The Use of DuoVisc® to Decrease Complication Rates In Cataract Surgery In Flomax Patients R. Toyos, M.D. Memphis,Tennessee,USA Financial Disclosure: Dr. Toyos is a consultant for Alcon

Background Flomax patients Purpose Increased risk of floppy iris syndrome Trend towards higher complication rates Could benefit from surgery without hooks or iris manipulation Purpose Describe surgical technique without iris manipulation Technique utilizes Viscoat® and ProVisc® Technique takes advantage of creating a pressure gradient with OVD

Toyos Tilt Technique Soft shell with DuoVisc®: Viscoat®: Chondroitin sulfate protects the endothelium ProVisc®: Provides the mechanical protection for space maintenance Capsulorhexis followed by hydrodelineation Tilt lens in the bag with round tip canula Add more ProVisc to AC Reduces chance of iris contraction and prolapse Creates mechanical barrier and pressure gradient Increases pressure in AC (AC > PC) Keeps lens below iris plane

Toyos Tilt Technique Video

Best Corrected Distance Visual Acuity Results: Seven Cases 20 40 60 80 100 >20/20 >20/25 >20/30 >20/40 <20/40 Snellen Distance VA Percent of Patients Preop 1 Day Post 1 Week Post 1 Month Post No Intraoperative or Postoperative Complications

Conclusion Technique safety Positive visual outcome results No intraopeative complications No iris prolapse or contraction No postoperative complications Positive visual outcome results 71.4% of patients 20/20 or better 1M postop All patients (100%) 20/30 or better 1M postop