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• Competence
• Compassion
• Committment
• Communication

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• Competence
• Compassion
• Committment
• Communication

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IOL's

HYDROPHOBIC

HYDROPHOBIC IOL'S

• HIGHER REFRACTIVE INDEX - THINNER
• MORE NEGATIVE DYSPHOTOPSIA
• STIFFER - EXCELLENT FOR SURFACE ENGINEERING : TORIC, MULTIFOCAL
• BETTER PCO PREVENTION
• LESS CALCIFICATION
• EXPENSIVE

HYDROPHILIC

HYDROPHILIC IOL'S

• LOW REFRACTIVE INDEX - THICKER
• LESS NEGATIVE DYSPHOTOPSIA
• COMPRESSIBLE : SMALLER INCISIONS
• CHEAP
• CAN CALCIFY!

SILICONE

SILICONE IOL'S

• MUCH MALIGNED
• FIBROSIS+++
• LOW REFRACTIVE INDEX
• FRAGILE - TEARS EASILY
• CAN'T BE SINGLE PIECE
• PROBLEM WITH VR SURGERY
• EXTREMELY FLEXIBLE

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CONCLUSION

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• IOL DESIGN IS COMPLEX
• RELATIONSHIP DESIGN-SURGERY-ENGINEERING
• MANY GOOD BUT NO PERFECT IOL
• CLINICALLY IMPORTANT DIFFERENCES

GENERAL ADVICE

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• CONTROL YOUR INSURANCE AND USE INFORMED CONSENT
• START STEP BY STEP : FIRST COMPLETE SURGERY ONLY AFTER 100 CASES
• FIND SOMEONE TO ASSIST YOU THE FIRST 100 CASES

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• RHEXIS : SUPPORT YOUR DOMINANT HAND WITH THE NON-DOMINANT HAND
• RHEXIS : SUPERFICIAL ! DO NOT TOUCH THE CORTEX
• HYDRODISSECTION : IT AIN’T OVER ‘TILL IT’S OVER…

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• PHACO : KEEP YOUR SECOND INSTRUMENT BETWEEN PHACO TIP AND CAPSULE!!!
• EVERY SURGEON HAS OR HAD COMPLICATIONS SO YOU ARE NOT ALONE...!

IN CASE OF EMERGENCY...

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• LOW BOTTLE
• LOW FLOW
• DON'T WITHDRAW YOUR PHACO TIP!
• DISPERSIVE VISCOELASTIC
• 'SLOW MOTION PHACO!'

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• LOW BOTTLE
• LOW FLOW
• DON'T WITHDRAW YOUR PHACO TIP!
• DISPERSIVE VISCOELASTIC
• 'SLOW MOTION PHACO!'

START TOPICAL, BIMANUAL I/A AND TEMPORAL