Eyeworld

Reporting from the Date AAAA City, Country EW MEETING REPORTER 146 October 2015 of not as ocular disorders, but as disorders of aging. That was the idea put forth by several leading physi- cians during the symposium "The aging eye: Can we delay or reverse the process?" Graham Wallace, MD, Bir- mingham, U.K., opened the session by asking: What is aging? Aging is a universal process that occurs in all members of a species, he said. It occurs even when all environmen- tal influences are eliminated; it is a progressive, gradual, cumulative pro- cess; and it is deleterious—it induces changes that shorten life. Researchers have put forth many theories on why and how we age, but it is clear that aging is inti- mately linked to cell senescence, Dr. Wallace said. DNA damage, repeated cell division, mitogenic signals, and reactive oxygen species (ROS) are some of the factors that can induce senescence and lead to aging. The idea that cells can become senescent may seem counterintuitive, but by arresting cell growth, senescence is a potent anti-cancer mechanism, Dr. Wallace said. As the parts of the eye most di- rectly exposed to the environment, the cornea and ocular surface are especially prone to aging, said Ula Jurkunas, MD, Boston. Dr. Jurkunas challenged attendees to think of Fuchs' dystrophy—corneal endothe- lial cell death that causes a slowly Surgeons may need to use a second room to complete these procedures, and this in turn could interfere with surgical flow. Additionally, the cost of the device and the cost of using it are both high, and true advantages need to be proven. Now, Dr. Packard said, there is another laser approach—the thermal laser. He delved into results with the CAPSULaser (Los Gatos, Calif.) and also mentioned the ZEPTO (Mynosys, Fremont, Calif.) and ApertureRx (Mount Pleasant, S.C.) lasers. "As surgeons, we should soon have a range of options available to make our capsulotomies more circular, predictably sized and posi- tioned," he said. IOL manufacturers are beginning to create designs to take advantage of this. The capsulotomy has changed with cataract surgery, Dr. Packard said. "Now, we have many devices from lasers to metallic thermal in- struments to create perfectly round, consistent, central capsulotomies," he said. "IOLs are being developed to take advantage of this, which may give better centration and effective lens position predictability." Diseases of the aging eye The most common diseases of the adult eye—including cataracts, glau- coma, macular degeneration, and corneal dystrophy—can be thought View videos from Monday at ESCRS 2015: EWrePlay.org Osama Ibrahim, MD, discusses SMILE for high myopes, aphakic patients, and patients with stable keratoconus.

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