MAR 2014

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

Issue link: https://digital.eyeworld.org/i/276058

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Page 169 of 210

E W MEETING REPORTER 1 67 corneal graft failure and corneal opacification combined with limbal stem cell failure. " The Boston Kpro [developed at Massachusetts Eye and Ear Infir- mary, Boston] is a useful weapon in our fight against corneal blindness," said Quresh B. Maskati, MD, Mumbai. "Careful case selection is mandatory for success." He said a keratoprosthesis is recommended in cases in which a c orneal graft has failed or a patient is not a good corneal graft candi- date. Anthony J. Aldave, MD, Los Angeles, moderated a course on the subject at the conference with a group of expert speakers who discussed various aspects of kerato- prosthesis implantation. He also p resented on complications of the keratoprosthesis, comparing his results to international results. He said the most encountered complication is retroprosthetic membrane, with other complica- tions including sterile corneal stromal necrosis, elevated IOP, infectious keratitis, persistent corneal epithelial defect, and infectious endophthalmitis. "Postoperative complications are common, but can typically be managed with medical therapy or minor surgical procedures," Dr. Aldave said. Sayan Basu, MD, Hyderabad, gave an overview on "Appropriate patient selection," and said patients who need visual rehabilitation are good candidates. The ideal first case is a patient with bilateral corneal blindness with a wet ocular surface, no lid abnormalities, and a deep fornix. It is best to avoid those patients who are well adapted to visual hand- icaps, and patients must understand the risks of the surgery, he said. The beginner surgeon should avoid cases with autoimmune disor- ders, including uveitis, and children. Samar Kumar Basak, MD, Kolkata, presented "Surgical tech- nique – preoperative evaluation and surgical planning," while Rajesh Fogla, MD, Hyderabad, presented "Surgical technique – keratoprosthe- sis assembly and insertion," both discussing the best ways to perform s uccessful keratoprosthesis implanta- tion. Radhika Tandon, MD, New Delhi, and Leela Raju, MD, Pittsburgh, presented separately on "Postoperative management," including the use of antibiotics both initially and long term to fight post- operative infection. " While it's not always possible to do cultures, if even periodically they're done to make sure that the flora is not changing over time and increasing your possible risk of a f ungal infection [that can be help- ful]," Dr. Raju said. "So therefore especially in India, where more fungal infections are en- demic than what I might see on the East Coast [of the U.S.], periodic use of antifungals, or a culture-driven use of them, may be very impor- tant." Impale a lens like Dracula: Unique aspects of phaco b urst mode Using an interesting comparison— the microburst mode of phaco, which is not often used by ophthal- mologists, and Count Dracula— Keiki R. Mehta, MD, Mumbai, discussed how to use this mode o f phacoemulsification with equally interesting results. continued on page 168 March 2014 164-169 MR AIOC_EW March 2014-DL2_Layout 1 3/6/14 7:36 PM Page 167

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