Eyeworld

79 December 2015 EW MEETING REPORTER age 60 and up have received it, Dr. Cohen added. Barriers to the vaccine include high cost, complex and par- tial reimbursement, frozen storage, and lack of strong recommendation from physicians. Dr. Cohen's lecture covered a new vaccine against zoster, ad- juvanted herpes zoster subunit, which is being studied currently. It has shown efficacy in studies, but the adjuvant used is not currently licensed by the FDA in the U.S., and Dr. Cohen said it will take years to become available in the U.S. To conclude her lecture, Dr. Cohen shared some of the lessons that she has learned from personal experiences with zoster. In terms of being a patient, she said that she learned what it is really like to not see well and that loss of vision in one eye is much worse than she previously thought. Although she had competent and caring doctors, she noted that it's very hard to be a patient. However, Dr. Cohen said to seize and enjoy opportunities to make contributions. She has found that she's been able to do more re- search and work more with medical school students. Editors' note: Dr. Cohen has no related financial interests. Current PRK efficacious in high myopes Photorefractive keratectomy is efficacious, accurate, and safe in patients with high myopia, accord- ing to research presented during a session at the meeting. Amir Rosenblatt, MD, Tel-Aviv, Israel, and colleagues sought to reevaluate the safety and efficacy of PRK using modern surgical techniques and technology. The study of 264 eyes in 136 patients with 3–20 months of follow-up found preop pachym- etry and smaller treatment zones were independent risk factors for haze. "When we checked, the initial corneal thickness was the significant factor and the correction itself, with the ablation depth, was not associat- ed with it at all," Dr. Rosenblatt said. accommodative tonus returned to normal, which negated the strong myopia control effect due primarily to changes in tonic accommodation, according to Dr. Mehta. The findings are significant because they could in- dicate a way to prevent the growing number of myopia cases worldwide from progressing to pathological/ high myopia, which is associated with more severe complications and blindness. Editors' note: Dr. Mehta has financial interests with Asia Genomics (Singa- pore), Carl Zeiss Meditec, Lenticor (Singapore), UK Network Medical (North Yorkshire, U.K.), and Ziemer (Port, Switzerland). Castroviejo Lecture Elisabeth Cohen, MD, New York, gave the Castroviejo Lecture on her- pes zoster. According to a PubMed search, in the first 8 months of 2015, 300 articles were published each on herpes zoster and herpes simplex, she said. There is an increasing incidence of zoster and decreasing age of onset of zoster, Dr. Cohen said. There is an ongoing debate on the role of the varicella vaccine in zoster epidemi- ology. There are risk factors before and after zoster to consider, as well as an ongoing debate relating to efficacy, safety, and timing of the vaccina- tion. It's estimated that the number of new cases per year in the U.S. is 1.2 million. Among people age 85 and older, there is a 7% mortality that has been reported, Dr. Cohen said. "It is a common misconception to think that healthy people are not at risk for zoster," she said. The rate of zoster goes up with age, and the number of cases is highest for those in their 50s. In Dr. Cohen's opinion, it is better to get the vaccine in your 50s and 60s, but she said that it is never too late. Worldwide insurance coverage of the zoster vaccine is very limit- ed, Dr. Cohen said. In the U.S., the underusage of the zoster vaccine re- mains a public health problem. Less than one quarter of eligible people available next year in the U.S. The Malyugin ring 2.0 is thinner than the original, in order to mitigate its impact on the iris, said Boris Malyugin, MD, PhD, Moscow, at the New Cataract Technology symposium. The new version of the technology that previously replaced iris hooks for many surgeons is specifically designed to work with smaller incisions. Editors' note: Dr. Malyugin has financial interests with MST (Redmond, Wash.). Treatments can reduce myopia progression Recent research indicates that the use of low dose myopia 0.01% atro- pine can reduce myopia progression with minimal side effects, according to data presented at a symposium at the meeting. "Low dose atropine may slow myopia by about 52%, and it has less side effects compared to 1% atropine dosing itself," said Jodhbir S. Mehta, MD, Singapore. The findings from a comparison of outcomes for patients treated with different levels of atropine for 1 year and then followed for 1 year after discontinuation of the drops found 0.01% atropine provided the most effective control of myopia progression, presumably because the Additionally, worse outcomes were found in 3.3% of femto patients and 1.3% of phaco patients. Although femto patients had less postop astig- matism and less surgery-induced astigmatism, the study found, they also had worse postop visual acuity, more postop complications, and more of them had worsened postop visual acuity compared to preop. The phaco group included "some of the top surgeons throughout Europe, and if you compared that group against the community just in phaco you would almost expect that group to do better," said David F. Chang, MD, Los Altos, Calif. Richard B. Packard, MD, Windsor, U.K., underscored the findings in light of the greater expense for patients treated with the femtosecond laser. Speakers noted femtosecond lasers provide good assistance in other areas, such as for corneal relaxing incisions. Editors' note: Dr. Chang has financial interests with Abbott Medical Optics, Allergan, and LENSAR (Orlando, Fla.). Dr. Packard has financial interests with Alcon. Malyugin ring 2.0 coming in 2016 The popular Malyugin ring will get an upgrade that is expected to be View videos from AAO 2015: EWrePlay.org Mark Greiner, MD, discusses the new finding of increased risk of Descemet's tears in graft preparation for DMEK surgery in donor tissue with diabetes mellitus. continued on page 80

• Cover