At the beginning of his talk, Dr. Crandall celebrated last year's 50th anniversary of phacoemulsification with a video he made of his first combined cataract and glaucoma procedure. He traced the innovations that have made the procedures more successful and less traumatic over the years.
Recent innovations promise further benefits, he said. These include an IOL whose power can be adjusted by a femtosecond laser. The laser induces a chemical reaction in a targeted area of the IOL, causing a localized increase in hydrophilicity, decreasing its refractive index.
These adjustments can be done quickly and noninvasively with topical anesthesia. They can be done multiple times, with premium functions added or removed, and without the need for special protective spectacles, said Dr. Crandall.
Another promising innovation is the Iantech miLoop, he said. A thin, elastic, self-expanding nitinol filament, the miLoop is designed to fragment lenses while minimizing the use of ultrasonic vibrations.
It is safe and effective for disassembling the nucleus for either extracapsular removal or phacoemulsification, said Dr. Crandall, and is excellent for hard cataracts and effective for pseudoexfoliation and eyes with loose zonules.
Near his John Moran Eye Center in Utah, Dr. Crandall has brought such state-of-the-art cataract and glaucoma procedures to a homeless center, undocumented workers and the Navajo Nation, he said.
Abroad he has done cataract and glaucoma procedures in Ghana and Tanzania among other developing countries.
Dr Crandall is a consultant to Alcon Laboratories, Allergan, Omeros, Glaukos, Ivantis, IanTech, AISCO and Epsilon.