Supported by an unrestricted independent medical educational grant from Alcon
Commercially supported by Carl Zeiss Meditec, Inc., Crestpoint Management, Glaukos, and MST

EPISODE 4 April, 2016

Severe Zonule Laxity: The Zonule-Friendly Technique

Accreditation Statement: This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Amedco and Postgraduate Health Education (PHE).Amedco is accredited by the ACCME to provide continuing medical education for physicians.
Credit Designation Statement: Amedco designates these enduring material videos for a maximum of .25 AMA PRA Category 1 CreditsTM each. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Financial Disclosure Information: Financial disclosure information is provided to learners and contains the relevant financial relationships that each individual in a position to control the content of CME disclosed to PHE. All of these relationships were treated as a conflict of interest, and have been resolved. (C7 SCS 6.1-­-6.2, 6.5) All planners disclosed they had no financial relationship. Richard J Mackool, MD has the following financial relationships: Consultant to Alcon and Diopsys. Proprietary interest in MST and Impex.
Target Audience: Ophthalmologists with an interest in cataract surgery.
Learning Objectives: After reviewing the educational video, learners should be able to anticipate and appropriately respond to evidence of zonular laxity during phacoemulsification, discuss the advantages provided by capsule retractors in eyes with zonular laxity, and describe methods to insert and remove capsule retractors.
Method of Physician Participation: Each physician will listen and follow along with the surgery video. Upon completion, must pass a posttest and answer evaluation questions to get their CME certificate.
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Episode 4: Severe Zonule Laxity: The Zonule-Friendly Technique

Pseudoexfoliation and a large nucleus that masks zonule laxity is the situation with this eye in which the anterior capsule behavior during capsulorhexis doesn't alert the surgeon to the true status of the zonule. Using Trypan Blue, 360º viscodissection, a back crack technique, special techniques to rotate the nucleus, capsule retractors and a CTR, I am able to perform zonule-friendly phaco and IOL insertion in an eye that continues to bring surprises throughout the case. The video is necessarily a bit long but I think you will really enjoy this one!

Richard J. Mackool, MD Financial disclosure: Consultant to Alcon, Diopsys. Proprietary interest in MST, Impex.