Eyeworld

Cornea Society News is the Cornea Society's quarterly electronic newsletter. Distributed to all members, the newsletter offers important society information and meeting reporting, along with the latest clinical, regulatory, and business news. Circulation: approximately 800 Digital Ad space available Corneasociety.org is the Cornea Society's member-centric website. It provides regular clinical updates, meeting and event information, video and Cornea Society University content, along with business news, quarterly Society newsletters, and the access to the journal Cornea. Tradi- tional banner advertising is available. Contact your sales representative for further information. News August 2019 Vol. 16, No. 2 A Cornea Society publication T he 2019 Cornea Day took place ahead of the ASCRS ASOA An- nual Meeting in San Diego and featured sections on anterior seg- ment reconstruction, corneal/lamellar or transplant surgery, the ocular surface, and controversies and complications. "We asked the moderators to focus on real-world, practical clinical challeng- es that cornea and anterior segment spe- cialists are faced with on a daily basis, and they delivered a program that ex- ceeded all expectations," said Elmer Tu, MD. "The speakers took our direction and did a fantastic job of mixing theory and practice together to deliver pearl after pearl of practicable knowledge." Kathryn Colby, MD, PhD, noted the high quality of the programming. The sessions on advanced techniques for anterior segment reconstruction and the ocular surface for cataract surgery were both excellent, she said. Dr. Colby mentioned presentations that touched on cataract surgery in the cloudy cornea and Descemet's stripping only (DSO), which she said will likely be a hot topic at the 2020 World Cornea Congress. During the section on lamellar sur- gery, Deepinder Dhaliwal, MD, discussed the best candidates for DSO. She first described the concept of DSO where the guttae are barriers to endothelial cell migration. You remove the central 4-mm zone of Descemet's membrane in patients with Fuchs' dystrophy, and you don't place any donor graft, she said. Dr. Dhaliwal said physicians need to be prepared for postop day 1, where patients may see massive central corneal edema. But she noted that most clear after 4 to 12 weeks. Dr. Dhaliwal said you should use this only in patients with central Fuchs' (with a clear periphery). It's not for patients with pseudophakic bullous keratopathy. She also stressed the impor- tance of careful counseling and said that this is only for "patients with patience." Vision can take 3 months to recover and is markedly reduced immediately postop, and therefore, the patient needs good vision in the fellow eye. If the cor- nea does not clear, Dr. Dhaliwal recom- mended DMEK. She said that DSO is indicated in patients with Fuchs' dystrophy and: 1. The presence of central guttae is deemed to be the chief cause of visual symptoms. 2. There is a clear peripheral cornea with an endothelial cell count of greater than 1,000 cells/mm 2 on confocal or specular microscopy. 3. The patient is otherwise contemplat- ing endothelial keratoplasty. She also shared several contraindica- tions for DSO: 1. Advanced corneal stroma edema 2. Peripheral endothelial cell count less than 1,000 cells/mm 2 3. Presence of secondary corneal pathology 4. History of herpes simplex virus or cytomegalovirus keratitis Another section of Cornea Day focused on preparing the ocular surface for cataract surgery. Chris Starr, MD, highlighted the ASCRS Preoperative OSD Algorithm, which was created by the ASCRS Cornea Clinical Committee. Oc- ular surface disease is common but often asymptomatic in cataract patients. It can also be visually significant. Visually significant ocular surface disease (VS- OSD) reduces accuracy of preoperative refractive measurements, reduces visual quality and quantity pre- and postoper- atively, and blepharitis may increase the risk of endophthalmitis. The goals of the ASCRS Cornea Clin- ical Committee were to create a "true algorithm" that was consensus- and evidence-based, that could be integrat- ed into preoperative surgery visits, had reliance on technicians and objective testing to reduce chair time, and that identified all visually significant sub- types of OSD prior to surgery. 2019 Cornea Day highlights ocular surface, corneal lamellar and transplant topics, and more continued on page 4 Dr. Starr presents during Cornea Day on the ASCRS Preoperative OSD Algorithm. February Space: January 1, 2020 Material: January 27, 2020 April Space: March 16,2020 Material: March 25, 2020 July Space: June 22, 2020 Material: July 1, 2020 September Space: August 17, 2020 Material: August 26, 2020 Full page: 8.5" x 11" Half page horizontal: 8.5" x 5.5" Half page vertical: 4.25" x 11" Bleed: 0.25" 300 dpi JPG or PDF format CMYK 300 dpi JPG or PDF format CMYK CORNEA SOCIETY 6

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