EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/387844
EW MEETING REPORTER 130 October 2014 Reporting from the 2014 European Society of Cataract & Refractive Surgeons (ESCRS) Congress, London In contrast, Ananth C. Viswanathan, MD, London, U.K., discussed "Function for diagnosing, staging, and monitoring," outlining how function in glaucoma "is of great importance." Dr. Iester tied the two topics together in his presen- tation "Added value of integrating structure and function." He outlined how the two can work together and help offset the complexities of each other because "the extent of damage is often difficult to detect. "Clinicians use measurements in one domain to support the inter- pretation of the measurements in the other domain," he said. Other events prior to the ESCRS Congress In addition to other programming prior to the ESCRS Congress, the Ophthalmology Futures Forum was held on Thursday, September 11. The event explored topics such as gene therapy and stem cells in treatment of eye disease, the ther- apeutic pipeline for retinal disease, ophthalmic imaging, ophthalmic device safety and efficac , and reim- bursement and outcomes in cataract surgery. A number of ophthalmic companies participated in the forum. Keith Barton, MD, London, U.K., and Kuldev Singh, MD, Palo Alto, Calif., U.S., introduced the meeting, which has been held 3 times previously. NICE assessment standards for evaluating crosslinking The ESCRS/EuCornea symposium "Corneal Crosslinking: Safety, Efficac , and the Unexpected" went into depth on the effects, concerns, and results of crosslinking. Hannah Patrick, consultant clinical advisor, National Institute of Clinical Excellence (NICE), London, U.K., spoke about the NICE assessment standards for evaluating the crosslinking procedure. Cross- linking is specifically addressed u - der NICE's IPG466 analysis to look at interventional procedure guid- ance. IPG466 particularly pertains to photochemical corneal collagen crosslinkage using riboflavin and ultraviolet A for keratoconus and keratectasia. The IP program was set up to support innovation, Ms. Patrick said. It is available to any procedure being used in the U.K.'s National Health Service and any procedure likely to be used in the near future. The goal of the interventional procedure program is to protect patients, help clinicians who want to do some- thing new, and foster innovation, Ms. Patrick said. NICE encourages research into CXL and also encourages further information pertaining to tech- niques used, whether epithelium-on or epithelium-off. Future outcomes should include data on visual acuity, corneal topography, and quality of life. NICE would be particularly in- terested in long-term outcome data in the future on crosslinking. NICE IP guidance was imple- mented to support innovation, Ms. Patrick said. It is not a standard of care, and because NICE examines procedures at such an early stage of development, guidance does not just reflect evidence, but reviews of patients, experts, etc. Procedures can also be reviewed in response to evidence on development or safety concerns. Examining crosslinking's predictability Francois Malecaze, MD, PhD, Toulouse, France, questioned whether the effect of crosslinking is predictable in the long-term. This question can be answered in 2 ways, he said. The first is to look at the accur - cy and reliability of the results. The second is looking at the long-lasting effect on the progression of kerato- conus as the aim of crosslinking is to block progression of the disease. To look at the long-lasting effect on keratoconus progression, Dr. Malecaze said it is necessary to consider the biology of the stromal collagen fibers, the natural progre - sion of keratoconus, and the long- term studies of crosslinking. Experimental evidence suggests crosslinking could decrease corneal drug penetration In the final presentation of the joint ESCRS/EuCornea symposium, Beatrice Frueh, MD, Bern, Switzerland, discussed what crosslinking does to the corneal penetration of drugs. The hypothesis related to stromal permeability, she said, is that increasing the densi- ty of crosslinks in the cornea will decrease permeability and solute diffusion. Crosslinks of collagen fibrils are present in normal corneas and increase with age, diabetes, or smoking, she added. According to Dr. Frueh's presentation, experimental evidence shows that both non-enzymatic and riboflavin U A crosslinking decrease View it now: ESCRS 2014 ... EWrePlay.org Sonia Yoo, MD, describes treatment of non-orthogonal and asymmetric astigmatism correction with the femtosecond laser.