Eyeworld

49 EW CORNEA February 2015 "Our results with DSAEK using the EndoGlide confirm that DSAEK provided for better visual outcomes and fewer complications." Five-year results show continued superiority of DSAEK over PK. PDEK the latest EK technique and glued IOL Amar Agarwal, MD, Chennai, India, described the pre-Descemet's endothelial keratoplasty (PDEK) procedure he developed with Harminder Dua, MD, Nottingham, U.K., following the discovery of the pre-Descemet's layer (Dua's layer). Dr. Agarwal has also combined the procedure so that one can do PDEK with the glued IOL technique. If necessary, a pupilloplasty is also done. The glued IOL acts as a tram- poline pushing the air up against the graft. IEK Conventional PK, said Choun-Ki Joo, MD, Seoul, South Korea, has "some problems." These include a high incidence of induced astigma- tism, a higher risk of decentration and graft dislocation, and a pro- longed healing time, sometimes lasting up to a year. Misalignment in particular is a major source of optical distortion in conventional PK. Using the IntraLase femtosec- ond laser (Abbott Medical Optics, Abbott Park, Ill.) to perform Intra- Lase-enabled keratoplasty (IEK) al- lows greater precision and accuracy with corneal wound construction, leading to better natural alignment of the donor and host corneas. Dr. Joo and his colleagues use a multiplanar incision possible only through the use of a femtosecond laser to provide greater wound stability and increased resistance to wound leakage. Comparing IEK with conven- tional PK in 64 consecutive cases (32 IEK, 32 PK) from 2010 to 2012, Dr. Joo and his colleagues found that BCVA was better with IEK at 2 and 4 months. The procedure also produced lower topographic astigmatism at 2, 4, and 6 months, although there were no significant differences in terms of compli- cations. They proposed from the modified multiplanar incision the posterior side cut was relatively deeper compared to the anterior side cut. The modified design is expected to enhance epithelial healing and reduce endothelial irregularity. KPro in Indonesia As of 2012, more than 6,000 pa- tients have been implanted with the Boston KPro keratoprosthetic device, according to Johan Hutauruk, MD, Jakarta, Indonesia. In Indonesia, Dr. Hutauruk looked at the results in 12 cases (11 for failed corneal grafts, 1 for Stevens-Johnson syndrome). Common complications were retroprosthetic membrane formation visit sn.im/op-eye for promotion info@opmarks.com • www.opmarks.com • 866.307.2757 • Economical – Reusable & autoclavable throughout hundreds of procedures • Bright red silicone provides highly recognizable neutral zone • Low proole minimizes blind reaching, reducing the risk of sharps injury • Durable – sufficiently permanent but easily removed post-op with alcohol swab or transpore tape • Visible on all skin tones – white background provides high visibility Ideal for ophthalmic, pediatric & elderly site marking continued on page 51

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