Eyeworld

EW CORNEA 48 February 2015 by Chiles Samaniego EyeWorld Asia-Pacific Senior Staff Writer Cornea highlights from past year T he Asia Cornea Society provided a concise cornea and ocular surface disease update for anterior segment surgeons in a symposium at the 2014 APACRS meeting. The sym- posium comprised all of the "Cor- nea Highlights of 2014" relevant to cataract and refractive surgeons. New indications for high- frequency radiowave electrosurgery Chul Young Choi, MD, Seoul, South Korea, discussed new indica- tions for high-frequency radiowave electrosurgery (HRES). "There's a new field of conjunc- tival surgeries," Dr. Choi said. He said that HRES has long been com- mon in mucosal or dermal surgery, particularly rejuvenation cosmetic surgeries. The use of high-frequency radiowaves in electrosurgery deliv- ered through a needle electrode has the advantage of minimizing heat dispersion to adjacent tissues, and so increases safety by avoiding collater- al damage. While HRES has already been used in the treatment of trichiasis and dry eye, new ophthalmic indi- cations include conjunctivochalasis, lymphangiectasis, superior limbic keratitis, and chronic chemosis. DSAEK vs. PK While most studies suggest that deep anterior lamellar keratoplasty (DALK) and endothelial keratoplasty (EK) have major advantages over penetrating keratoplasty (PK), the Australian Cornea Graft Registry recently released data showing that lamellar surgery is not as effective as PK. The Australian data distin- guished between efficacy—results of studies conducted under ideal con- ditions—and effectiveness—results under so-called real world condi- tions—with the Registry touting that its data reflected the latter. Arundhati Anshu, MD, Singapore, presenting a talk for Donald Tan, MD, Singapore, offered a rejoinder based on data from their own Singapore Corneal Transplant Study (SCTS). The study has tracked more than 3,000 cases since 2000. Dr. Anshu traced the evolution of keratoplasty from the days of open sky PK through the various techniques for Descemet's stripping automated endothelial keratoplas- ty (DSAEK). Over the years they have performed DSAEK using the taco-fold technique, using a Sheets glide, and finally using Dr. Tan's Tan EndoGlide (Angiotech, Reading, Pa.). Each iteration has progressively improved on the postop endothelial cell loss: PK had a 40% loss, DSAEK with the taco-fold technique 61.4%, DSAEK Sheets glide 29.5%, and DSAEK EndoGlide 14.9%. "DSAEK with the EndoGlide is exceptionally good," said Dr. Anshu. visit sn.im/eyeworld for promotion info13@viscot.com • www.viscot.com • 800.221.0658 #1451 The standard in correct site marking. The Mini Surgical Skin Marker • Economical - upwards of 50% - 75% less than full size markers! • Sized for single patient use • Available sterile and non-sterile #1425 #1424 Surgical markers for precise lines

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