Eyeworld

MAR 2014

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

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E W MEETING REPORTER 1 65 from AIOS, which he added is wholly capable of delivering every- thing they want and deserve. Incoming AIOS president focused on diabetic-related eye conditions The son of a former AIOS president is the incoming president this year, and is making diabetes and blind- ness from diabetic retinopathy his main focus, with a vision for a screening process in India that could help stop blindness from that dis- ease. Q uresh B. Maskati, MD, Mumbai, is this year's incoming president. His father was president in 1987. In an interview, he said that he is honored and excited to be the new Society president, especially with his family link. "I am extremely proud to take over this organization," Dr. Maskati, a cornea and pediatric specialist, said. "I also have the unique honor of being [part of] the only father and son combination to helm this organization." Ophthalmology and its needs are rapidly growing in India, and the AIOS is reflecting that growth, according to Dr. Maskati. It is the biggest society when counting live members, he said. Much still needs to be done in the ophthalmic field in the country, he said. In his year tenure, he is looking to focus on the all-impor- tant topic of diabetes and diabetic retinopathy. "My vision in 2014 and 2015 is going to be diabetes and the eye," he said. "Unfortunately, India is becom- ing the diabetic center of the world thanks to our increasing income and sedentary lifestyles. We're gaining more diabetics than any other country in the world." There is a lack of awareness about the disease in the country as well, he said. "The knowledge that diabetes can cause blindness is abysmal in India. We have very few diabetic s pecialists, endocrinologists, and they're all so busy bringing blood sugars levels down from 400 to 200 that they really have no time to counsel their patients to seek ophthalmic advice." He said diabetic patients with good vision do not often visit an ophthalmologist, and this is a prob- l em. Patients, physicians, specialists, the government, NGOs, corporate India, all need awareness education, which the Society—as the largest and only representative body of ophthalmologists in the country— can and should provide, Dr. Maskati said. He said the groups should work hand-in-hand to make this happen, encouraging all diabetic patients to visit an ophthalmologist at least once a year. "The ophthalmologist will guide them on the frequency of examina- tions required depending on what the ophthalmologist finds in the eye," he said. Diabetics can be located through screening camps, he said. It is his goal to have these screening camps run in every state society in India, about 25 or 30 places in a given week. That week will be desig- nated as a "diabetic week," he said. "We will examine diabetic patients free of charge with dilated pupils and examine their fundus. … There will be certain centers that are equipped with non-mydriatic cam- eras, where you don't have to dilate the pupil," Dr. Maskati said. Telemedicine will assist in rural areas of the country, with ophthal- mologists who are "sitting in cen- ters" examining patients in remote parts of India by the internet. The Indian government is also supporting the idea, especially in terms of public awareness education for both the rural and urban poor, he said. Injection revolution "Intravitreal [IV] injections have be- come one of the most common eye p rocedures done by any eye surgeon across the globe," said Lalit Verma, MD, hony. general secretary of AIOS. Dr. Verma called the proce- dure a "burning topic" in ophthal- mology today. The procedure, he said, is used to deliver a wide range of therapeu- tic devices and agents including a ntibiotics, triamcinolone, steroids, and steroid implants such as Ozurdex (sustained-release dexamethasone implant, Allergan, Irvine, Calif.), as well as the anti- VEGF agents Avastin (bevacizumab, Genentech, South San Francisco) and Lucentis (Genentech), thus revolutionizing the management of various conditions including dia- betic macular edema (DME), age-re- lated macular degeneration (ARMD), and retinovascular occlusion (RVO). Dr. Verma focused on the treat- ment of these conditions with anti- VEGF agents. About a decade ago, he said, conditions such as these were treated with lasers. "The problem with lasers is that they are destruc- tive," said Dr. Verma. As a result, patients undergoing laser treatments experience deterioration in the q uality of vision following the procedure. In contrast, 80% of patients treated for RVO and 40% for DME all experience improved vision after IV injections of anti-VEGF agents, he said. In addition, the effect is immediate: In a study recently published in the Indian Journal of O phthalmology, Dr. Verma reported that about 80% of patients with RVO treated with intravitreal injec- tions see the results of the procedure within 24 hours—leading him to dub the procedure the "one-day wonder." Patients with DM and ARMD see results within two weeks—not as impressive, but still very good. Following these results, lasers, said Dr. Verma, have taken a back- seat to IV injections—at least in India. The problem, according to Dr. Verma, is that patients need repeated injections. The best results, he said, are seen with regular monthly injections; unfortunately, this protocol, in addition to being March 2014 View it now ... EWrePlay.org Keiki R. Mehta, MD, describes how the microburst mode of phaco can be compared to the likes of Count Dracula by impaling a lens using a phaco tip. continued on page 166 164-169 MR AIOC_EW March 2014-DL2_Layout 1 3/6/14 4:30 PM Page 165

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