EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/387844
and penetrating keratoplasty (PK). Descemetic deep anterior lamellar keratoplasty (dDALK) or pre-De- scemetic is the technique of choice when keratoplasty is indicated in keratoconus, Dr. Güell said. BCVA and quality are the same as PK but long-term survival clearly favors DALK. ESCRS Glaucoma Day highlights latest in glaucoma hot topics ESCRS Glaucoma Day 2014, with a scientific program organized by the European Glaucoma Society (EGS), gave attendees an in-depth look at a variety of hot topics in glaucoma, all presented by expert clinicians. The program featured a look at glaucoma subsets including angle closure as well as pseudoexfoliation syndrome and pseudoexfoliation glaucoma. Sir Peng Khaw, MD, London, U.K., delivered the Keynote Lecture, on "Simple strategies and techniques to improve the outcome of glauco- ma filtration surge y." EGS President Carlo Enrico Traverso, MD, Genova, Italy, welcomed attendees to the event, which has been held for the past few years prior to the ESCRS program. He encouraged them to attend the 12th EGS Congress in Prague, Czech Republic, from June 19–23, 2016. "Our previous meet- ings have all been successful so far, thanks to the enthusiastic participa- tion of our community," he said. Roles of structure, function nuanced in tracking glaucoma, experts say The measurements of structure and function form a sometimes "difficult relationship" in tracking glaucoma diagnosis and progression, a clinician said. "In early glaucoma, structural loss appears greater than function- al loss," said Michele Iester, MD, Genoa, Italy. "In more advanced disease, function changes at a greater rate than structure. In the future, [with] more sensitive systems to detect ganglion cell number or function, we might have a different relationship." In a session at ESCRS Glaucoma Day 2014, three physicians discussed "Structure and function: Compete or combine" Andrew McNaught, MD, Cheltenham, U.K., presented "Structure for diagnosing, staging, and monitoring." He said structure is an important part of the clinical exam in glaucoma and essential to diagnosis. Technology for obtaining and recording images of the optic nerve has improved greatly in the last few years. "With normal visual fields, structure is essential for diagno- sis and staging," he said. It is also essential for detecting progression. "Even with abnormal and possibly progressing fields, structure provides useful confirmation. Four imaging technologies exist for measuring structure: stereo-pho- tography, which is well established and "comes close to examining the patient in the flesh"; HRTIII; GDx; and OCT. Each has benefits, but D . McNaught cautioned: "don't just rely on machines." He pointed out that structure is not as useful in advanced dis- ease and is best in those with mild to moderate disease. "The value of imaging decreases with more advanced glaucoma," Dr. McNaught said. "Adversely, the value is greatest with early, especially pre-perimetric, glaucoma." "Structure is certainly less valuable in advanced disease, where visual fields become absolutely essential," he said. "It's all about measuring the 'floo .' The structural measurements tend to hit the 'floor' sooner in the disease than the visual fields. continued on page 130