Eyeworld

DEC 2014

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

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11 EW NEWS & OPINION December 2014 A renowned TED and TEDMED speaker will deliver the must-see, annual ASCRS Lecture on Science & Medicine in San Diego. Daniel Kraft, MD, will deliver his lecture on Sunday, April 19 at 10 a.m. at the Sunday Summit. He epitomizes the out-of-the-box thinking that is shaping the future of healthcare, wellness, prevention, and biopharmaceuticals. Dr. Kraft's diverse TED and TEDMED talks have been viewed worldwide more than 1 million times. If you are attending the ASCRS•ASOA Symposium & Congress from Friday, April 17 to Tuesday, April 21, 2015, you will want to make sure this lecture is on your schedule. Dr. Kraft is the classic Renaissance man—known as an esteemed physician, scientist, inventor, entrepreneur, and inno- vator. He is founder and executive In the journal . . . Transepithelial corneal crosslinking Sebastian P. Lesniak, MD, Peter S. Hersh, MD Can transepithelial crosslinking be used to effectively treat keratoconus? Investigators in a prospective clinical trial involving 30 eyes of 20 patients set out to determine this. Using proparacaine with benzalkonium chloride 0.01% in conjunction with riboflavin 0.10% without dextran, investigators performed transepithelial crosslinking in these eyes with keratoconus. The eyes were randomized to receive riboflavin in the cornea every minute or every 2 minutes over a 30-minute period, in conjunction with undergoing ultraviolet-A treatment during this time. Investigators determined that there was a 0.9 D mean flattening of the maximum K reading with a mean improvement in CDVA of 0.83 Snellen lines. In 1 patient, K readings declined by 2 D. In addition, in 1 patient there was a loss of 2 lines of CDVA. When it came to the administration of the riboflavin, administrators found that whether this was instilled every minute or every 2 minutes, there was no difference in uncorrected or corrected distance visual acuity or in keratometry results. The conclusion reached was that at 6 months there was a statistically significant improvement in maximum K values and CDVA readings. However, investigators noted that to determine if corneas remain stabilized in the long term, further follow-up is needed. Suction loss in refractive lenticule extraction Chee Wai Wong, MMed (Ophth), Cordelia Chan, FRCS(Ed), Donald Tan, FRCOphth, Jodhbir Mehta, FRCS(Ed) In this retrospective case series, investigators looked at suction loss in refractive lenticule extraction to consider the incidence, management, and outcomes. Included here were all of the patients at a tertiary eye hospital who were reported to have suction loss during refractive lenticule extraction in the period between March 9, 2010 and August 5, 2013. They found that there was a 3.2% cumulative incidence of suction loss in the 340 refractive lenticule extractions performed during this period. When they considered the type of procedure performed, investigators noted that for femtosecond lenticule extraction the incidence of suction loss was 4.3%, for small-incision lenticule extraction 4.4%, and for pseudo small-incision lenticule extraction 0.9%. When they looked at resulting visual acuity they determined that 72.7% of the 11 eyes in which suction loss occurred had 20/30 uncorrected distance visual acuity or better. At the 3-month mark, 81.8% were within 0.5 D of emmetropia. Investigators concluded that there was a relatively low incidence of suction loss during refractive lenticule extraction and determined that when this did occur, appropriate management allowed for good visual outcomes. Laboratory science: long-term evaluation of a new accommodating IOL Justin C. Kohl, MD, Liliana Werner, MD, PhD, Joshua R. Ford, MD, Scott C. Cole, MD, MS, Shail A. Vasavada, DO, DNB, FICO, Gareth L. Gardiner, BS, Rozina Noristani, Nick Mamalis, MD The aim in this study was to consider a new accommodating intraocular lens and evaluate its long-term biocompatibility. Included here were 14 rabbits who underwent bilateral phacoemulsification, in which one eye received the FluidVision accommodating IOL (PowerVision, Belmont, Calif.) and the other a standard acrylic lens. Investigators found that during the study's 6-month duration, biocompatibility in clinical and pathologic examinations were similar for both types of lenses. For eyes with the accommodative lens, no anterior capsule opacification was seen, and there was significantly less posterior capsule opacification than in the control group. Histopathologic findings at 6 months confirmed a lower amount of capsule opacification in those eyes with the accommodative lens being studied and an absence of any inflammatory or toxic reaction. The conclusion reached was that despite the large size of the haptic elements in the accommodating IOL, there was no significant contact with the anterior capsule. As a result, uveal and capsular biocompatibility were maintained, and overall capsular bag opacification was prevented. December 2014 ASCRS Lecture on Science & Medicine speaker announced by Abbie B. Elliott ASCRS•ASOA Communications Manager director of Exponential Medicine; founder and CEO of IntelliMedicine & Bioniq Health; inventor of the MarrowMiner; and medicine track faculty chair at Singularity Univer- sity. Still an avid pilot, Dr. Kraft has served in the Massachusetts and California Air National Guard (as an officer and flight surgeon) with an F-16 Fighter Squadron. He has also conducted research on aerospace continued on page 12 2015 ASCRS•ASOA Symposium & Congress San Diego April 17–21, 2015 Daniel Kraft, MD EyeWorld @EWNews Keep up on the latest in ophthalmology! 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