. Slide or VHS projectors are not foreseen.
  • Speakers are requested to go to the speakers ready room at least three hours before their presentation,
    hand to the technicians a copy of their work on CD, DVD and their USB Memory stick. The work can also
    be downloaded from one’s own PC at the speakers ready room
  • Personal PCs can only be used at courses.
  • Speakers are advised to have a copy of one’s work on CD, DVD and USB Memory stick and to verify with
    the technicians of the speakers ready room the compatibility with the equipment at the congress. Speakers
    should be in their allocated rooms at least 30 minutes before they are due to start.
  • The work should be prepared on MS Power Point 2003 (Office 2003) and “*.pdf” (Adobe Acrobat) files,

                                                                                                                             GENERAL INFORMATION
    suitable to be visualized with a 1024x768 (XGA) resolution.
  • All the congress positions (PCs in speakers ready room and PCs in congress rooms) will have the latest
    updated version of OFFICE 2003 and the most widely diffused video codecs: MPEG-2, DivX, Intel INDEO
    and Cinepak. The speakers who present a video with a codec, that has not been specified above, should
    provide the technicians with their codec installation file to enable them to install it. This will guarantee the
    visualization of the videos in Power Point.
  • For MAC users: save the work in Power Point. For films included in the presentation select the “Quick time”
    option to save the film in “*.mpeg 1 (2)”,“*.DIVx”, o “*.avi”. The speakers are asked to verify the com-
    patibility of their work at the speakers ready room at least three hours before their presentation.
  • It is not possible to project a film and a PC presentation simultaneously as each room will only have one
    projector to show either a film or a PC presentation at any given session.
Speakers ready room
There will be two Speakers Ready Rooms: Sala Giselle for the programmes in Sala Cavalieri and Sala Pisa for the
programmes that will be held in all the other rooms.
The service will be available at the following hours:
• Tuesday 19 May                             from 6.00 pm to 8.00 pm
• Wednesday 20 May                           from 8.00 am to 7.00 pm
• Thursday 21 and Friday 22 May              from 7.30 am to 7.00 pm
• Saturday 23 May                            from 7.30 am to 1.00 pm

Simultaneous translation
An English-Italian translation service will be provided for the International sessions in Sala Cavalieri (Plenary Hall) on
Thursday 21, Friday 22 and Saturday 23 of May 2009. Furthermore, an Italian-Portuguese translation service will
be provided on the occasion of the “Symposium based on Brazilian and Italian Scientific Cooperation”.
                        WEDNESDAY 20 MAY
                        RETINA DAY                             Sala Cavalieri
                        GLAUCOMA DAY                           Sala Belle Arti
                        CORNEA DAY                             Sala Ellisse

                        THURSDAY 21 MAY
                                                     Sala Cavalieri - h. 9.30 am

                                               SYMPOSIUM BASED
                                                    Sala Cavalieri - h. 4.15 pm
                               SOI ROUND TABLE – “NOTE 78 AND ANTI AGIOGENETICS”
                                Sen. Cesari Cursi, Sen. Luigi D’Ambrosio Lettieri, On. Chiara Moroni
                                            On. Giuseppe Palumbo, Dott. Carlo Tomino

14                      FRIDAY 22 MAY and SATURDAY 23 MAY
                                                           Sala Cavalieri
                                  14th   ANNUAL JOINT MEETING OF SOI, OSN & AICCER
                                Live surgery from the Ophthalmic Department “Ospedale Britannico”
                                          of the San Giovanni Addolorata Hospital in Rome

                        THURSDAY 21 MAY
                                                      Sala Ellisse - h. 1.00 pm

                                ANNUAL GENERAL MEETING OF THE ASMOOI MEMBERS
                              Union Association of the Italian Ophthalmologist and Orthoptist Doctors

                        FRIDAY 22 MAY
                                                    Sala Cavalieri - h. 6.00 pm

                                                    Sala Cavalieri - h. 6.10 pm

                              ANNUAL GENERAL MEETING OF SOI MEMBERS
FRIDAY 22 MAY                                                                                 Sala Cavalieri
 Benedetto Strampelli Medal Lecture
 R.F. Steinert
 Professor of Ophthalmology, Professor of Biomedical Engineering, Chair of the Department of Ophthalmology,
 Director of the Gavin Herbert Eye Institute, University of California, Irvine
 The Pursuit of Implants to Correct Presbyopia

 Gian Battista Bietti Medal Lecture
 S. Chang
 Edward S. Harkness Professor and Chairman of Ophthalmology at Columbia University
 Optic Nerve Anomalies and Retinal Detachment

SOI Award 2009                                                                                                   15

THURSDAY 21 MAY                                                                                Sala Cavalieri
 A life spent serving Ophthalmology
 Giuseppe Benanti
 Chairman and CEO of SIFI SpA

FRIDAY 22 MAY                                                                                 Sala Cavalieri
 Honorary Award in Ophthalmology
 Mary D’Ardis
 Chief Executive Officer ESCRS

SATURDAY 23 MAY                                                                                Sala Cavalieri
 Mario Gelsomino SOI Award
 Sonia De Francesco, MD
                     COMPANY                                         BOOTH     COMPANY                                   BOOTH

                     AGENZIA INTERNAZIONALE PREVENZIONE CECITA'                FRASTEMA OPHTHALMICS S.r.l.               92-93

                     ALCON ITALIA S.p.A.                     30-31-32-33-34    I.M. MEDICAL s.a.s.                           3

                     ALFA INTES S.r.l.            48-49-50-51-52-53-60-61-62   INNOVED S.r.l.                               14

                     ALLERGAN S.p.A.                            10-11-12-13    LEICA MICROSYSTEMS S.p.A.                   100

                     AMO ITALY S.r.l.                                 90-91    LIGI TECNOLOGIE MEDICALI S.p.A.              40

                     ASMOOI                                              96    LUMENIS ITALY S.r.l.                      42-43

                     ASSICURAZIONI SOI                                    8    MECCANOTTICA MAZZA S.r.l.                    95

                     BAUSCH & LOMB IOM S.p.A.                        4-5-6-7   N.T.S. S.r.l.                                41

                     BECTON DICKINSON ITALIA S.p.A.                       1    NEW TECH S.p.A.                     63-64-73-74

                     BRUSCHETTINI S.r.l.                                  2    NIDEK MEDICAL S.r.l.              78-79-80-81-82

                     C.B. MEDICAL S.r.l.                                 24    NIKON INSTRUMENTS S.p.A.                    102

                     C.S.O. S.r.l.                                 45-46-47    OCULAR SURGERY NEWS EUROPE                   99
                     CARL ZEISS S.p.A.                    75-76-77-83-84-85    OFTAGEN                                   56-57

                     COMPAGNIA ITALIANA OFTALMOLOGICA SCARL 65-66-67           OFTALMEDICA S.r.l.                  86-87-88-89

                     COOPERVISION ITALIA S.r.l.                          15    OPTIKON 2000 S.p.A.                          26

                     D.I.P.O.                                            28    POLYOFTALMICA NEW S.r.l.                     94

                     EDIZIONI MINERVA MEDICA S.p.A.                      18    S.I.D.O. S.c.r.l.                 68-69-70-71-72

                     EOS OFTALMICA S.r.l.                                27    S.I.F.I. S.p.A.                   35-36-37-38-39

                     ESPANSIONE MARKETING S.p.A.                         97    SALMOIRAGHI & VIGANO' S.p.A.                  9

                     ESSEBIEMME S.r.l.                                   29    SOLEKO S.p.A.                                98

                     EYELAB S.r.l.                                       19    TOPCON ITALIA                             21-22

                     F.A.S.S. S.r.l.                                    101    TRANSITIONS OPTICAL Ltd                      44

                     FABIANO GROUP S.r.l.                             16-17    VISION SERVICE GROUP S.p.A.                  23

                     FARMIGEA S.p.A.                            54-55-58-59    VISUFARMA S.p.A.                             25

                     FOGLIAZZA FRANCESCO                                 20


                                                                                           SALA PISA                                                     40                           97   98             99   100             101   102
                                                                                                                                                                                                                                                                     SALA          SALA
                                                                                                                                                                                                                                                                    GISELLE       ROMEO
                                                                                                                                                                                      95   94             93   92


                                                                           SALA MALTA
                                           S. GIOVANNI                                                                                                                                                                                                                             JULIET





                                           S. GIORGIO






                                            S. PAOLO                                                                                                                                                                                       SALA CAVALIERI

                                                                                                                                                                                                                                           (PLENARY HALL)

                                                                                                                         32                 37





                                                                                                                                                                                                                       UD I



                                                                                                                                                                                                                     BO SO



        LOCATED AT MAIN                                                    W.C. MEN


                                                                      EN                    19
                                                    .C                                                   21
LEGENDA                                            W                   18                                               16

     SCIENTIFIC SESSIONS                                                                                      17




                                                                                      12                                                                                                SALA
     BAR                                                                                   13                                                                                          ELLISSE
     W.C.                                                                        10

      BOOTH 3x2                                                                                                                                 7

                                            LA O
        BOOTH 4x2                        SA AR D                                      SALA                                              6
                                           N                                                                                                5                      3

                                     L   EO                                           ORO
       BOOTH 4x3                                                                                                                                                                                                                                            BELLE ARTI

                                                                                                                                                                                                CME DELEGATE PACKS

         BOOTH 4x4
            BOOTH 5x2                                                                                                   ROSSA

            BOOTH 5x3                                                                                   SALA
            BOOTH 6x2

              BOOTH 7x4

                                                                                                                                                                                                EXHIBITION PLANIMETRY
                       THURSDAY 21 MAY

                         Sala Cavalieri
                         9.30 am    Session 6 – SOI Symposium
                         1.15 pm    Symposium based on Brazilian and Italian Scientific Cooperation
                                    Simultaneous translation Italian/English/Portuguese
                                          Chairmen: C. Balacco Gabrieli (Italy), M.Â. Padilha (Rio de Janeiro, Brasil)
                                          Moderators: A. Crema (Rio de Janeiro, Brasil), M. Piovella (Italy)
                         9.30       Italian/Brazilian scientific cooperation: why and how - M. Motta, President of the SBO
                         9.35       Introduction to the Symposium - C. Balacco Gabrieli (Italy)
                         9.40       Artisan and Artiflex for correction of high ametropias - J.R. Rehder (São Paulo, Brasil)
                         9.51       PRL implantation for myopia correction - D. Dementiev (Italy/Russian)

                         9.59       The role of ocular surface in refractive surgery - P. Troiano (Italy)
                         10.07      Refractive Lens Exchange: personal considerations - M.Â. Padilha (Rio de Janeiro, Brasil)
                         10.18      Shallow Anterior Chamber as Indications for Refractive Lens Exchange - M. Piovella (Italy)
                         10.26      Presbyopia treatment with radiofrequency: personal experience and results - J.R. Rehder (São
                                           Paulo, Brasil)
                         10.37      Corneal Cross Linking: 2 years follow-up - P. Vinciguerra (Italy)
                         10.45      Refractive Surgery and Orthokeratology - R. Dossi (Italy)
                         10.53      Discussion
                                           Panelists: U. Merlin (Italy), G. Perone (Italy), G. Tassinari (Italy), V. De Molfetta (Italy)
                         11.10      SOI Award “A life spent serving ophthalmology” 2009
                                         Giuseppe Benanti
                         11.15      Quality results with refractive lens implant - M. Piovella (Italy)
                         11.23      Multifocal IOLs: why bad results? - A. Crema (Rio de Janeiro, Brasil)
                         11.31      Mix and Match - S. Rossi (Italy)
                         11.39      Surgical Management of Congenital Cataract - A. Rapisarda (Italy)
                         11.47      Phacoemulsification in special situations - M.Â. Padilha (Rio de Janeiro, Brasil)
                         11.55      Microincisions Technique in Cataract Surgery - G. Lofoco (Italy)
                         12.03      Capsular morphological modifications with Trypan Blue - L.C. Portes (Rio de Janeiro, Brasil)
                         12.11      Management of subluxated lenses - A. Crema (Rio de Janeiro, Brasil)
                         12.19      Important aspects of retinal evaluation at the pre and pos cataract surgery - M. Motta (Rio de
                                          Janeiro, Brasil)
                         12.27      Management of anterior segment surgery complications: retinal surgery - T. Rossi (Italy)
                         12.35      Discussion
                                          Panelists: G. Beltrame (Italy), A. Caporossi (Italy), G. Caramello (Italy), V. Picardo (Italy)
                         1.15       End of the Session

                         Sala Cavalieri
                         2.00-4.00 pm Session 7 – Video-Symposium SOI
                                    Difficult and Complicated Cases in the Surgery of the Anterior Segment
                                    Simultaneous translation Italian/English
                                          Chairman: G. Ravalico
                                          Scientific Coordinator: D. Tognetto
                                          Moderators: A. Caporossi, A.Franchini, S. Rossi
                         2.00       Complications and difficulties in using capsular tension rings - G. Alessio
                         2.04       DLK-faco: grasp the moment - R. Bellucci
                         2.08       Use of the IOL with iris fixation in dealing with complicated cataracts - G. Beltrame
                         2.12       Difficulties during standard facoemulsification - A. Caporossi
                                                                                              THURSDAY 21 MAY

2.16        Dealing with youth cataracts - L. Cappuccini
2.20        Complications and difficulties in cataract surgery in patients suffering from uveitis -
                   G.M. Cavallini
2.24        Cataract, low chamber and reduced endothelial count - P. Fantaguzzi
2.28        Expulsive haemorrhage - A. Franchini
2.32        Explant of facic IOL: really reversible surgery? - P. Giardini
2.36        IOL implant and Baerveldt valve in corneal transplant and glaucoma - G. Marchini
2.40        Complicated secondary implants - R. Mencucci
2.44        How to deal with a traumatic cataract - S. Morselli
2.48        Difficulties in dealing with explant-implant in cataract surgery - A. Mularoni
2.52        Complications in subluxed cataract - V. Orfeo

                                                                                                                               SCIENTIFIC PROGRAMME
2.56        How to remove an IOL and substitute it - M. Piovella
3.00        The Cionni Ring in subluxed cataracts - G. Pirazzoli
3.04        Haemorrhagic complications during implant of facic lens - S. Rossi
3.08        Cataract and narrow pupil - R. Sciacca
3.12        Congenital cataract (persistence of tunica vasculosa lentis) - G. Tassinari
3.16        Subluxed cataract in vitrectomized patients - P. Vinciguerra
3.20        Debate

Sala Cavalieri
4.15-5.45 pm Session 7 bis - SOI Round Table
            Note 78 and Antiangiogenetics
            Simultaneous translation Italian/English
            Note 78
4.15        Therapy costs - C. Bianchi
4.18        Glaucoma is cureless - S. Miglior
4.21        Note 78 and private doctors - M. Piovella
4.24        SOI-PVFV campaign to abolish Note 78 - P. Troiano
4.27        Social aspects - D. Mazzacane
4.30-4.50   Speakers:
                   Sen. Cesare Cursi, Chairman 10th Commission Industry, Commerce and Tourism - Senate of the Italian
                   Republic, Chairman of Health Observatory
                 On. Giuseppe Palumbo, Chairman of XII Commission Social Affairs - Chamber of Deputies
4.50        IVT Costs - C. Bianchi
4.53        SOI Position - M. Piovella
4.56        Why it is useful to have different molecules at one’s disposal - G. Lesnoni
4.59        SOI guidelines and informed consent - F. Carraro
5.02        Present state of the antiangiogenetics refundability - P. Troiano
5.05        Insurance aspects - P. d’Agostino
5.08        Where does the present refundability of antiangiogenetics come from and how it could
                  evolve - C. Tomino
5.18-5.38   Speakers:
                  Sen. Luigi D’Ambrosio Lettieri, Secretary 12th Commission Hygiene and Health - Senate of the Italian
                   Republic, Member of the Parliamentary Commission of Enquiry on Efficacy and Effectiveness of the National
                   Health Service
                   On. Chiara Moroni, V Commission Budget, Treasury and Planning
                       THURSDAY 21 MAY

                         Sala Cavalieri
                         5.50-7.15 pm Session 8 – ASMOOI Symposium – Union Association of the Italian Ophthalmologist and
                                      Orthoptist Doctors - in cooperation with ADMOI and AIOL – Executive Officials Association of
                                      Oculist Doctors and Italian Academy of Legal Ophthalmology
                                     Ophthalmologist profession: lights and shadows. Clinical risk and professional
                                     liability: legal and insurance aspects
                                     Simultaneous translation Italian/English
                                           Chairman: C. M. Villani
                                           Moderator: C. Bianchi
                                           Coordinator: D. Mazzacane

                         5.50        Clinical governance and management of clinical risk - D. Siravo
                         6.00        Hospital Ophthalmologists Round Table - F. Tenerelli, P. Troiano
                         6.07        NHS Ophthalmological Surgeries - P. Sottotetti, D. Mazzacane
                         6.14        Private Ophthalmologists who have an NHS agreement - G. Lesnoni, V. Orfeo
                                     Table of Experts
                         6.21        • The Jurist - V. Castiglione
                         6.31        • The Insurer - P. d’Agostino
                         6.41        • Trade Unionist - G. Garraffo
                         6.51        • Manager of the Italian Health Service - S. Coronato
                         7.01        Conclusions

                                                                                         FRIDAY 22 MAY

Sala Cavalieri
8.00 am    Session 12 - 14th Annual Joint Meeting of SOI, OSN & AICCER
1.00 pm          Live Surgery from the Ophthalmic Department “Ospedale Britannico”
                 of the San Giovanni Addolorata Hospital, in Rome
                 Simultaneous translation Italian/English
                 Chairman: C.M. Villani
                 Live Surgery Program Directors: M. Piovella, G. Tassinari
                 Vitreoretinal Surgery Consultants: N. De Casa, S. Rizzo

           Part One
                 Auditorium Chairpersons: F.I. Camesasca, A. Mocellin, G. Panzardi
                 Surgical Theatre Chairpersons: M.A. Pileri, M. Schiavone

                                                                                                                SCIENTIFIC PROGRAMME
8.00       Live cataract surgery
                  Surgeons: A. Marino (Alcon), S. Rizzuto (B&L, Akreos MI60), R. Colabelli Gisoldi (Alcon)
8.40       Current Concepts in the Diagnosis and Treatment of Cystoid Macula Edema (CME) - K. Warren
8.46       Comparison of NSAIDs by OCT for Control of Retina Thickening Post Cataract Surgery - R. Toyos
08.52      IOLs: Lighting, Aging and Circadian Physiology - M. Mainster

8.58       Live cataract surgery in complex cases
                 Surgeons: P. F. Fiorini (Optikon Physiol), M. Piovella (Amo)
9.25       Optimizing Outcomes in Refractive Cataract Surgery Through New Phacoemulsification
           Technology - Y.R. Chu
9.31       Every Pupil Should be Viewed as an Intraoperative Floppy Iris Syndrome (IFIS) - I.H. Fine

9.37       Live cataract surgery in complex cases                                                                   21
                 Auditorium Chairpersons: C. Balacco Gabrieli, I.H. Fine, R.L. Lindstrom, F.I. Camesasca
                 Surgeons: A. Bartolino (Acrysof ReSTOR IQ +3D), A. Scialdone (Acrysof ToRIC)

10.04      Introducing Benedetto Strampelli Medal Lecture 2009 - R.L. Lindstrom

10.07      Benedetto Strampelli Medal Lecture 2009
           The Pursuit of Implants to Correct Presbyopia - R.F. Steinert

10.21      Live surgery in complex cases
                  Auditorium Chairpersons: G. Caramello, C. Carbonara, R. Dossi
                  Surgeons: G. Orefice (Zeiss), L. Cappuccini (SIFI), M. Sbordone (AMO)
11.00      Comparison of Vision with Accommodating IOLs - G. Beiko
11.06      Comparing the 4.0 and 3.0 Add ReStor Lenses in Clinical Practice - S.F. Brint
11.12      Clinical Experience with Acri.LISA - C. Lovisolo

11.18      Live surgery in complex cases
                 Auditorium Chairpersons: C. Balacco Gabrieli, M. Stirpe, R.L. Lindstrom, F.I. Camesasca
                 Surgeons: S. Solarino (Optikon Physiol), L. Zeppa (OII), F. Fiormonte (Hoya CIO iMics Y-60H)

11.57      Introducing Gianbattista Bietti Medal Lecture 2009 - M. Stirpe

12.00      Gianbattista Bietti Medal Lecture 2009
           Optic Nerve Anomalies and Retinal Detachment - S. Chang

12.14      Introducing SOI Honorary Award in Ophthalmology - M. Piovella

12.16      SOI Honorary Award in Ophthalmology 2009
           Mary D’Ardis

12.21      Live surgery in complex cases
                 Surgeons: G. Grieco (Zeiss), A. Bedei (Hoya CIO iSert PY-60AD), P. Caruso (AMO)

1.00       End of the Session
                       FRIDAY 22 MAY

                        Sala Cavalieri
                        2.00-5.50 pm Session 13 - 14th Annual Joint Meeting of SOI, OSN & AICCER
                                         Live Surgery from the Ophthalmic Department “Ospedale Britannico”
                                         of the San Giovanni Addolorata Hospital, in Rome
                                         Simultaneous translation Italian/English
                                         Chairman: C.M. Villani
                                         Live Surgery Program Directors: M. Piovella, G. Tassinari
                                         Vitreoretinal Surgery Consultants: N. De Casa, S. Rizzo

                                   Part Two
                                         Auditorium Chairpersons: A. Caporossi, L. Mastropasqua, P. Vinciguerra

                                         Surgical Theatre Chairpersons: M.A. Pileri, M. Schiavone

                        2.00       Cataract surgery in complex cases
                                          Surgeons: G. Gigante (AMO), C. Carlevale (Optikon Physiol), R. Bellucci (B&L Crystalens HD500)
                        2.40       Clinical Results with the Crystalens HD500 Accomodating IOL: How does it compare to the
                                   AT45, AT50 and HD100? - J.A. Davies
                        2.46       Comparing Bilateral Crystalens HD to Other Presbyopia-Correcting IOL Combination and
                                   Pseudophakic Monovision in RLE - J.E. Stahl
                        2.52       Update on the Crystalens HD - R.L. Lindstrom

                        2.58       Cataract surgery in complex cases
                                           Surgeons: S. Rossi (B&L Crystalens HD500), M. Ortolani (AMO), Acri.Lisa Torica (Zeiss)
                        3.38       Crystalens HD: personal experience - E. Ligabue
22                      3.44       What to do if miss the Target? Treatment Options for Refractive Surprises with the Crystalens
                                   Accomodating Intraocular Lens Implant - J.A. Davies
                        3.50       Making Crystalens work for you and your Patients - Two successful Approaches - J. Mc Donald
                        3.56       Choosing the Right Lens for the Right Patient: Incorporating Presbyopia Correcting IOLs Into
                                   Your Profile - Y.R. Chu
                        4.02       Dealing with the Unhappy Premium IOL Recipient - J.D. Horn
                        4.08       Optimizing IOL Optic Material Performance - M. Mainster
                        4.14       Early Clinical Results with the Alcon ReStor 3-0 - J.D. Horn
                        4.20       Implants: Refractive Surgery and Patients’ Profile – Which are the Surgeon’s Options - E. Leite
                        4.26       Visumax - a New Femtosecond laser from Carl-Zeiss - Meditec - K. Ditzen
                        4.32       Safety Criteria for Phakic Posterior Chamber IOLs - P. Sourdille
                        4.38       Comparative Study: Artisan® vs. Artiflex® for the Correction of Myopia - C.J. Budo
                        4.44       State of the Art in Phakic IOLs: The Alcon Acrysof AC Phakic - M.C. Knorz
                        4.50       Irisfixated Phakic IOLs in Children - C.J. Budo
                        4.56       The Future Phakic IOL: Which are Today Waive Guidelines to Patients’ Profile - E. Leite
                        5.02       Recent Advancement in Femtosecond Laser Corneal Surgery - L. Mastropasqua
                        5.08       Femtosecond Laser Surgery: Flaps, Transplants and Intrastromal Corrections - M.C. Knorz
                        5.14       Comparison of Intraoperative Subtraction Pachymetry and Postoperative Anterior Segment
                                   OCT Imaging of Mechanical and Femtosecond LASIK Flaps - E.E. Manche
                        5.20       Customizing Femtosecond Laser Flaps with the Intralase IFS for Optimal Visual and
                                   Biomechanical Outcomes - J.E. Stahl
                        5.26       Improving Accuracy and Reducing Enhancements with the Wavelight EyeQ Laser - S.F. Brint
                        5.32       Fine Tuning Enhancement After Corneal Refractive Surgery - K. Ditzen
                        5.38       Wavefront-guided PRK Following Previous LASIK, PRK and RK - E.E. Manche
                        5.44       Discussion
                        5.50       End of the Session
                                                                                      SATURDAY 23 MAY

Sala Cavalieri
8.00 am    Session 17 - 14th Annual Joint Meeting of SOI, OSN & AICCER
1.30 pm          Live Surgery from the Ophthalmic Department “Ospedale Britannico”
                 of the San Giovanni Addolorata Hospital, in Rome
                  Simultaneous translation Italian/English
                  Chairman: C.M. Villani
                  Live Surgery Program Directors: M. Piovella, G. Tassinari
                  Vitreoretinal Surgery Consultants: N. De Casa, S. Rizzo

           Part Three
                 Auditorium Chairpersons: C. Bianchi, F. Dossi, D.J. Rhee, M. Schiavone
                 Surgical Theatre Chairpersons: V. Picardo, M.A. Pileri

                                                                                                                    SCIENTIFIC PROGRAMME
8.00       Live cataract and amniotic membrane surgery
                 Surgeons: S. Scalia (Alcon), K.R. Kenyon (Amniotic Membrane), P. Gatta (AMO)
8.40       Aqueous Physiology: Inflow and Drainage - D.J. Rhee
8.46       Corneal Thickness: Why it Matters - B. Flowers
8.52       Microincision Trabeculectomy - H. Fukasaku

8.58       Live glaucoma surgery in complex cases
                 Surgeons: L. Zeppa (Ahmed Valve), S. Zuccarini (Express Optonol)
9.28       Cataract Surgery in the Glaucoma Patient - R.L. Lindstrom
9.34       Canaloplasty: 24 Month U.S. Data - B. Flowers
9.40       Evidenced-Based View of Trabectome (ab interno Trabeculectomy) and Canaloplasty - D.J. Rhee
9.46       Live glaucoma surgery in complex cases
                  Auditorium Chairpersons: M. Borgioli, F. D’Arrigo, R. Dossi
                  Surgeons: A. Rapisarda (Gold Shunt), G. Caramello (Canaloplasty), M.A. Pileri (Optikon Physiol)
10.33      Principles and Pearls of Anterior Vitrectomy for Complicated Cataract Surgery - K. Warren
10.39      Simple Solutions for Complex Problems in Cataract Surgery - I.H. Fine
10.45      Preoperative Antibiotics for Prophylaxis of Infection in Cataract Surgery - F.I. Camesasca

10.51      Mario Gelsomino Award 2009
                Sonia De Francesco

10.55      Live cataract surgery in complex cases
                  Surgeons: M. Piovella (OII), S. Rizzo (Cataract and Macular Pucker - Alcon Acrysof IQ),
                  M. Marullo (SIFI)
11.45      Intense Pulse Light for Dry Eye Syndrome - R. Toyos
11.51      Amnion Membrane Extract (AME) for Treatment of Persistent Corneal Epithelial Defects -
           K.R. Kenyon

11.57      Live surgery in complex cases
                 Surgeons: D. D’Eliseo (Hoya CIO iMix Y-60H), M. Prantera (SIFI), G. Lofoco (B&L Akreos MI60)
12.37      Topical Cyclosporine Management of Dry Eye in Laser Vision Correction - K.R. Kenyon
12.43      Fork Tip in Cataract Phaco Surgery - H. Fukasaku

12.49      Live surgery in complex cases
                 Surgeons: G.C. Spinelli (Zeiss), G. Rubiolini (OII)

1.30       End of the Session
                                                                            Session 6 – SOI Symposium
                                                            Symposium based on Brazilian and Italian Scientific Cooperation

                                   POSTERIOR CHAMBER PHAKIC REFRACTIVE IOL FOR                            rence (P=0.13). Mean baseline SIM K flattest meridian, SIM K
                                   CORRECTION OF LOW, MODERATE, AND HIGH HYPEROPIA:                       steepest meridian and SIM K average decreased significantly at
                                   SHORT-AND LONG-TERM FOLLOW-UP EXPERIENCE,                              18 months follow up (P<0.05). Mean average pupillary power

                                   RESULTS, COMPLICATIONS, AND SURGICAL EVOLUTION                         (APP) and apical keratometry (AK) decreased significantly at 18
                                   Dimitrii D. Dementiev                                                  months (P<0.05). Mean baseline pupil center pachymetry and
                                   Purpose: to evaluate right choice of preoperative examination,         total corneal volume decreased significantly (P<0.05) at 18
                                   patient selection, surgical technique, operative and postoperative     months from baseline. At 3 mm we observed a significant reduc-
                                   considerations for PRL implantation in eyes with low, moderate         tion (P<0.05) in total, high order and astigmatic total and corne-
                                   and high hyperopia. Analyze follow-up results in order to minimi-      al wavefront aberrations measured by Optical Path Difference
                                   ze the incidence of complications as well as anticipate and pro-       Platform (NIDEK, Gamagori, Japan) and a significant difference
                                   perly manage those that may occur. Methods: different dioptric         in total coma and total spherical aberration after CCL (P< 0.05).
                                   range of hyperopic PRLs implantations performed in last 12 years       Conclusions: CCL appears to be effective in improving UCVA
                                   for correction of different degree of hyperopia (from 2.5D to          and BSCVA in eyes with progressive early stage KC by significan-
                                   +15.0D), using different techniques and different instruments          tly reducing corneal APP, AK and total and corneal wavefront
                                   have been analyzed to propose the best patient selection and           aberrations at 18 months follow-up.
                                   most safe surgical procedure for hyperopic PRL implantation.
                                   Results: surgical technique and Instrumentation have been signi-       REFRACTIVE SURGERY AND ORTHOKERATOLOGY
                                   ficantly improved in last 12 years. Correct selection of patient and   Roberto Dossi, Elisabetta Suppo, Mauro Frisani, Fabio Dossi
                                   preop examination, the appropriate PRL dioptric power calcula-         Aim of the study: to evaluate the efficacy and safety of the use
                                   tion, standardized surgical implantation using proven instru-          of gas permeable contact leses during the night in corneal remo-
                                   ments, viscoelastics and techniques is important to prevent ope-       deling of aberrations due to excimer laser surgery. Materials
                                   rative complications such as damage to the lens, corneal endo-         and methods: 30 eyes that, after excimer laser surgery, had
                                   thelium or other intraocular tissues and postoperative complica-       aberrations influencing negatively the qualità of vision under-
                                   tions such as, increased lOP and PRL decentration and luxation in      went the application of customized contact lenses during the
                                   the vitreous. Conclusion: Hyperoic PRL implantation showed             night. The reduction of the aberrations was evaluated with cor-
24                                 good refractive and functional results in short-and long-term fol-     neal topographies after 1 night, 7 days, 1 month and 3 months
                                   low-up. According to implant technical paramenters it can be           after the use of the contact lenses. Keratometries, aberrometric
                                   used in successful surgical correction of extremely high degree of     indexes, corneal asphericity, asimmetry and pupillare corneal
                                   hyperopia (+15.0D) in some cases, where no any other technique         power were monitored. Results: the Root Mean Squame (RMS)
                                   can be helpful. It was seen like hardly surgically dependant pro-      of the aberrations was, before the application of the contact len-
                                   cedure and the unique standardized preoperative, surgical and          ses, of 1,247 microns. Ater the use of the contact lenses, RMS
                                   postoperative protocol helps to avoid possible complications.          was 0,743 microns. The BCVA improved of 2,3 lines.
                                                                                                          Conclusions: the corneal remodeling with orthokeratology
                                   CROSS LINKING RESULTS IN EARLY STAGE KERATOCONUS                       seems to be safe and it allowed, in all the cases, an improvement
                                   Paolo Vinciguerra                                                      of the visual conditions of the patients with corneal aberrations
                                   Purpose: to report the intraoperative and the 18-months topo-          after excimer laser treatments.
                                   aberrometric, refractive and pachymetric outcomes after corne-
                                   al cross linking (CCL) in eyes with progressive early stage kerato-    MULTIFOCAL IOLs: WHY BAD RESULTS
                                   conus (KC). Methods: prospective, non randomized clinical con-         Armando Stefano Crema, MD
                                   trolled study including 156 patients undergoing riboflavin/UVA         Five multifocal IOLs clinical cases will be presented, where pre,
                                   cross linking procedure. Results: mean baseline UCVA and               intra, and post-operative causes of bad outcomes with unhappy
                                   BSCVA increate significantly at 18-months follow-up (P<0.05).          patients will be discussed. Management of sub-luxated lenses.
                                   Mean refraction showed a significant reduction of spherical            Surgical alternatives for sub-luxated lenses will be presented,
                                   equivalent of 0.52D. Comparison of endothelial cell count chan-        and the personal experience and technical preferences for diffe-
                                   ges before CCL and at 18 months showed no significant diffe-           rent causes of sub-luxated lenses will be discussed.
                                                      Session 12
                                   14th Annual Joint Meeting of SOI, OSN & AICCER

CURRENT CONCEPTS IN THE DIAGNOSIS AND TREATMENT                       bromfenac. Also we had one case of clinically significant macu-
OF CYSTOID MACULA EDEMA (CME)                                         lar edema in the diabetic ketorolac group.
Keith A. Warren, MD

                                                                                                                                          ABSTRACTS INTERNATIONAL SESSIONS
Purpose: to evaluate the morbidity and frequency of CME follo-        IOLs: LIGHTING, AGING AND CIRCADIAN PHYSIOLOGY
wing uncomplicated cataract surgery. The efficacy of treatment        M.A. Mainster, PhD, MD, FRCOphth and P.L. Turner, MD
of CME with the currently available NSAID’s and their role in pro-    Purpose: age-related crystalline lens yellowing and pupillary
phylaxis will be examined. Methods: the current literature on         miosis progressively reduce ocular blue light transmission and
the frequency and etiology of pseudophakic CME will be revie-         circadian photoreception. Normal indoor illumination may be
wed. Rational for the various treatment modalities will also be       inadequate for the nonvisual circadian demands of many
reviewed. In addition, two studies evaluating the efficacy of cur-    adults. We analyze how environmental lighting affects circa-
rent NSAID’s for the treatment of CME in both steroid respon-         dian photoreception at different ages in phakic and pseudo-
ders and as combination therapy in chronic CME will be presen-        phakic adults. Methods: the spectral sensitivity of circadian
ted. Results: review of the literature reveals a reported inciden-    photoreception (melatonin suppression) in humans peaks in
ce of biomicroscopic apparent CME following uncomplicated             the blue part of the spectrum at approximately 460 nm. Age-
surgery of approximately 2% with retinal thickening occurring in      related transmittance spectra of crystalline lenses and photopic
up to 12% of patients. High risk patients groups include diabe-       pupil diameter are used with the spectral sensitivity of melato-
tic and those with other retinovascular disease. Eleven (11) of 15    nin suppression and the transmittance spectra of intraocular
eyes studied in known steroid responders treated with NSAID’s         lenses (IOLs) to analyze how aging and IOL chromophores
as monotherapy had significant improvement in retinal thickness       affect circadian photoreception. Results: inadequate circadian
and visual acuity. In a separate study, eyes with chronic CME         photoentrainment can cause “free-running” wherein physiolo-
were randomized to treatment with a currently available NSAID         gical cycles progressively deviate from and then return to the
in addition to intravitreal steroid and anti-VEGF therapy. The        phase of environmental day-night cycles. Young adults free-
results to be presented here demonstrate a reduction in retinal       run at indoor illuminances under 80-200 lux. Illuminances of
thickness in all groups and improvement in visual acuity in one       184-460, 256-640, 400-1000 and 536-1340 lux would be ina-
subset of patients. Conclusions: CME is an important cause of         dequate to prevent free-running in 55, 65, 75 and 85 year old
visual loss and morbidity in patients following uncomplicated         adults, respectively. Residential illuminances average only                25
cataract surgery. Prostaglandins appear to have a role in the etio-   around 100-200 lux and have redder spectra less effective for
logy of CME and blockade of prostaglandin related inflamma-           circadian photoreception than outdoor illuminances which can
tion may reduce the incidence and severity of CME. NSAID’s            exceed 100,000 lux. Yellow chromophores in IOLs eliminate
appear to have a role in the treatment and possibly prophylaxis       67-83% of violet light and 27-40% of blue light depending on
of CME and appear effect in treating CME in steroid responder         their dioptric power. Violet and blue light provide 94% of S-
and in combination in those with Chronic CME.                         cone, 75% of circadian and 45% of rod photoreception for
                                                                      isoilluminance light sources. In addition to photoentrainment,
COMPARISON OF NSAIDS BY OCT FOR CONTROL OF RETI-                      nonvisual photic effects which are spectrum and intensity
NA THICKENING POST CATARACT SURGERY                                   dependent include cognition, alertness, sleep quality and sub-
Rolando Toyos, MD                                                     jective mood. Conclusions: light deficiency whether due to
I will be presenting data from a study that we did comparing          improper timing, suboptimal spectrum or insufficient intensity
ketorolac, nepafenac, and bromfenac for post operative inflam-        may contribute to medical conditions commonly assumed to
mation of the retina. Two distinct study groups were looked at:       be age-related inevitabilities. Nonvisual, unconscious circadian
diabetic and non diabetic patients undergoing cataract surgery.       photoreception is vital for good health and meditated by highly
Patients were randomly assigned a non steroidal drop to take pre      blue-light sensitive retinal ganglion photoreceptors. Sensitivity
and post op for standard phacoemulsification. We measured             spectra show that the ideal IOL for vision in dim environments
maculas with OCT pre operatively then again at one month and          and circadian photoreception should transmit as much blue
3 months. Results showed that there was thickening in all             light as possible. Unconscious and conscious photoreception
groups post operatively. All three drops performed equally as         should be considered in IOL design and selection in order to
well in the non diabetic group. In the diabetic group the ketoro-     maximize both the nonvisual as well as visual benefits of cata-
lac showed a trend of more thickening than nepafenac and              ract surgery.
                                                                                         Session 13
                                                                      14th Annual Joint Meeting of SOI, OSN & AICCER

                                   MODATING IOL: HOW DOES IT COMPARE TO THE AT45,                       SBYOPIA-CORRECTING IOLS COMBINATIONS AND PSEUDO-
                                   AT50 AND HD100?                                                      PHAKIC MONOVISION IN RLE

                                   James A. Davies, MD, FACS                                            Jason Stahl, MD
                                   The Crystalens accommodating IOL is a silicone, multipiece IOL       Purpose: to evaluate visual outcomes, quality of vision and
                                   designed to mimic accommodative arching, the natural secon-          satisfaction when comparing bilateral Crystalens HD (HD/HD)
                                   dary mechanism of crystalline lens accommodation. Con-               to bilateral ReSTOR (RS/RS), ReSTOR/ReZOOM (RS/RZ),
                                   traction of the capsular bag changes the shape of the optic          Crystelens 5-0/ReSTOR (CL/RS) combinations and pseudopha-
                                   and radius of the lens to allow the eye to focus over a broad        kic monovision (mono) in refractive lens exchange (RLE)
                                   range of distances. The AT-45 has a 4.5 mm optic and the AT-         patients. Methods: RLE was performed in 10 patients in each
                                   50 (Five-O) has a 5.0 mm optic. Recently, the Crystalens HD          group: HD/HD, RS/RS, RS/RZ, CL/RS and monovision. Manifest
                                   was introduced with a modification of the central part of the        refraction, BCVA, UCVA (distance, intermediate and near),
                                   anterior optic designed to optimize the accommodative effect         defocus curves, wavefront, contrast sensitivity, OQAS and
                                   of the lens and improve near vision. The HD 100 is on the AT-        patient questionnaire were performed in patients greater than
                                   45 platform for the FDA clinical trial in order to facilitate com-   3 months postop. Results: mean MRSE: +0.29 ± 0.31 D
                                   parison with the parent AT-45 IOL. The HD 500 is on the Five-        RS/RS, +0.10 ± 0.45 D RS/RZ and -0.28 ± 0.44 D CL/RS. Mean
                                   O platform and is the marketed version of the lens.                  UCVA-D: 20/22 RS/RS, 20/16 RS/RZ and 20/18 CL/RS; mean
                                   Comparison of outcomes from the FDA clinical trials for the          UCVA-I: 20/83 RS/RS, 20/50 RS/RZ and 20/41 CL/RS; mean
                                   Crystalens HD 100 and AT-45 IOLs shows the HD 100 perfor-            UCVA-N: 20/23 RS/RS, 20/26 RS/RZ and 20/25 CL/RS.
                                   med as well, or better, than the AT-45 IOL in low light condi-       Crystalens HD and monovision data will be presented at mee-
                                   tions (with or without glare), with no loss of contrast sensitivi-   ting. RS/RZ and CL/RS defocus curves are significantly larger
                                   ty under photopic conditions. Under mesopic conditions, the          than RS/RS due to larger intermediate range. All groups repor-
                                   contrast sensitivity was significantly higher for the Crystalens     ted satisfaction with surgery and spectacle independence at
                                   HD at 1.5 and 6 cpd without glare, and 1.5, 3.0, 6.0, and 12.0       distance and near. Detailed questionnaire results will be pre-
26                                 cpd with glare (P<0.04). Near visual acuity was compared for a       sented including quality of vision. Detailed quality of vision
                                   subgroup of 60 patients each from clinical trials for the AT-45,     data including contrast sensitivity, wavefront and OQAS
                                   Five-O and Crystalens HD 100 IOLs that were within 0.5 D of          results will be presented. No patients lost lines of BSCVA.
                                   the targeted refraction at 4-6 months postoperative.                 Conclusion: Bilateral Crystalens HD, bilateral ReSTOR,
                                   Uncorrected near VA of J1 or better was achieved by 35.0% of         ReSTOR/ReZOOM, Crystalens/ ReSTOR combinations and
                                   AT-45 eyes, 43.0% of Five-O eyes, and 55.0% of HD 100 eyes.          pseudophakic monovision are safe and effective. ReSTOR/
                                   UCNVA of J3 or better was achieved by 78.0% of AT-45 eyes,           ReZOOM and Crystalens/ReSTOR combinations provided an
                                   90.0% of Five-O eyes, and 100% of HD 100 eyes. Distance-             increased range of near/intermediate vision compared to bila-
                                   corrected near VA of J1 or better was achieved by 13.3% of           teral ReSTOR. Crystalens HD provides improved near vision
                                   AT-45 and Five-O eyes, and 33.3% of HD 100 eyes. DCNVA of            compared to Crystalens 5-0. Pseudophakic monovision is a
                                   J3 or better was achieved by 65.0% of AT-45 eyes, 70.0% of           good option for treating presbyopia.
                                   Five-O eyes, and 90.0% of HD 100 eyes. Data from the
                                   DataLink online registry show similar uncorrected distance           UPDATE ON THE CRYSTALENS HD
                                   visual acuities for the Crystalens HD 500 and its predecessor,       Richard L. Lindstrom, MD
                                   the Crystalens Five-O with improved near and intermediate            The Crystalens HD is a blended bispheric accommodation IOL.
                                   visual acuity for the Crystalens HD 500. Binocular UCDVA of          This new design has enhanced the visual performance of the
                                   20/20 or better was achieved by 53% of Five-O and 53% of             prior generation Crystalens Five-0 at distance, intermediate
                                   HD patients and UCDVA of 20/40 or better was achieved by             and especially near. The results obtained in the FDA clinical
                                   91% of Five-O and 89% of HD 500 patients. Binocular uncor-           trial and collected through the DataLink Registry will be pre-
                                   rected intermediate VA of 20/20 or better was achieved by            sented. Clinical Pearls to obtain the best outcomes will be
                                   70% of Five-O and 89% of HD patients and UCIVA of 20/40              discussed including a target of plano to +0.25 diopters in the
                                   or better was achieved by 92% of Five-O and 99% of HD 500            distance eye and plano to -0.25 diopters in the near eye, a
                                   patients. Binocular uncorrected near VA of 20/20 or better was       large capsulorhexis of 5.5-6.0 mm, careful cortical clean up,
                                   achieved by 31% of Five-O patients and 48% of HD 599                 and extended topical anti-inflammatory therapy to reduce
                                   patients while 85% of Five-O and 96% of HD 500 patients              capsular fibrosis.
                                   achieved 20/40 or better. These data suggest that successive
                                   versions of the Crystalens accommodating IOL, culminating in         WHAT TO DO IF I MISS THE TARGET? TREATMENT OPTIONS
                                   the Crystalens HD 500 IOL have maintained excellent contrast         FOR REFRACTIVE SURPRISES WITH THE CRYSTALENS
                                   sensitivity and distance visual acuity while improving near and      ACCOMMODATING INTRAOCULAR LENS IMPLANT
                                   intermediate visual acuities for patients desiring to correct pre-   James A. Davies, MD, FACS
                                   sbyopia as well as aphakia after cataract extraction surgery.        As with all lens implant technologies, the final refractive results
may result in unexpected myopia or hyperopia. The first step is       gical technique, the refractive results or endothelial cell loss
to confirm that there is a targeting error. Presentation of posto-    show similar results for both Artisan® as Artiflex®. The advan-
perative refraction pearls for the Crystalens will walk through       tages of the Artisan® over the Artiflex® are its range to correct
assessing the patient in the early post-operative period.             myopia and that there is never any reaction to the used mate-
If, in spite of meticulous attention to the details of lens implant   rial (giant cells). Conclusions: This comparative study betwe-
calculation and postoperative assessment, the patient is still        en the Artisan® and the Artiflex® shows an advantage of the

                                                                                                                                           ABSTRACTS INTERNATIONAL SESSIONS
unhappy with their visual acuity, it may be because of an unex-       Artiflex® over the Artisan® lens due to less induced astigma-
pected final “resting place” of the lens optic. The volume of the     tism and faster recuperation for the patient and similar posto-
capsular bag is the one variable that cannot be accurately mea-       perative refractive results. The disadvantages of the Artiflex®
sured before cataract surgery. If the capsular bag is larger than     are its more limited range of correcting power and a possible
expected, the optic will be more anterior than expected resul-        reaction to the used material (giant cells). Both lenses prove to
ting in unanticipated myopia. If it is further posterior than plan-   be safe for the correction of myopia and show excellent
ned, the result will be a hyperopic refractive error. This becomes    results.
more critical with premium lens patients who have high expec-
tations for their visual acuity outcomes. Unexpected results can      IRISFIXATED PHAKIC IOLs IN CHILDREN
also be technique dependent. A presentation on critical steps         C. Budo
intraoperatively will show how to avoid myopic and hyperopic          Purpose: to discuss my experience with and published articles
surprises. When they occur in spite of perfect calculation and        about the Phakic Artisan® Lens with children and the long term
surgery, suggestions will be offered on how best to deal with         follow-up with this lens for adults. Methods: my paper shows
residual refractive errors.                                           the follow-up of 4 patients with whom I have implanted a
                                                                      Phakic Artisan Lens since 1991 and the publication of 2 cases in
SAFETY CRITERIA FOR PHAKIC POSTERIOR CHAMBER IOLs                     articles published in ophthalmological journals. In most cases
Philippe Sourdille1, Marina Modesti2                                  the implantation of a Phakic Artisan is performed with children
1. Clinique Sourdille, Nantes                                         showing an amblyopia and problems with glasses and contact
2. Fabia Mater Clinic, Rome                                           lenses. We will show following results: visual acuity, objective
Phakic IOLs have benefited from recent developments of ima-           and subjective refraction, endothelial cell loss, etc. Results: in
ging, in particular laser interferometry (OCT) and high frequency     these few cases, the results with children are good. Additionally,          27
ultra sound, 35 and 50 megahertz. White to white measure-             the long term study of the Phakic Artisan Lens with adults is
ments are known to be irrelevant for both angle to angle and          excellent if we respect the indications and if we perform meti-
sulcus to sulcus distances. In case of posterior chamber IOLs only    culous surgery. Conclusions: the results with children show that
high frequency ultra sound will give the exact sulcus diameters,      this technique is a good option if conventional therapy fails in
posterior chamber and lens volume. Large inter-individual ciliary     treating their amblyopia. Furthermore, the long term study with
sulcus differences exist (up to 1,5 mm), mainly but non only, rela-   the Artisan® Lens has proved to be a safe technique for the cor-
ted to axial length. Intra-individual differences, according to the   rection of moderate and high myopia with adults. Larger stu-
state of accommodation, also exist and are significant.               dies should be performed for the implantation of Phakic Artisan
Postoperative inflammation is present and laser flare and cell        Lens for children, but these results show that it is a promising
numbers, higher than preoperative levels for months, illustrate       technique.
the need for prolonged anti –inflammatory treatments.
Prevention of IOL-related lens opacities development could be         COMPARISON OF INTRA-OPERATIVE SUBTRACTION PACHY-
improved by sizing, basal iridectomies (rather than self occluding    METRY AND POST-OPERATIVE ANTERIOR SEGMENT OCT
“peripheral” iridotomies) to improve aqueous circulation, and         IMAGING OF MECHANICAL AND FEMTOSECOND LASIK
modified IOL designs to better prevent central and peripheral         FLAPS
contacts.                                                             E.E. Manche
                                                                      Purpose: to compare intra-operative subtraction pachymetry
COMPARATIVE STUDY: ARTISAN® VS ARTIFLEX® FOR THE                      flap thickness measurements to post-operative anterior seg-
CORRECTION OF MYOPIA                                                  ment optical coherence tomography (OCT) flap thickness mea-
C. Budo                                                               surements in eyes treated with either a femtosecond laser or a
Purpose: to discuss my experience with the Artisan® and               mechanical microkeratome. Methods: one hundred eyes of
Artiflex® for the correction of myopia and make a comparati-          fifty consecutive patients were treated with custom wavefront-
ve study between both lenses based on my own patient data.            guided LASIK for myopia in a prospective randomized clinical
Methods: in my paper I will compare the indications, surgical         trial. One eye was treated using a mechanical microkeratome
technique, postoperative results (induced astigmatism, objec-         and the fellow eye was treated using a femtosecond laser.
tive and subjective refraction, endothelial cell loss, patient        Intraoperative subtraction pachymetry and post-operative OCT
satisfaction, etc) and complications. This study will cover 5         measurements were performed after the one-year post-operati-
years of experience with the Artiflex® Lens and 18 years with         ve visit. Thirty-four eyes of 17 subjects were available for the
the Artisan® Lens. Results: my study shows that the Artiflex®         one year OCT analysis. Results: intra-operative subtraction
Lens has less induced astigmatism and faster recuperation for         pachymetry revealed a measured flap thickness of 118.6 +/-
the patient which results in more patient satisfaction. The sur-      18.7 um (range 69 -173 um) and 137.0 +/- 21.7 um (range 87
                                   -179 um) in the femtosecond group and mechanical keratome          FINETUNING ENHANCEMENT AFTER CORNEAL REFRACTIVE
                                   group respectively. Anterior segment OCT imaging revealed an       SURGERY
                                   achieved flap thickness of 108.8 +/- 4.6 um (range 103 – 124       Klaus Ditzen, MD
                                   um) and 144.8 +/- 10.8 um (range 125-165 um) in the femtose-       Purpose: refractive surgery can be done with topography- and
                                   cond group and mechanical group respectively. Conclusions:         wavefrontguided ablations in preoperated decentered and irregu-
                                   Post-operative OCT imaging showed that the flaps created with      lar corneas as an enhancement. Methods: several decentered and

                                   the femtosecond laser were more uniform in configuration with      irregular preoperated laserinduced corneas had enhancements
                                   a tighter standard deviation than flaps created with a mechani-    with the new Carl-Zeiss-Meditec (CZM) MEL 80 and the Custo-
                                   cal microkeratome. The results suggest that intra-operative sub-   mized Refractive Surgery Master (CRS-Maser). Results: 3 eyes
                                   traction pachymetry may be less accurate and more prone to         with five enhancements over 8 years showed an upgrade in BSCVA
                                   measurement error than post-operative anterior segment OCT         from 20/50 to 20/24/32, UCVA from 20/60 to 20/40/32. HO-RMS
                                   imaging.                                                           increased and changed for blurring, ghost images and night vision.
                                                                                                      4 eyes with decentered ablation had one enhancement.
                                   CUSTOMIZING FEMTOSECOND LASER FLAPS WITH THE                       Decentration could be corrected. Conclusion: with the CZM MEL
                                   INTRALASE IFS FOR OPTIMAL VISUAL AND BIOMECHANI-                   80 and the CRS-Master it was possible to correct severe decentra-
                                   CAL OUTCOMES                                                       tions in three eyes with 5 enhancements and 4 eyes with one
                                   J.E. Stahl                                                         enhancement. HO-RMS were increased. Examples will be shown.
                                   Purpose: to review the new features, including the increa-
                                   sed ability to customize corneal flaps, on the 150-kHz iFS         WAVEFRONT-GUIDED PRK FOLLOWING PREVIOUS LASIK,
                                   Femtosecond Laser (AMO, Santa Ana, CA) and to explain              PRK AND RK
                                   how these benefits translate into improved outcomes in             E.E. Manche
                                   LASIK. Methods: The 5th generation femtosecond laser               Purpose: to evaluate the efficacy, predictability and safety of
                                   offers a number of design changes from the 4th generation,         wavefront-guided photorefractive keratectomy (PRK) in highly
                                   including increased speed (from 60 kHz to 150 kHz) and new         aberrated myopic eyes after previous keratorefractive surgery.
                                   software that allows the surgeon to customize the corneal          Setting: Stanford University School of Medicine, Department of
                                   flap to a greater degree by changing the shape for the flap,       Ophthalmology, Stanford, California 94305, USA. Methods: this
28                                 as well as the angle and shape of the sidecut. This presenta-      retrospective analysis includes 35 eyes of 30 patients who under-
                                   tion will review the clinical studies done to date to evaluate     went wavefront-guided PRK re-treatment surgery. All eyes had
                                   this new system. Results: the 5th generation femtosecond           previously undergone laser in situ keratomileusis (LASIK), PRK or
                                   laser is 2.5 times faster than the 4th generation with a flap      radial keratotomy (RK). Primary outcome variables including
                                   creation time of less than 10 seconds. Further, this high          uncorrected visual acuity (UCVA), best spectacle-corrected visual
                                   repetition rate enables the use of tight spot separation (2 to     acuity (BSCVA), higher order aberrations (HOA) root mean square
                                   8 microns compared to 4 to 10 microns with the 60 kHz). A          (RMS) analysis and spherical equivalence were evaluated at posto-
                                   rabbit eye study demonstrated that the ability to create an        perative month 1, 3 and 6. Results: mean patient age was 43.6 ±
                                   inverted side cut, which enables the surgeon to tuck the flap      8.99 years (SD) (range, 28 to 58 years), and mean preoperative
                                   into the peripheral cornea, makes these corneal flaps as bio-      manifest refraction spherical equivalent (MRSE) was -1.23 ± 0.79
                                   mechanically stable as a cornea following PRK. This study          diopters (D) (range, -4.00 to -0.13 D). Postoperative MRSE at 6
                                   also showed that an inverted side-cut (140°) was approxima-        months was 0.03 ± 0.42 (range -0.75 to 0.88) with 84% of eyes
                                   tely 1.5-times stronger than normal side-cut (70°). In a           within ± 0.5 D of emmetropia and 100% within ± 1.00 D of
                                   human eye study, there was greater flap adhesion at 10             emmetropia. At 6 months, 96.5% and 55. 1% of eyes achieved
                                   weeks when a 150-inverted side cut was used compared to            an UCVA of 20/25 or better and 20/20 or better, respectively. No
                                   either a 70-degree femtosecond flap or a flap created with a       eyes lost 2 or more lines of BSCVA at 6 months. Wavefront analy-
                                   mechanical microkeratome. Conclusions: the greater ability         sis demonstrated that the mean HOA RMS remained stable, from
                                   to customize the corneal flap allows surgeons to create a          0.59 ± 0.22 microns pre-operatively to 0.58 ± 0.20 microns at 6
                                   flap that is specific to the patient’s needs and the excimer       months. Conclusion: Wavefront-guided PRK surgery in highly
                                   laser ablation, while the new inverted sidecut increases the       aberrated myopic eyes after previous keratorefractive surgery is an
                                   biomechanical strength of the flap.                                effective, predictable, and safe procedure.
                                                        Session 17
                                     14th Annual Joint Meeting of SOI, OSN & AICCER

AQUEOUS PHYSIOLOGY: INFLOW AND DRAINAGE                                  IOP primarily by increasing extracellular matrix turnover in the
Douglas J. Rhee, MD                                                      uveoscleral pathway. Miotic agents cause constriction of ciliary
Introduction: the cornea, lens, and trabecular meshwork do not           body smooth muscle cells leading to increased resistance (i.e.

                                                                                                                                             ABSTRACTS INTERNATIONAL SESSIONS
have a blood supply. The cornea and lens must be transparent so          less drainage) through the uveoscleral tract. Conversely, cyclo-
the absence of blood vessels is critical to the normal functioning       plegic agents will sometimes lower IOP by relaxing the CBSM
of these tissues. Aqueous humor provides the nutritional and             cells and allowing greater uveoscleral drainage.
waste removal circulation for these structures. Aqueous is color-
less and transparent with a refractive index of 1.33 between the         CORNEAL THICKNESS: WHY IT MATTERS
cornea and the lens. Aqueous Production: Aqueous is produced             Brian E. Flowers, MD
within the ciliary processes by diffusion (solutes down a concen-        The importance of central corneal thickness (CCT) in the glau-
tration gradient), ultrafiltration (bulk flow of blood plasma            coma patient has taken center stage in the last decade. When
across the fenestrated ciliary capillary endothelia into the ciliary     Goldmann designed his applanation tonometer, he understood
body stroma), and active secretion (energy dependent transport           the effect variations in corneal thickness would have on his
of solutes against a concentration gradient). Active secretion is        device. He unfortunately may have underestimated the
responsible for between 80-90% of total aqueous humor for-               amount of variability in the human population. The publication
mation. Active secretion is energy dependent and pressure                of the Ocular Hypertensive Treatment Trial (OHTS) solidified the
insensitive at near physiologic IOP. However, ultrafiltration is sen-    need to pay closer attention to this parameter. Many studies
sitive to changes in IOP; decreasing with increasing IOP. This phe-      have shown that the distribution of CCT by diagnosis supports
nomena is called “pseudofacility” (facility of inflow). Termed this      an effect on intraocular pressure (OHT>Normals>POAG>NTG).
because pressure-induced decrease in inflow falsely appears as           The OHTS study showed CCT to be the single most important
an increase in drainage. In humans pseudofacility has a very             variable in determining which patients would progress to glau-
minor role in total facility. Aqueous turns over about 1-1.5% of         coma. At first glance it appeared that the effect was merely an
total volume per minutes i.e. 2.5 ul per minute. The most impor-         error in the measurement of IOP. Thus the popularity of conver-
tant enzymes for aqueous production are carbonic anhydrase               sion tables began to develop. Then the EMGT showed that
and sodium-potassium –activated adenosine triphosphate. As a             CCT was not a risk factor for the development of glaucoma in
result of active transport, aqueous composition is different from        its trial. A subsequent review of the OHTS data showed that                29
plasma. Aqueous is very low in protein (20 mg/100 ml) 200x less          after correcting IOP for CCT, CCT was still an independent risk
than serum and very high is ascorbic acid (20x greater), lactate is      factor for progression to glaucoma. What is going on here?
in excess, chloride, as well as some amino acids. Blood Aqueous          There are likely two factors at work. There is some over/unde-
Barrier: the BAB is not a discrete struction, but a series of events     restimation of true IOP based on CCT. Secondly, CCT is likely
that maintain the differences in aqueous from plasma.                    correlated with some unknown anatomic factor that increases
Capillareis of ciliary processes and choroid are fenestrated, but        the risk of optic nerve damage. Clinic based studies (OHTS)
the interdigitating surfacesof the retinal pigmented epithelial          likely select for thick corneas, thus demonstrating an IOP rela-
layer and the non-pigmented epithelium of ciliary processes are          ted effect. Population based trials (EMGT) have a more normal
joined by tight junctions and constitute an effective barrier.           distribution of CCT and thus do not show an effect. The next
Aqueous Drainage: Aqueous leaves the anterior chamber prima-             frontier is to gain a better understanding of the significance
rily though two pathways: 1) the conventional pathway -                  the structural composition of the eye plays in the development
through the trabecular meshwork (TM) into Schlemm’s canal,               of optic nerve damage. In the meantime, we should under-
then onto the collecting channels, and finally through the epi-          stand the lessons that have been learned thus far. CCT has an
scleral veins. 2) the uveoscleral pathway - through the ciliary          independent, yet modest, effect on IOP. CCT has always been
body face and into the choriocapillaris; some components then            a surrogate measurement for the cornea’s “stiffness”. Patients
either diffuse through the sclera while others exit via the vortex       should be placed in broad categories (thick, thin, average) and
veins. In the conventional pathway, the majority of resistance is        their risk of nerve damage should be considered accordingly.
believed to be located within the trabecular meshwork – specifi-         There will always be exceptions to this categorization with
cally the juxtacanalicular area (the part of the TM immediately          regards to risk of nerve damage.
adjacent to Schlemm’s canal). It is estimated that between 66-
75% of outflow resistance is located within the juxtacanalicular         CATARACT SURGERY IN THE GLAUCOMA PATIENT
area. The juxtacanalicular area is not a static structure. It is amor-   Richard L. Lindstrom, MD
phous and dynamic. There are three mechanisms that potential-            Cataract surgery may well represent the most frequent glauco-
ly regulate IOP: 1) the formation of openings (termed “B pores )         ma procedure performed by the Comprehensive Ophthal-
between Schlemm’s canal inner wall cells (also known as the              mologist. Ten to fifteen per cent of patients with reduced vision
“paracellular pathway”), 2) the formation of openings ((termed           secondary to cataract have associated ocular hypertension or
“I pores”) within cells (also known as the “transcellular                glaucoma. Fortunately, cataract surgery alone reduces IOP signi-
pathway”), and 3) turnover of extracellular matrix which sur-            ficantly, and the reduction is proportional to preoperative IOP,
rounds the cells and is at the openings of the pores. In the uveo-       measuring 6-8 mmHg in the patient with a pressure between
scleral pathway, the resistance is controlled by 1) altering the         22-30mmHg. The rationale for approaching most glaucoma in
extracellular matrix turnover and 2) the muscular tone of the            association with cataract with cataract surgery alone and the
ciliary body smooth muscle cells. Prostaglandin analogues lower          outcomes to be anticipated will be discussed.
                                   CANALOPLASTY: 24 MONTH U.S. DATA                                       ach. In recent history, several different techniques have been
                                   Brian E. Flowers, MD                                                   described such as trabeculopuncture, goniophotoablation, laser
                                   Trabeculectomy with/without antimetabolite use has been the            trabecular ablation, and goniocurretage. All of these procedures,
                                   standard of care for glaucoma surgery for many years. Although         including the trabectome, are variations of goniotomy which is
                                   it is an effective means of lowering intraocular pressure, nume-       incision (without removal) of the trabecular meshwork allowing
                                   rous intraoperative and postoperative complications are known          direct communication between the anterior chamber and

                                   to occur. The search for an effective means of intraocular pres-       Schlemm’s canal. Through a temporal clear corneal approach, a
                                   sure lowering without the formation of a filtering bleb has been       probe is inserted through trabecular meshwork and into
                                   ongoing. Canaloplasty is one such procedure, which seeks to            Schlemm’s canal. Thermal ablation is used to remove the nasal
                                   lower intraocular pressure in a non penetrating fashion. In cana-      trabecular meshwork and internal wall of Schlemm’s canal for
                                   loplasty one seeks to create flow through a Descemet’s window          60-140 degrees. Mechanism of IOP Lowering: Aqueous leaves
                                   into Schlemn’s canal. This is combined with viscodilation and          the anterior chamber primarily though two pathways: 1) the
                                   stenting open Schlemn’s canal to improve flow into the aqueous         conventional pathway - through the trabecular meshwork (TM)
                                   collector channels. The procedure involves creating a half thick-      into Schlemm’s canal, then onto the collecting channels, and
                                   ness triangular or parabolic scleral flap, which is followed by a      finally through the episcleral veins. 2) the uveoscleral pathway -
                                   second deep scleral flap to expose Schlemn’s canal and create a        through the ciliary body face and into the choriocapillaris; some
                                   Descemet’s window. A 250 micron flexible catheter is then inser-       components then either diffuse through the sclera while others
                                   ted into Schlemn’s canal and passed for 360 degrees. The cathe-        exit via the vortex veins. In adults, between 65-90% of aqueous
                                   ter has fiberoptic illumination for guidance and a lumen for           humor exits through the conventional pathway. The trabecular
                                   injection of viscoelastic. A prolene suture is then attatched to the   meshwork is estimated to contain 90% of the resistance of the
                                   distal tip of the catheter once it is retrived from the opposite cut   conventional pathway. The anatomic location that is generally
                                   end of Sclemn’s canal. The catheter’s direction is then reversed       believed to be the site of the greatest resistance to outflow is the
                                   and viscoelastic injected to viscodiltate the canal and to thread      juxtacanalicular TM. Theoretically, removal of the trabecular
                                   the prolene suture into the canal. The suture is then tied tightly     meshwork should bypass a very large proportion of outflow resi-
                                   to stent open the canal. The deep scleral flap is removed and the      stance. Clinical Effectiveness: as a stand alone procedure, to
                                   superficial scleral flap and conjunctiva are closed in a watertight    date, there have been four longitudinal case series in the peer
                                   fashion. In the U.S. a multicenter study is underway and 24            reviewed literature (Minckler DS et al., Ophthalmology, 2005).
                                   month data is now available. Pertinent inclusion criteria were         The first was the original report of the first of 37 eyes performed
30                                 IOP >21, open angle glaucomas, suture successfully placed, and         outside the United States with a follow up was between 3 and
                                   no postoperative blebs. Pertinent exclusion criteria were previous     13 months. In this series, the mean IOP lowered from 28.2 + 4.4
                                   angle surgery, more than 2 trabeculoplasties, and secondary            mmHg (after 1 week of medication washout) to roughly 17 +
                                   glaucomas. The publication of 24 month data is currently in            2.5 mmHg at 6 and 12 months. Additionally, there was a reduc-
                                   press at the Journal of Cataract and Refractive Surgery. There         tion in the number of medications. Each of the three subsequent
                                   were 127 patients enrolled, with 101 patients reaching 12              publications have been inclusive of the previous series patients
                                   months and 106 patients reaching 24 months. Baseline IOP was           with extended follow up (Minckler DS et al Trans Am
                                   23.6 +/- 4.8 on 1.9 +/- 0.8 medications. IOP at 12 months and          Ophthalmol Soc 2006;104:40-50, Filipoppolous T, Rhee DJ. Curr
                                   24 months respectively was 15.4 +/- 4.2 on 0.4 +/- 0.7 meds and        Opin Ophthalmol 2008;19:149-155, and Minckler D et al Trans
                                   16.0 +/- 4.2 on 0.5 +/- 0.8 meds. The IOP was lower in patients        Am Ophthalmol Soc 2008;106:149-150). Both series demon-
                                   who had canaloplasty combined with phacoemulsification. For            strated that the average IOP reduction is approximately 30%
                                   canaloplasty alone eyes, 24 month IOP was 16.3 +/- 3.7 on 0.6          with final IOPs in the mid-teens and an decrease in the number
                                   +/- 0.8 meds. For canaloplasty combined with phacoemulsifica-          of medications. There has been one case series of evaluating the
                                   tion, IOP at 24 months was13.4 +/- 4.0 on 0.2 +/- 0.4 meds. IOP        effectiveness of combined trabectome and phacoemulsification
                                   was correlated with the degree of distention of the canal. Those       cataract extraction (Frances BA, et al. J Cataract Refract Surg.
                                   with excellent distention had IOP of 15.7 +/- 3.1 versus 18.3 +/-      2008;34:1096-1103). They reported on 252 patients with a pre-
                                   4.2 in patients with lesser distention. The goal of non penetra-       operative IOP of 19.7 mmHg and final IOP in the mid-teens 15.5
                                   ting surgery is to minimize complications associated with con-         mmHg at 12 months and a subsequent decrease of medications
                                   ventional filtration surgery. No complication occurred in more         from 2.65 to 1.55.
                                   than 8% of patients. The most common complications were                Canaloplasty
                                   hyphema and early elevated IOP. There was one case of hypoto-          Introduction/Description: using an external/transconjunctival
                                   ny and no choroidal detachments. Visual acuity was well preser-        approach, a cutdown to Schlemm’s canal is made. The outer wall
                                   ved. The U.S. data is similar to data from our European counter-       of Schlemm’s canal is removed and a flexible microcatherter is
                                   parts (Tetz et al). In their series of 65 patients that reached 24     used to circumfrentially to inject viscoelastic to dilate Schlemm’s
                                   months of follow-up, the baseline IOP was 23.1 +/- 4.1 on 1.8          canal. Typically, a prolene suture is tied under tension within
                                   +/- 0.7 medications. This was reduced to 15.7 +/- 3.0 on 0.7 +/-       Schlemm’s canal. The sclera flaps are then tied with the intention
                                   0.8 medications at 24 months.                                          of a water-tight closure. Mechanism of IOP Lowering: the exact
                                                                                                          mechanism is unknown, but it is believed that the combination
                                   EVIDENCED-BASED VIEW OF TRABECTOME (AB INTERNO                         of the dilation and chronic stretch of the trabecular meshwork
                                   TRABECULECTOMY) AND CANALOPLASTY                                       induced by the prolene suture decrease aqueous outflow. A pos-
                                   Douglas J. Rhee, MD                                                    sible mechanism may be enhanced transcellular outflow. Clinical
                                   Ab Interno Trabeculectomy (Trabectome)                                 Effectivenss: as a stand-alone procedure, there has been one
                                   Introduction/Description: ab interno trabeculectomy refers to          case series of 168 patients with approximately one year follow
                                   removal of trabecular meshwork tissue from an internal appro-          up (Lewis RA, et al JCRS 2007). They found that the IOP effecti-
veness was enhanced using the tensioning suture. In that group       racteristics and cutter speed can result in more efficacious use of
of 74 patients, the IOP lowered from the low 20’s to approxima-      vitrectomy in the anterior segment. Indication for posterior
tely 15 mmHg at 12 months. When combined with phacoemul-             vitrectomy and referral to the vitreoretinal surgeon are more
sification cataract extraction, there has been one series            easily recognized by the anterior segment surgeon as a result of
(Shingleton B, et al JSCRS 2008) of 54 patients showing an IOP       an improved understanding of the principles of vitrectomy.
lowering from 24 mmHg to 14 mmHg at one year with a decrea-          Conclusions: Anterior vitrectomy is an important competence for

                                                                                                                                           ABSTRACTS INTERNATIONAL SESSIONS
se of 1.3 medications.                                               the cataract surgeon. An understanding of the principle and
                                                                     practice of vitrectomy is important in reducing the incidence of
PRINCIPLES AND PEARLS OF ANTERIOR VITRECTOMY FOR                     complications related to this procedure. The newer vitrectomy
COMPLICATED CATARACT SURGERY                                         instruments have excellent applicability to the anterior segment.
Keith A. Warren, M.D.                                                Techniques for vitreous visualization and new variable cutter spe-
Purpose: to discuss the principle of vitrectomy for the safe remo-   eds offer great advantages for the anterior segment surgeon. A
val of vitreous from the anterior segment in complicated cataract    better understanding of the instrumentation, their limitation and
cases. New instrumentation, vitreous flow characteristics, vitrec-   potential pitfalls may lead to improved outcomes in complicated
tomy settings and potential pitfalls will be presented. Methods:     cataract surgery.
The anatomic and mechanical considerations for vitreous remo-
val will be presented. The history of vitrectomy and instrument      INTENSE PULSE LIGHT FOR DRY EYE SYNDROME
design will also be reviewed. Issues pertaining to vitreous flow     Rolando Toyos, MD
characteristics, the role of instrument diameter, and cutter speed   Meibomian Gland Dysfunction is the leading cause of evaporati-
as they relate to anterior vitrectomy are discussed.                 ve dry eye. Many of those patients have telangiectasias that feed
Representative cases will be used to demonstrate the application     inflammatory cytokines to the glands which prevent proper fun-
of vitrectomy and vitrectomy instrumentation for anterior seg-       ction. For many years dermatologists have been using intense
ment complications and disease. Results: Complications related       pulse light, IPL, to treat telangiectasias of the skin. We found
to anterior segment vitrectomy are most commonly related to          that intense pulse light helped meibomian gland dysfunction,
inadvertent vitreous traction not recognized by the surgeon.         MGD, in rosacea patients. We completed a study 3 years ago
Techniques for vitreous visualization and an understanding of        showing that IPL is an effective treatment in all patients with
the anatomy may reduce these complications. While smaller            MGD. For the last six years we have been using IPL to treat dry
vitreous cutters have excellent applications for the complicated     eye due to MGD. In our talk we will be presenting six year data,
cataract surgery, an understanding of the principles of flow cha-    showing technique, and explaining my theory on why it works.                 31
FABIANO GROUP srl - Canelli (AT)

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