Eyeworld

15 EW NEWS & OPINION M aking good on its domestic humanitarian care plans, the ASCRS Foundation's Oper- ation Sight Network completed its 100th charitable cata- ract surgery in December 2014. Launched in August 2014, Op- eration Sight's prime objective is to eliminate treatable cataract blind- ness in the United States by provid- ing care to those unable to access or afford surgery. For many Americans who lack private insurance or are ineligible for government care, the visual impairment from cataracts leads to a significant decrease in quality of life. With an aging Baby Boomer population, the problem of cataracts is only expected to grow. "Good vision plays a basic role in health and quality of life," said Randall J. Olson, MD, chair and CEO of the John A. Moran Eye Center in Salt Lake City, a charter Operation Sight Network partner. "We want to help everyone who needs it, not just those who can afford it." Operation Sight draws from a network of established charitable organizations and ASCRS member volunteer surgeons to deliver its care. The program offers the advan- tage of a centralized approach that brings together organizations and surgeons interested in providing humanitarian care. At the same time, it centralizes patient pro- cessing and provides the necessary financial support to offset the cost of charitable care. While many ophthalmologists are interested in charitable surgery, they are often unsure how to pro- ceed. Operation Sight addresses that problem by providing the personnel and resources to help ophthalmol- ogists meet many of the challenges that come with offering charitable care. Its services range from helping ophthalmologists identify needy patients in their communities and processing paperwork, to delivering fully vetted patients to practices for surgery and providing a financial stipend to participating surgeons. "We were excited when the ASCRS Foundation approached us about a partnership," Dr. Olson said. "It brings so much more attention, financial assistance, and volunteer resources to the problem of prevent- able blindness in the U.S." Go to ASCRSFoundation.org for more information. Attend the ASCRS Opening General Session on April 18 from 10:00–11:45 a.m. to hear more about the ASCRS Foundation's work and how you can get involved. EW Contact information Elliott: aelliott@ascrs.org In the journal . . . Corneal sensitivity after epi-off and epi-on CXL in keratoconic eyes Leopoldo Spadea, MD, Serena Salvatore, MD, Maria Pia Paroli, MD, Enzo Maria Vingolo, MD Does corneal crosslinking with or without the epithelium affect surface sensitiv- ity? In this prospective case series, investigators set out to compare how sensi- tivity in eyes with keratoconus that underwent the epithelium-off crosslinking procedure compared to those that underwent the procedure with this still on. Of the 50 eyes treated with crosslinking, 25 underwent the epithelium-on procedure and 25 the epithelium-off. Investigators found that for up to 3 months, eyes in the epithelium-off group showed significantly reduced sensitivity, which grad- ually returned to normal. Likewise, for up to 7 days, those in the epithelial-on group had significantly reduced sensitivity. However, after that the sensitivity was significantly better than in the epithelium-off eyes. Investigators concluded that while both procedures reduce sensitivity, this was more pronounced with the epithelium-off technique. Both groups ultimately recovered corneal sensitivity, but when the epithelium was left on, this took a shorter time. 5-year follow-up of a presbyopia-compensating corneal inlay Alois K. Dexl, MD, MSc, Gerlinde Jell, MD, Clemens Strohmaier, MD, Orang Seyeddain, MD, Wolfgang Riha, MD, Theresa Rückl, MD, Alexander Bachernegg, MD, Günther Grabner, MD In this prospective study, investigators considered how the KAMRA corneal inlay (AcuFocus, Irvine, Calif.) fared long term in compensating for presbyopia. They found that the mean binocular uncorrected near visual acuity, in the 32 emme- tropic presbyopic eyes in which this was implanted, improved from J6 to J2. Like- wise, uncorrected intermediate vision improved from 0.2 logMAR to 0.1 logMAR. Meanwhile, uncorrected distance visual acuity went from –0.2 logMAR to –0.1. At the 5-year mark investigators found that 74.2% of patients had uncorrected near visual acuity of J3 or better, while 87.1% had uncorrected intermediate vision of 0.2 logMAR or better. When it came to uncorrected distance visual acuity 93.5% had 0.0 logMAR or better. In one case, due to patient dissatisfaction resulting from hyperopic shift, the inlay was removed at 36 months. Investigators con- cluded that while uncorrected near visual acuity and intermediate visual acuity increased long term with monocular implantation of the corneal inlay in emme- tropic presbyopic eyes, uncorrected distance acuity was slightly compromised. Comparing accelerated CXL and standard CXL Hassan Hashemi, MD, Akbar Fotouhi, MD, PhD, Mohammad Miraftab, MD, Hooman Bahrmandy, MD, Mohammad Amin Seyedian, MD, Kazem Amanzadeh, MD, Shahab Heidarian, MD, Hamidreza Nikbin, MD, Soheila Asgari, PhD Investigators here wanted to determine how results with accelerated collagen crosslinking compared to the traditional approach. In this randomized study of 31 eyes with keratoconus, the group that received accelerated CXL underwent treatment for 5 minutes at 8 mW/cm 2 compared to the standard group, which underwent traditional crosslinking at 3 mW/cm 2 for 30 minutes. At 6 months, in- vestigators found that there was no significant difference in either uncorrected or corrected distance visual acuity or in the manifest refraction spherical equivalent. Likewise, the mean changes of asphericity, mean keratometry, and mean decrease in maximum keratometry were similar between the 2 groups. However, in the standard group, the central corneal thickness was higher. The corneal resistance factor and the mean changes in corneal hysteresis were not significantly different between the groups. The conclusion reached here was that the progression of keratoconus is similarly halted at 6 months whether the accelerated or standard crosslinking approach is used. March 2015 ASCRS Foundation's Operation Sight Network completes 100th surgery by Abbie Elliott ASCRS•ASOA Communications Manager Truck driver Kevin Scow lost his commercial driver's license due to cataracts. He was treated at 2 different charity surgery days and was able to return to his career. Source: John A. Moran Eye Center March 2015 ASCRS update

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