EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/1008383
EW MEETING REPORTER 70 August 2018 Reporting from the 2018 World Ophthalmology Congress, June 16–19, Barcelona, Spain Priya Narang, MD, Ahmed- abad, India, described a double infusion cannula technique that could be used to allow for secondary IOL fixation followed by endothelial keratoplasty. The technique involves the first cannula (a trocar cannula) being placed for fluid infusion at the pars plana site and the second (either an anterior chamber main- tainer or a trocar anterior chamber maintainer) placed in the anterior segment for fluid and pressurized air infusion. Dr. Narang showed how this technique worked in a case of pseu- dophakic bullous keratopathy with a secondary IOL. After making two scleral flaps, debriding the corneal epithelium (to enhance surgical visualization in this case), the first cannula was placed at the pars plana site, and a glued IOL procedure was performed. Afterward, a four-throw pupilloplasty was performed, which Corneal lamellar surgery: tips and clinical outcomes of various techniques Jorge Alio, MD, PhD, Alicante, Spain, presented research on a cor- neal stroma regeneration technique for keratoconus patients. Dr. Alio and co-investigators identified stem cells from adipose tissue as the best autologous stem cell option that would produce corneal collagen. After performing animal trials with these stem cells, finding it did in fact produce human collagen in the rabbit cornea, fur- ther research showed that acellular corneal laminas would be the best scaffold for cellular regeneration. A pre-clinical trial, in which only acellular corneal laminas were inserted through a femtosecond la- ser-created pocket vs. acellular lami- nas with adipose stem cells, showed an improvement in visual and ker- atometric parameters, Dr. Alio said. While there was initial visual loss at 1 month, transparency progressively increased. There was also significant improvement in stromal thickness parameters. Confocal microscopy showed a significant increase in cells in both groups, including the group without stem cells, showing that the patient's own cells repopulated on the scaffold as well. Overall, Dr. Alio said this re- search has shown the feasibility of corneal stromal enhancement based on stem cell therapy. A multicenter clinical trial sponsored by the Span- ish Ministry of Health is beginning this year. While the research was per- formed on advanced keratoconus patients who would otherwise need a graft, Dr. Alio said he thinks there are different indications for this technique, such as in earlier kerato- conus or other corneal dystrophies. Reporting from the 2018 World Ophthalmology Congress