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The right hand holds the device, the smallest cartridge can be used, and we don't have to screw any- thing. We're not pushing the plunger; the plunger is footswitch- driven. The device also delivers the lens without the surgeon overcoming the buildup of potential energy. After a brief pause for seating the lens, the surgeon can select the speed at which the lens enters the eye. This gives the surgeon control over the initial and end velocity, and surgeons can opt for machine- control or linear-control based on the footswitch. It is also possible to select how far the plunger will extend into the eye. Initially, I tested the device using cadaver eyes in a laboratory setting and was impressed. When I used it for the first time in a human eye, it was wonderful. The AutoSert IOL Injector handpiece does fulfill an unmet need because it allows surgeons to have their left hand available for countertraction while their right hand holds the device. Instead of the third hand to screw the device, the foot serves that purpose. It is simple and completely automated. The AutoSert IOL Injector hand- piece gives a reproducible, consis- tent way of injecting the lens through a very small incision. 1 I believe it is going to turn out to be a gentler, less invasive way to insert the IOL. Because of increased con- trol, and especially the countertrac- tion that facilitates the lens insertion process, many surgeons are going to be very happy with this innovation. Reference 1. Allen, D, Habib, M, et al. (2012). Final inci- sion size after implantation of a hydrophobic acrylic aspheric intraocular lens: New motor- ized injector versus standard manual injector. J Cataract Refract Surg; 38(2): 249-255. Dr. Osher is professor of ophthalmology, College of Medicine, University of Cincinnati, and medical director emeritus, Cincinnati Eye Institute. Contact information Osher: 513-984-5133, rhosher@cincinnatieye.com EW Chicago 2012 3 EX-PRESS device compares favorably to trabeculectomy in many respects Osher continued from page 2 With fewer post-op visits needed and faster return to baseline visual acuity, the EX-PRESS device provides a viable surgical option for certain patient groups T he EX-PRESS Glaucoma Filtration Device, which is non-valved and made of medical grade 316L stain- less steel, has been utilized as an alternative to standard tra- beculectomy for several years. Use of the EX-PRESS device has increased steadily since its introduction be- cause of perceived improvements in the reproducibility of aqueous filtra- tion when compared with trabeculectomy while avoiding the need for a surgical sclerectomy and iridectomy. My own clinical observations have revealed that the EX-PRESS device does have its advantages. While IOP reduction has been demonstrated to be similar between EX-PRESS device procedures and trabeculectomy, I have found a decrease in vascularity of blebs with by Malik Y. Kahook, M.D. New technologies enhancing patient outcomes " Use of the EX-PRESS device has increased steadily since its introduction because of perceived improvements in the reproducibility of aqueous filtration when compared with trabeculectomy " Malik Y. Kahook, M.D. The EX-PRESS device in the eye Source: Alcon continued on page 4

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