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INFINITI Vision System continues to expand capabilities www.eyeworld.org New technologies enhancing patient outcomes 2 0 1 2 A S C R S • A S O A C h i c a g o S h o w D a i l y S u p p l e m e n t This Show Daily supplement is sponsored by Alcon. Two new innovations expand options in cataract surgery: AutoSert IOL Injector and ULTRACHOPPER tip AutoSert IOL Injector I OL insertion isn't a simple "push" and it's in. That's a good thing, because investing a little time to understand IOL insertion—especially what is currently at the cusp of innovation —should help deliver superior outcomes for cataract patients. The newest addition to my surgical portfolio on the INFINITI Vision System (Alcon, Fort Worth, Texas) is the INTREPID AutoSert IOL Injector (Alcon). AutoSert is an auto- mated IOL injector handpiece that enables me to control advancement of the IOL with the INFINITI system foot pedal. This frees my other hand to stabilize the eye with a second in- strument, which can also be used to adjust the position of the IOL as it is entering the capsular bag. When I use MONARCH delivery systems (Alcon), I don't have this same ability. I need both hands on the MONARCH insertion device to hold the injector and advance the plunger. Therefore I don't have a convenient way to stabilize the eye. In that scenario, if the patient starts to move, I must press the cartridge against the incision to keep the IOL from being delivered outside the eye. Other surgeons have used a one- handed injector or a three-handed technique (so to speak). In the three- handed technique, one hand is on the MONARCH injector, one hand is on the second instrument in the side port, and a surgical technician's hand advances the MONARCH plunger and IOL. However, not everyone is willing to execute a three-handed delivery. Perhaps a more controlled velocity is going to make a difference in the integrity of the incision. In my experience, the INTREPID AutoSert IOL Injector allows for a higher level of control in IOL deliv- ery. In addition to the foot pedal control of the IOL advance, the INFINITI system software has three parameter settings the surgeon can control to meet his/her unique requirements. These parameters are: initial velocity, pause time, and final velocity. Based on my experience with hundreds of procedures with the AutoSert IOL Injector—from ini- tial tests on cadaver eyes to clinical procedures on human eyes—these parameter settings offer advantages over using a manual injector. With the AutoSert IOL Injector, the software will advance the IOL, using the initial velocity down the cartridge to the ready-to-insert posi- tion. Then when the surgeon presses the foot pedal, the AutoSert IOL Injector will advance the IOL to the end of the cartridge, where the software will pause the plunger advancement for a period of time. This pause time, set by the surgeon on the INFINITI system console, allows the IOL time to form in the tip of the cartridge and, in my expe- rience, allows me time to prepare for insertion. After the pause time elapses, and with my foot still depressed on the foot pedal, the AutoSert IOL Injector will begin to move the IOL out of the cartridge at the final velocity. The surgeon can set this final veloc- ity to be fixed or linear. Linear veloc- ity is like an accelerator you use when driving a car. As I push down on the foot pedal, it increases the ve- locity of insertion. If I want to slow down, I come off the foot pedal a bit. " In my experience, the INTREPID AutoSert IOL Injector allows for a higher level of control in IOL delivery " Donald Serafano, M.D. continued on page 2 Dr. Serafano injects an IOL using the AutoSert IOL Injector handpiece on the INFINITI Vision System This supplement was produced by EyeWorld and sponsored by Alcon. The doctors featured in this supplement received compensation from Alcon for their contributions to this supplement. Matt Young, EyeWorld contributing editor based in Singapore, assisted in writing this supplement. Copyright 2013 ASCRS Ophthalmic Corporation. All rights reserved. The views expressed here do not necessarily reflect those of the editor, editorial board, or the publisher, and in no way imply endorsement by EyeWorld or ASCRS. by Donald Serafano, M.D. Please refer to pages 10-12 for important safety information about the Alcon surgical products described in this supplement.

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