EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
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160 EW MEETING REPORTER March 2013 Reporting live from Hawaiian Eye 2013, Big Island, Hawaii back to the patient and the physician," Dr. Wiggs said. "Eventually what we are looking forward to is a comprehensive gene panel that will tell us everything about patients with regard to their glaucoma." Editors' note: Dr. Wiggs has no financial interests related to this talk. Thursday, January 24 Editors' note: This Meeting Reporter contains original reporting by the EyeWorld news team from Hawaiian Eye 2013. After early morning sessions on retina and improving post-surgical outcomes, the main focus at Thursday's Hawaiian Eye meeting was the management of the ocular surface. Nicoletta Fynn-Thompson, M.D., Boston, gave a review of indications and innovations for using bandage contact lenses (BCLs) to treat ocular surface diseases such as painful erosions from stromal edema and injuries from chemical burns, among others. "BCLs provide pain relief and comfort from exposed nerve endings that occur with corneal abrasions from corneal dystrophies, neurotrophic keratopathy, or post-surgical states," she said. The benefits of BCLs include mechanical protection for migrated and/or newly formed cells from the blinking action of the eyelids; wound healing with or without ad- junct use of amniotic membrane; and as a vehicle for drug delivery by increasing drug release duration without impacting vision or oxygen permeability while simultaneously allowing for better permeation and absorption of the drug, Dr. FynnThompson said. "It also will provide a smooth anterior corneal optical surface and will improve the patient's vision as the eye is healing underneath," she said. Dr. Fynn-Thompson said surgeons should look for a bandage lens with water content greater than 70% and a diameter large enough to cover the cornea and 1 mm of limbus. The lens should have minimal movement during blinking and be replaced every two to four weeks in active disease. "However, if you have longterm use, you can leave them in as long as three months," Dr. FynnThompson said. Contraindications include an unreliable patient, a patient with severe keratoconjunctivitis sicca or a pronounced decreased corneal sensation. Potential BCL complications include infectious keratitis, emergence of resistant organisms, tight lens syndrome, surface deposits, corneal neovascularization and edema and giant papillary conjunctivitis. Editors' note: Dr. Fynn-Thompson has no financial interests related to her talk. Repairing the ocular surface Amniotic membrane is the ideal tissue for surface repair and reconstruction and offers a wide variety of clinical indications, a speaker said at Hawaiian Eye 2013. It suppresses inflammation, scarring and neovascularization, while promoting re-epithelization and anatomical and visual rehabilitation, said Kenneth R. Kenyon, M.D., Boston. "There are multiple and increasingly variant products that are used in a variety of clinical settings with techniques suited for these situations," Dr. Kenyon said. Amniotic membrane currently is available in both frozen and cryogenic forms. "It really is different strokes for different folks," Dr. Kenyon said. "One can use as a patch over the cornea, a sort of biologic bandage." Amniotic membrane also can be used as permanent grafts with tectonic support.