EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/274531
T he issue of corneal infections is the unifying theme for this month's EyeWorld. Every ophthalmologist is bound to come across various cases of infectious keratitis in his or her prac- tice, and while culturing large central ulcers is considered a standard, new technologies may allow for more specific and rapid diagnosis of t he offending organism in the future. While corneal ulcers related to contact lens wear are always a concern, bandage contact lenses are used therapeutically. In the arena of meibomian gland dysfunction and related complications, antibiotic use for its anti-inflammatory properties has been lauded, and clinicians continue to study how antibiotics can be optimally tailored for these patients. In this issue, Drs. Daluvoy, Lee, and Saini discuss the use of therapeutic s ilicone bandage contact lenses and the associated low infection rates. While at times controversial, this modality can be very useful in appropriately selected patients. Protocols, cautions, and antibiotic prophylaxis recommen- dations are reviewed by the experts. Drs. Lemp, Margolis, Tauber, Foulks, Jeng, and McCulley review new findings indicating that oral azithromycin may have a role in treating meibomitis and issue some cautions as well. Infectious and/or inflammatory problems of the meibomian glands can cause a plethora of ocular surface problems and is nearly of epidemic standards. This topic should be of inter- est to cataract and refractive surgeons alike, who strive to achieve excellent outcomes for patients with lofty expectations. We have expert lamellar corneal surgeons discussing the advances, pearls, and pitfalls when performing DALK (deep anterior lamellar keratoplasty—where the recipient abnormal stroma is removed and replaced with donor tissue that has no endothelium and Descemet's membrane) and DMEK (Descemet's membrane endothelial keratoplasty—where only the Descemet's membrane is transplanted). Drs. Baig, Garg, Holland, Lee, Price, Shamie, and Straiko provide their tips for surgeons making the transition to performing these delicate and challenging procedures. Considering the tens of thousands of cases of infectious keratitis diagnosed each year, the ability to accurately diagnose and treat with appropriate anti-infectious agents is paramount to prevent significant ocular damage. Corneal scrapings for cultures has long been the standard, but require time and may not always yield useful results. Polymerase chain reaction, or PCR, testing offers potential for high testing sensitivity, even if there is only a small amount of organism DNA present. Drs. Hawwa, Iovieno, Jeng, and Mr. Kowalski discuss the current status of such molecular diagnostic tools and how this technology can change the future of infectious keratitis management. We hope you enjoy this issue of EyeWorld, and thank you to all the physicians above for taking the time to share their expertise. Clara Chan, MD, FRCSC, FACS, cornea editor Publisher Donald R. Long d on@eyeworld.org Editorial Editor Jena Passut j ena@eyeworld.org Managing Editor Stacy Majewicz stacy@eyeworld.org S enior Staff Writer Erin Boyle e rin@eyeworld.org S taff Writer Ellen Stodola ellen@eyeworld.org Production Graphic Designer Julio Guerrero julio@eyeworld.org Production Manager Cathy Stern c athy@eyeworld.org 7 03-383-5702 P roduction Assistant Carly Peterson carly@eyeworld.org Contributing Writers Vanessa Caceres L akeland, Florida Michelle Dalton Reading, Pennsylvania Matt Young M alaysia Enette Ngoei D ublin Rich Daly Arlington, Virginia Senior Contributing Writer Maxine Lipner N yack, New York Advertising Sales ASCRS Media 4 000 Legato Road Suite 700 F airfax, VA 22033 703-591-2220 fax: 703-591-0614 eyeworld@eyeworld.org www.eyeworld.org Advertising Sales Jeff Brownstein jeff@eyeworld.org 703-788-5745 Paul Zelin p aul@eyeworld.org 703-383-5729 Classified Sales Cathy Stern cathy@eyeworld.org 703-383-5702 EyeWorld Special Projects and Events Jessica Donohoe jessica@eyeworld.org 703-591-2220 ASCRS Publisher: EYEWORLD (ISSN 1089-0084) is published monthly by ASCRS Ophthalmic Services Corp., 4000 Legato Road, Suite 700, Fairfax, VA 22033-4055; telephone: 703-591-2220; fax: 703-591-0614. 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POSTMASTER: Send change of address to EYEWORLD, 4000 Legato Road, Suite 700, Fairfax, VA 22033. Periodical postage paid at Fairfax, VA 22033 and at additional mailing offices. The ideas and opinions expressed in E YEWORLD do not necessarily reflect those of the editors, publisher, or its advertisers. P U B L I S H I N G S T A F F February 2014 Volume 19 • No. 2 A S C R S The official publication of the American Society of Cataract & Refractive Surgery World view Eyeing corneal infections Clara Chan, MD, FRCSC, FACS, c ornea editor Boston Fun Fact The state dog of Massachusetts is the Boston terrier. Source: www.cityofboston.gov