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EW IN OTHER NEWS 64 January 2016 by Michelle Dalton EyeWorld Contributing Writer T wo years ago, Penny Asbell, MD, heard about the Hawaiian Eye Foun- dation's medical training program in Myanmar for the purpose of training residents Corneal specialist goes back to Myanmar a second time to continue skills transfer training Paying it forward Index to Advertisers Abbott Medical Optics (AMO) Page: 65 and Cover 4 Phone: 714-247-8314 Fax: 714-247-8682 www.amo-inc.com APACRS Page: 40 and 41 Phone: 65-63278630 www.apacrs.org Alcon Laboratories Inc. Page: Cover 2 and page 3 Phone: 800-862-5266 Fax: 800-241-0677 www.alconlabs.com BRASCRS Page: 59 www.Brascrs2015.com.br Bio-Tissue Page: 7 Phone: 866-296-8858 Fax: 305-412-4429 www.biotissue.com Clarity Medical Systems Page: 21 Phone: 925-463-7984 Fax: 925-463-7992 www.claritymsi.com Diamatrix Ltd. Page: 31 Phone: 281-367-8081 Fax: 281-292-5481 www.diamatrix.com ESCRS Page: 57 and 61 Phone: 941-751-0588 Fax: 941-752-4738 www.escrs.org International Sight Restoration Page: 51 Phone: 877-477-3210 www.ISREYEBANK.com Katena Products Page: 46 Phone: 973-989-1600 Fax: 973-989-8175 www.katena.com Lacrivera Page: 35 Phone: 855-857-0518 www.lacrivera.com Marco Ophthalmic Inc. Page: 5 Phone: 904-642-9330 Fax: 904-642-9338 www.marcooph.com New Orleans Academy of Ophthalmology Page: 12 Phone: 504-861-2550 Fax: 504-861-2549 www.noao.org Ophthalmology Innovation Summit Page: 53 www.oisascrs.com Omeros Page: Cover 3 and page 66 Phone: 206-676-5000 Fax: 206-676-5005 www.omeros.com Rhein Medical Inc. Page: 15 Phone: 813-885-5050 Fax: 813-885-9346 www.rheinmedical.com Stephens Instruments Page: 27 Phone: 800-354-7848 Fax: 859-259-4926 www.usiol.com Wills Eye Institute Page: 16 and 37 Phone: 877-289-4557 www.willseye.org World Ophthalmology Congress Page: 49 www.WOC2016.org ASCRS•ASOA Meeting Information 2016 ASCRS Symposium and ASOA Congress Page: 9 AnnualMeeting.ascrs.org 2016 ASOA Congress Page: 55 www.asoa.org ASOA John Pinto Page: 29 www.asoa.org 2016 ASCRS Glaucoma Day Page: 45 www.ASCRSGlaucomaday. org 2016 Cornea Day Page: 47 www.corneaday.org ASCRS Residents & Fellows Page: 23 AnnualMeeting.ascrs.org Tech Talks/ASCRS 2016 Page: 17 www.annualmeeting.ascrs. org YES ACT Page: 8 and 19 AnnualMeeting.ascrs.org 2016 EyeWorld Corporate Events Page: 25 www.eyeworld.org EyeWorld Events at ASCRS 2016 Page: 13 www.eyeworld.org and surgeons on various eye surgical techniques and quickly volunteered her time and expertise. So it was no surprise to the organizers that Dr. Asbell once again stepped up when they were looking for volunteers this past summer to help with training on corneal transplant techniques (among 7 other ophthalmic spe- cialties) at the Yangon Eye Hospital (YEH). The Hawaiian Eye Foundation (HEF) is well known for its phil- anthropic work in the Pacific and Southeast Asia. Myanmar meeting organizer and HEF president John M. Corboy, MD, has noted the country only has 310 ophthalmol- ogists to serve its 60 million inhabi- tants—and only one cornea-trained specialist. Most of the trained oph- thalmologists work in Yangon, the country's largest city, Dr. Asbell said. Although Myanmar started an eye bank in 1993, the eye bank only receives between 100 and 150 cor- neas a year, and about 170 corneal transplants are performed yearly. Unfortunately, YEH has a waiting list of 3,000 patients who need cor- neal transplant surgery, according to Tin Win, MD, head of the ophthal- mology department at the hospital. Cataract and lens-related disorders are among the leading causes of morbidity; the prevalence of cataract alone is more than 40%. As recently as 2013, there was no equipment or experience in Myanmar for the newer corne- al transplant procedures, such as Descemet's stripping automated endothelial keratoplasty (DSAEK) or Descemet's membrane endothelial keratoplasty (DMEK), meaning sur- geons were performing only tradi- tional penetrating transplants. Intense program The statistics may be daunting, but the outcome of these training programs is overwhelming, Dr. Asbell said. She gave 5 lectures with attending physicians, students, and residents; spent a day seeing patients; spent the next 1.5 days providing surgical care; and spent 1 day on follow-up. "We covered a lot in relatively few days," she said. "The people there had a full week, with some attending more lectures in cornea or other subspecialties and others concentrating on additional surgical techniques. Everyone we dealt with was welcoming and enthusiastic, and clearly interested in learning new techniques and providing the best care they can to their patients." The corneal lecture topics ranged from antibiotic resistance to the use of crosslinking to treat kera- toconus, how to implant the Boston keratoprosthesis (KPro), dry eye, and myopia control. "I lectured on the last topic, which is becoming a big area of concern throughout Asia," Dr. Asbell said. "The increase in myopia (worldwide) is likely a combination of environmental and genetic fac- tors, but in some parts of Asia more than 90% of people are myopic, many with high myopia greater than –6 D." Patients and outcomes During the patient consultations, Dr. Asbell saw many candidates for the KPro procedure—numerous patients with bilateral, heavy corneal scleral scarring. "A popular activity is chewing betel juice, from the betel nut, or chewing areca nuts and tobacco wrapped in a lime-coated betel leaf," she said. It gives the user a sense of euphoria but can lead to oral cancer, and the lime paste is likely calcium hydroxide that when accidental- ly squirted into the eye results in serious chemical burn with resulting corneal decimation and only light perception (LP) vision. "One of the patients we saw was relatively young with total opacifi- cation," she said. "He had no stem cells left. However, we were able to place a KPro in one eye, and he went from LP to 20/60 overnight." In another case, Dr. Asbell consulted on congenital hereditary endothelial dystrophy, or CHED, in 2 brothers with bilateral CHED. One of the brothers who underwent a corneal transplant had only count- ing fingers vision preop. "He's doing much better now and becoming self-sufficient, and that's truly gratifying," Dr. Asbell said. The group also performed the country's first DMEK. "No one had done a DMEK in Myanmar, so it was an incredible learning experience for everyone from the eye bank to the nurses and surgeons," she said. "They'd done