SEP 2013

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

Issue link: https://digital.eyeworld.org/i/176967

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82 EW MEETING REPORTER Live reports from the 26th Asia-Pacific Association of Cataract and Refractive Surgeons Annual Meeting, July 11-14, 2013, Singapore September 2013 Pearls from the orient APACRS's first Cornea Day highlights past, present, future of keratoplasty To kick off the first Cornea Day in the history of APACRS, the opening session focused on "The Changing Face of Keratoplasty," moderated by Donald Tan, MD, Singapore, and Christopher Rapuano, MD, U.S. Dr. Tan said this topic is very important to the field. One of the key topics in this session was a special lecture on the past, present, and future of keratoplasty by Francis Price, MD, U.S. He said there are many advancements over the past 100 years that have influenced this, including the development of monofilament sutures, topical antibiotics and steroids, operating microscopes and injectable topical anesthetics. "When I think about penetrating keratoplasties, in my experience there's four scourges that really afflict penetrating grafts," Dr. Price said. These include ocular surface disease, structural deficiencies, immunological graft rejections, and glaucoma. He said that over the last 20 years, there has been a change in the demographics of the grafts. "Instead of replacing the entire cornea, we're only replacing the part with the disease," he said. And this practice ends up being a lot safer for the patients. "If we look at the evolution that we've seen in keratoplasty, it's very similar to the evolution that we've seen with cataract surgery," Dr. Price said. "Smaller incisions equal better vision and safer surgery for the patient." The biggest benefit of endothelial keratoplasty has been safety, he said. DMEK, which is the newest iteration, is becoming a lot like cataract surgery, Dr. Price said. The second session of Cornea Day, moderated by Elmer Tu, MD, U.S., and Ma. Dominga Padilla, MD, Philippines, focused on "Infections From Around the World." Prof. Tan presented results so far from the Asia Cornea Society Infectious Keratitis Study (ACSIKS), one of the largest studies of its kind to date. Prof. Tan said there have been many studies looking at infections, but they often have different criteria and tests. "We have a vastly different spectrum of infections in Asia," Prof. Tan said. "There is a difficulty inherent in comparing some of these studies." ACSIKS is a multicenter, prospective, observational study involving 12 study centers in eight major Asian countries. The study is supported by the Asia Cornea Foundation, Alcon, Allergan, Bausch + Lomb, Santen, and Project Orbis. So far, 5,843 cases of infectious keratitis have been recruited to the study. "Infectious keratitis remains a significant cause of corneal morbidity and corneal blindness in Asia," Prof. Tan said. "Fungal and bacterial infections remain the main causes of infectious keratitis, and more knowledge regarding risk factors, organisms, and microbial resistance patterns is needed." "When this study is complete, we will better understand the clinical challenges in infectious keratitis in different Asian countries, including the different types of microbial infection and disease causation," Prof. Tan continued. "We haven't even begun to look at resistance yet." AACGC meeting highlights issues related to disease At the Asian Angle Closure Glaucoma Club (AACGC) Satellite Meeting, held in conjunction with the 26th APACRS Annual Meeting, "Current Trends and Future Directions in Angle Closure Glaucoma," including in screening, imaging, and genetics, were discussed. Tin Aung, MD, Singapore, gave the opening speech at the event. He said angle closure glaucoma is a huge problem in Asia and a major cause of blindness in the region. "Angle closure glaucoma is really our problem. People in the West—in the U.S., Europe—they have very little interest in angle closure glaucoma," he said. "There's almost no research being done and no funding provided for angle clo-

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