Eyeworld

105 EW IN OTHER NEWS March 2019 Reference Sharma VK, et al. Novel use of Malyugin ring to avoid intraoperative positive vitreous pressure during triple procedure. J Cataract Refract Surg. 2019. Epub ahead of print. Global consensus on definition of limbal stem cell deficiency In 2012, the Cornea Society estab- lished the Limbal Stem Cell Working Group in order to develop a globally accepted definition and diagnostic criteria for limbal stem cell deficien- cy (LSCD). In January they released a consensus. Overall, the definition describes LSCD as "an ocular surface disease caused by a decrease in the population and/or function of cor- neal epithelial stem/progenitor cells; this decrease leads to the inability to sustain normal homeostasis of the corneal endothelium." The working group goes on to list the different classifications of LSCD, diagnosis, and staging based on clinical presentation. Reference Deng SX, et al. Global consensus on definition, classification, diagnosis, and staging of limbal stem cell deficiency. Cornea. 2019;38:364– 375. Topography-guided versus wavefront-optimized LASIK A prospective comparative study of topography-guided versus wave- front-optimized LASIK found that both resulted in safe and effective refractive surgery. However, topogra- phy-guided LASIK resulted in fewer higher order aberrations, especially ocular trefoil, corneal total HOAs, and coma, according to Kim et al. Overall, uncorrected distance visual acuity of 0.0 logMAR or better occurred in 90.7% of eyes that re- ceived either topography-guided or wavefront-optimized treatments. EW Reference 1. Kim J, et al. Comparison of surgical out- comes with topography-guided versus wave- front-optimized LASIK for myopia. J Cataract Refract Surg. 2019. Epub ahead of print. Minimizing endothelial cell loss due to Descemet's membrane stamping Stamping an orientation reference on Descemet's membrane for trans- plantation can result in endothelial cell loss in that area. A study by Newman et al., however, found that endothelial cell loss due to stamping can be minimized by using a small- er, F-shaped stamp and by using pre- stripped tissue vs. preloaded tissue. Reference Newman LR, et al. Minimizing endothelial cell loss caused by orientation stamps on pre- loaded Descemet membrane endothelial kera- toplasty grafts. Cornea. 2019;38:233–237. Malyugin ring for chamber stability in some cataract cases In a recent study, Sharma et al. describe a novel use of a Malyugin ring, usually employed for pupil expansion, for chamber stability in open-sky cataract cases. Sharma et al. wrote that using the Malyugin ring under the margins of the host cornea can stabilize the chamber in the presence of positive vitreous pressure to allow for safe capsulor- hexis creation and cataract removal. They find this technique is espe- cially useful in cases with a hyper- mature cataract and a non-dilating pupil where the patient requires a triple procedure. Shedding light on genetics of AMD Scientists from the National Eye Institute identified genes that are associated with AMD, a discovery that could lead to new treatment pathways for this leading cause of blindness and vision loss in those older than 65. "If we were conduct- ing a criminal investigation, prior research would have localized dif- ferent crime syndicates to 52 streets within 34 zip codes. These latest findings identify actual suspects— direct targets that we can more closely investigate," lead investiga- tor Anand Swaroop, PhD, said in a press release statement. Conducting RNA analysis from more than 400 donor retinas with and without AMD—the first study to analyze transcriptional RNA in the context of AMD—the researchers searched for genetic variants that regulate gene expression, which led them to six target disease genes. They combined this knowledge with data from earlier studies and identified three other target AMD genes. Overall, this research suggests 20 new candidate genes that could play a role in AMD. In the course of this study, the team developed EyeGEx, a retinal gene expression database that can be used by other vision researchers looking at other diseases. Reference Ratnapriya R, et al. Retinal transcriptome and eQTL analyses identify genes associated with age-related macular degeneration. Nat Genet. 2019. Epub ahead of print. Low-stress training a boon to acquiring surgical skills A study of 15 medical school students with aspirations to be surgeons found that training in a low-stress environment seemed to enhance their ability to master surgical skills. According to the re- search published in Scientific Reports, they were able to master microsur- gical suturing and cutting in as little as five sessions lasting 1 hour each. "It appears that by removing exter- nal stress factors associated with the notoriously competitive and harsh lifestyle of surgery residencies, stress levels during inanimate surgical training plummet," Ioannis Pavlid- is, PhD, said in a press release state- ment. "In five short sessions these students, approaching surgery for fun or as a hobby, had remarkable progress achieving dexterity levels similar to seasoned surgeons, at least in these drills." Reference Pavlidis I, et al. Absence of stressful condi- tions accelerates dexterous skill acquisition in surgery. Sci Rep. 2019;9:1747. Stats on eye trauma hospitalizations A review of eye trauma hospitaliza- tions from 2001 to 2014 found a decrease in primary eye trauma as a cause for admission and an increase in eye trauma as a secondary diag- nosis among admittees. The latter increase, according to Iftikhar et al., was due to an increase in the num- ber of falls among elderly patients. Primary orbital fracture was the most common diagnosis for primary trauma while contusion and adnexa were the most frequent diagnoses for secondary trauma. Reference Iftikhar M, et al. Changes in the incidence of eye trauma hospitalizations in the United States from 2001 through 2014. JAMA Oph- thalmol. 2019;137:48–56. News in brief

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