ROME — There are challenging cases such as hard brunescent or white cataracts that can lead to capsule rupture, vitreous loss, retained lens fragments and the inability to properly implant the IOL. The miLOOP helps prevent these complications by transecting hard, difficult lenses in a safe and easy manner with simple maneuvers that do not stress the zonules, according to one surgeon.
“When the going gets tough, go to the miLOOP,” Alan Faulkner, MD, said at the OSN Italy meeting here.
The miLOOP (Zeiss) is a single-use instrument with a flexible, retractable nitinol loop that is inserted in the capsular bag, encircles the cataractous lens and, when retracted, chops it in half. The same maneuver can be repeated multiple times to break the lens into smaller pieces.
“The material is soft and pliable, yet it has a very good memory. It folds up to a very small circle which enters the eye through a small incision, opens up to adapt to the shape of a lens and then tightens like a snare to chop the lens when you press the button. It does this mechanically, with forces that are inwardly directed and put very little stress on the zonules,” Faulkner said.
The miLOOP can be used with cataracts of any grade. It also loosens the cortex, making irrigation and aspiration easier. It minimizes the amount of phaco energy required to carry out the operation, leading to less trauma, reduced endothelial cell loss and faster recovery.
“Mechanical fragmentation with the miLOOP is also more efficient as compared with femtosecond laser fragmentation. With dense lenses, the femtolaser is often unable to create perfect fragments,” Faulkner said.
He uses the miLOOP routinely on difficult cataracts.
“There is a cost involved, so I don’t use it with every cataract, though the OR time you save by using it might partly compensate the extra cost,” he said. – by Michela Cimberle
Faulkner A. A novel device for lens fragmentation. Presented at: OSN Italy meeting; May 24-25, 2019; Rome.
Disclosure: Faulkner reports he is a consultant to Alcon, Avedro, Bausch + Lomb and Omeros.