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Meticulous attention to suppres- sion of inflammation days and even a few months out postoperatively can help reduce recurrences, Dr. Jacobs said. "When [recurrence] happens, it happens early," she said. Her technique has been to re- move sutures at 1 week if they were used and maintain a long tail on the steroid taper, monitoring for steroid response. Dr. Lee said he aggressively uses both topical corticosteroids and combined antibiotic/steroid ointments after pterygium surgery. "I also use subconjunctival steroids when indicated in the early postop- erative course if increased inflamma- tion is present as this can represent a nidus for recurrence if the inflam- mation is not controlled," he said. Topical cyclosporine can be helpful as nearly all patients have some form of dry eye, he added. EW Reference 1. Kaufman SC, Jacobs DS, Lee WB, Deng SX, Rosenblatt MI, Shtein RM. Options and adjuvants in surgery for pterygium: a report by the American Academy of Ophthalmology. Ophthalmology. 2013;120(1):201–208. Editors' note: Dr. Kaufman has finan- cial interests with IOP Ophthalmics (Costa Mesa, Calif.) and Bio-Tissue (Doral, Fla.). Dr. Lee has financial interests with Allergan (Irvine, Calif.), Bausch + Lomb (Bridgewater, N.J.), and Merck (Whitehouse Station, N.J.). The other physicians interviewed have no financial interests related to their comments. Contact information Deng: deng@jsei.ucla.edu Jacobs: djacobs@bostonsight.org Kaufman: Stephen.Kaufman@downstate.edu Lee: lee0003@aol.com associated with a higher recurrence rate compared to conjunctiva so if the latter is available, amniotic membrane is not needed," he said. Ultimately, "the evidence is that amniotic membrane grafting is inferior to conjunctival or limbal autografting in pterygium surgery," Dr. Jacobs said. "In our paper, amniotic membrane did not decrease the recurrence rate of pterygium, but it certainly makes the patient more comfortable and provides scaffold- ing for the new cells to grow over," Dr. Kaufman said. There is also a cost issue, as it can be challenging to get reimbursed for amniotic membrane at outpa- tient surgical facilities, leading often to a net loss, Dr. Lee added. Sutures or tissue glue? Every surgeon will have an individ- ual preference for sutures or tissue glue. "I still prefer the use of 10-0 dissolvable sutures. Conjunctival sutures remain the gold standard for closing conjunctival defects," Dr. Lee said. Although sutures can increase initial discomfort postoperatively, Dr. Lee said his technique uses a large conjunctival graft, so he is concerned about fibrin glue induc- ing a higher risk of potential graft dislocation. "I think fibrin glue can be useful if a surgeon uses smaller grafts," he said. Dr. Kaufman uses fibrin tissue adhesive off label, and he has not experienced any complications or allergic reactions. "I like it because it's non-in- flammatory, more comfortable, and it dissolves. It seems to last 5 to 10 days. During that time, the tissue adheres and heals," he said. Use of topical cyclosporine, steroids Although use of topical cyclospo- rine and corticosteroids may help decrease potential inflammation, the key to better outcomes is good postop control of inflammation, Dr. Deng said. Asia Cornea Society Daily now online at: daily.EyeWorld.org Read the latest news from the Asia Cornea Society 4th Scientific Meeting held in Taipei, Taiwan, with pages of photos from the key events. DailyNews T he Asia Cornea Society (ACS) launched into its 4th Biennial Scientific Meeting (2014 ACS) accompanied by the propulsive beats of the Ten Drum Percussion Art Group. The strength of the group's beating drums represents the "enduring vitality and radiant energy" of the meeting's host country, Taiwan. In her welcome address at the meeting's opening ceremony, Fung- Rong Hu, MD, president, 2014 ACS, and president, Ophthalmological Society of Taiwan (TOS), said she hoped the meeting "would provide a platform for the exchange of knowl- edge and for the enhancement of vital skills in the rapidly advancing field of cornea." "We hope to foster greater un- derstanding and promote advance- ments in the diagnosis and manage- ment of corneal diseases," she said. Dr. Hu thanked the meeting's international partners: the Cornea Society, the American Academy of Ophthalmology (AAO), the Interna- 2014 ACS launched to the sound of drums by Chiles Samaniego EyeWorld Senior Staff Writer EyeWorld Daily eNews • The official 2014 ACS Taipei Daily Sunday November 16, 2014 digital.eyeworld.org tional Society of Refractive Surgery (ISRS), the Association of Eye Banks of Asia (AEBA), and SightLife—de- scribed on their website as "the only non-profit global health organi- zation focused solely on eliminat- ing corneal blindness around the world." Apart from participating in the scientific sessions, Dr. Hu encour- aged attendees to take time to enjoy "the rich Chinese culture and hospitality" of Taiwan, a country she said is "full of cultural, natural, and hi-tech wonders." ACS Vice President Shigeru Kinoshita, MD, Kyoto, Japan— speaking for ACS President Donald Tan, MD, Singapore, who could not be present at the meeting due to a family emergency—also welcomed attendees. He extended the ACS Council's "immense appreciation" for Dr. Hu for her "superb support and cooperation" to make the meet- ing possible. In addition to allowing important academic exchange, he said that the ACS biennial meeting was established to "promote mutual friendship among Asian corneal spe- cialists and the younger generation of ophthalmologists, researchers, and co-workers." "We feel very fortunate that many of the most distinguished ophthalmologists and scientists in the cornea field worldwide are gathering here in Taipei," he said. "This meeting comes at a point in time when cutting edge advance- ments are being made in the field of ophthalmology and visual science. The state-of-the-art developments are greatly impacting the treatment of corneal diseases. "This meeting succinctly encap- sulates our aim of zooming in on the newly emerging advancements in surgical and laser technologies as well as translational and clinical re- search," he added. "This meeting is guaranteed to promote an enormous amount of international scientific exchange." At the time of the opening cer- emony, the ACS had counted over 600 participants from all over the world in attendance. The ACS also honored its most distinguished members and partners at the opening ceremony. Fung-Rong Hu, MD continued on page 3

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