Eyeworld

EW AAO PREVIEW 35 Subspecialty day highlights corneal infection to transplantation and beyond C ornea Subspecialty Day at the AAO Annual Meeting always brings out dedi- cated practitioners bent on keeping up with emerging issues. This year's session, dubbed "Cornea 2011: Controversies and Consensus," is scheduled for Saturday, October 22, from 8:30 a.m. -5:30 p.m. The day will begin with a sec- tion on Ocular Surface Disease. Christopher S. C. Liu, F.R.C.Ophth., consultant ophthalmic surgeon, Sus- sex Eye Hospital, Brighton, U.K., will give a talk on "The Osteo-Odonto- Keratoprosthesis (OOKP) for Man- agement of Severe Ocular Surface Disease." Dr. Liu hopes to widen recognition of this option. "There are people who are corneal blind who are denied the procedure be- cause their physicians are not aware that it is possible," he said. Dr. Liu will highlight the indications and contraindications of the OOKP and explain the patient's journey from initial consultation through the vari- ous stages of surgery. During Section II on Infectious Keratitis, Francis S. Mah, M.D., co-medical director, Charles T. Campbell Ophthalmic Microbiology Laboratory, University of Pittsburgh School of Medicine, will discuss "Perioperative Antibiotics: Looking for Consensus Amid the Chaos." Among other things, Dr. Mah, who said there are no definitive answers, plans to highlight growing experi- ence with intracameral antibiotics. "It's definitely overwhelming in terms of the positive evidence that intracameral antibiotics are effica- cious and probably going to be the future," he said. Dr. Mah also plans to discuss mechanisms of endoph- thalmitis and how practitioners might improve, with current rates leaving room for improvement. "We still seem to have the same rates of endophthalmitis, and these might even be growing," he said. One of the highlights of Section III on Lamellar Keratoplasty is the talk on "Descemet's Membrane Endothelial Keratoplasty (DMEK): Is It Time for You to Convert from Descemet's Stripping Endothelial Keratoplasty?" to be given by Francis W. Price Jr., M.D., medical director, Price Vision, Indianapolis. Dr. Price will be spotlighting DMEK, which offers excellent vision, but has the knock of being challenging. "There have been people criticizing us, saying, 'You're losing too many donors, it's too hard, there's no ad- vantage, and we do just as well with the others,'" Dr. Price said. He plans to address each of these issues. "The arguments that I hear are the same ones that I hear about why people shouldn't change from PK to DSEK," he said. "It's actually easier and cheaper to make the transition to DMEK than it is to transition to fem- tosecond cataract surgery." During Section IV on Penetrat- ing and Pediatric Keratoplasty, Stuart I. Brown, M.D., professor of ophthalmology, Shiley Eye Center, University of California, San Diego, will tackle "Pediatric Keratoplasty: Pearls and Pitfalls." He finds that in the majority of cases with a mini- mum of a 10-year follow up, trans- plant success rivals that of adults. Visual results appear to surpass those, with approximately 40% of pediatric patients seeing 20/40 or better. Long term, Dr. Brown has 50 children with more than 10 years of success. He hopes to stress just how manageable pediatric keratoplasty can be. "There are misconceptions regarding the impossibility of doing corneal transplants in babies even though there have been increasing reports over the last decade of peo- ple doing them," he said. As part of the section on Ocular Surface Disease, Penny A. Asbell, M.D., professor of ophthalmology and head of the cornea service, Mount Sinai School of Medicine, New York, will drive home the mes- sage that understanding and treating dry eye is not just for corneal spe- cialists and that the ability to deliver care has become much more sophis- ticated. Before toric lenses, astigma- tism patients with 20/30 acuity were told to "live with it." "As we learn more about dry eye disease and un- derstand better how to treat it we don't have to say 'live with it' be- cause we have the opportunity to treat it," Dr. Asbell said. She plans to urge attendees to make the diagno- sis, take the time to try and inter- vene, and ultimately improve patients' symptoms. In the final section, dubbed a Corneal Potpourri, Majid Moshirfar, M.D., professor of ophthalmology, John A. Moran Eye Center, Univer- sity of Utah School of Medicine, Salt Lake City, will discuss "Corneal Imaging: Confocal, OCT, and Ultra- sound Biomicroscopy—What They are Good For." He will bring to light how these can best be used. If a long-ago LASIK patient comes in, for example, OCT helps Dr. Moshirfar to determine the thickness of the flap and cornea. "Another patient walks into my office and wants to get a phakic intraocular Visian ICL (STAAR Surgical, Monrovia, Calif.) using the high resolution ultra- sound. This allows me to get a good by Maxine Lipner Senior EyeWorld Contributing Editor Cutting-edge cornea Christopher S. C. Liu, F.R.C.Ophth. Francis S. Mah, M.D. Stuart I. Brown, M.D. Penny A. Asbell, M.D. continued on page 36 30-39 AAO Preview_EW October 2011-DL3_Layout 1 9/29/11 5:14 PM Page 35

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