Mark Packer, MD Financial Disclosure Consultant –Advanced Medical Optics, Inc. –Advanced Vision Science, Inc. –Bausch & Lomb, Inc. –Candeo Clinical/Science.

Mark Packer, MD

Financial Disclosure

Consultant

– Advanced Medical Optics, Inc.

– Advanced Vision Science, Inc.

– Bausch & Lomb, Inc. – Candeo Clinical/Science Communications, LLC– Carl Zeiss Meditec, Inc.

– Carl Zeiss Surgical GmbH

– Celgene Corporation

– General Electric Company

– Gerson Lehman Group, Inc.– Ista Pharmaceuticals, Inc.

– i-Therapeutix, Inc.

– Johnson & Johnson Vision Care, Inc.

– Leerink Swann & Company– LifeGuard Health, LLC─ Sirion Therapeutics, Inc.

– Transcend Medical, Inc.

– TrueVision Systems, Inc.

– Visiogen, Inc.

– VisionCare, Inc.

– WaveTec Vision Systems

Travel & Honoraria– Endo Optiks, Inc.

September 1, 2008

Re-opening bag, Repositioning the IOL,

and IOL exchange

Mark Packer, MD, FACS

Clinical Associate Professor

Department of Ophthalmology

Oregon Health & Science University

Drs. Fine, Hoffman & Packer, LLC

Eugene, Oregon

Opening the Bag

• Viscodissection– Dispersive OVD– Small, blunt cannula– Don’t fill AC– Haptic/optic junction– Expand bag

Repositioning the IOL

• Rotation

• Strip fibrotic membranes

• I/A

IOL Exchange

• Dysphotopsia– To YAG or not to YAG

• Power– Piggyback, Cornea

• No support– Suture

Thank You