EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/618732
65 EW IN OTHER NEWS January 2016 Contact information Asbell: penny.asbell@mssm.edu HEF: contact@hawaiianeyefoundation.org DSEKs before, but we had worked to tweak the standard DSEK and come up with a few tricks to make it go more smoothly." For example, rather than use an inserter, Dr. Asbell used a 30-gauge needle and bent the tip to slide it in. "Inserters are expensive, and the country has a limited budget for medical care," she said, adding 80% of the hospital's funding comes from the government. "In another case we performed a pull-through procedure that uses a suture that attaches to the donor cornea," she said. "We tried to sim- plify as much as we could because a lot of this instrumentation is expensive so we incorporated ideas that can save some strain on their budget." She noted that some of the techniques are employed in the U.S. as well. Skills transfer For Dr. Asbell, this trip was all about skills and knowledge transfer. She would start a surgery but rapidly moved into the assistant role while one of the YEH surgeons completed it. "I think I was doing the max- imum training in terms of getting their hands involved in what we were doing and understanding how they can go forward on their own," she said. She plans on returning in another 2 years and to continue the relationships she developed with the YEH staff. "I hope that some of them might even be able to come to the U.S. to continue their train- ing," she said. "The faculty were very interested in developing their techniques and skills and to have an ophthalmic hospital comparable to anywhere else in the world. These surgeons are looking to be first class surgeons using the most modern techniques available." Industry support Without the support of industry, the mission would not have come to fruition, Dr. Asbell said. Donations for the cornea section of the train- ing program included corneal tissue donations from the San Diego Eye Bank; Boston keratoprostheses from Claes Dohlman, MD, Massachusetts Eye and Ear Infirmary; trephines from Jedmed Instrument Company (St. Louis); trephine and surgical instruments for DSAEK and DMEK techniques from Moria (Antony, France); Lester T. Jones Tear Duct Tubes for DMEK insertion from Gunther Weiss Scientific (Portland, Ore.); and disposable anterior cham- ber maintainers from Hurricane Medical (Bradenton, Fla.). EW Editors' note: Dr. Asbell received an ed- ucational grant to assist with planning and attending this meeting. HEF is a non-profit organization, and volunteers fund their own travel and lodging. HEALTHCARE PROFESSIONAL INDICATION AND IMPORTANT SAFETY INFORMATION The STAR S4 IR® Excimer Laser and iDESIGN Advanced WaveScan Studio System for wavefront-guided LASIK in patients with myopia. CAUTION: U.S. Federal Law restricts this device to sale, distribution, and use by or on the order of a physician or other licensed eye care practitioner. ATTENTION: Reference the Operator's Manual for a complete listing of Indications and Important Safety Information. INDICATIONS: The STAR S4 IR® Excimer Laser and iDESIGN Advanced WaveScan Studio System is indicated for wavefrontguided LASIK in patients with myopia as measured by iDESIGN System up to -11.00 D SE, with up to -5.00 D cylinder; with agreement between manifest refraction (adjusted for optical infinity) and iDESIGN System refraction of 1) SE: magnitude of the difference is ˂ 0.625 D, and 2) cylinder: magnitude of the difference is ≤ 0.5 D; with patients 18 years of age and older, and with refractive stability (a change of ≤ 1.0 D in sphere or cylinder for a minimum of 12 months prior to surgery). CONTRAINDICATIONS: Laser refractive surgery is contraindicated in patients with: collagen vascular, autoimmune, or immunodeficiency diseases, pregnant or nursing women, keratoconus, abnormal corneal topography, epithelial basement membrane disease (EBMD) and degenerations of the structure of the cornea, symptoms of significant dry eyes, corneal thickness would cause anticipated treatment would violate the posterior 250 microns (μm) of corneal stroma, advanced glaucoma, and uncontrolled diabetes. If the patients have severely dry eyes, LASIK may increase the dryness; this may or may not go away. Severe eye dryness may delay healing of the flap or interfere with the surface of the eye after surgery; it may result in poor vision after LASIK. WARNINGS AND PRECAUTIONS: LASIK is not recommended in patients who: have a history of Herpes simplex or Herpes zoster keratitis, have severe allergies or tendency rub their eyes often, are taking the medication Isotretinoin (Accutane®), are taking antimetabolites for any medical conditions. The safety and effectiveness of this laser for LASIK correction have NOT been established in patients: with progressive refractive errors; previous corneal or intraocular surgery; or trauma in the ablation zone, who are taking the medication Sumatriptan (Imitrex®), or Amiodarone hydrochloride (Cordarone®), with corneal neovascularization within 1.0 mm of the ablation zone, over the long term (more than 1 year after surgery), for patients who engage in activities that could endanger or damage the LASIK flap, for patients who have a family history of degenerative corneal disease, history of inflammation of the eye, for patients who have a history of crossed eyes (strabismus) or who have undergone strabismus surgery, prior LASIK or Refractive Surgery, with history of any eye diseases or abnormalities such as corneal scars or active disease, and whose BSCVA is worse than 20/20. To reduce the risk of corneal ectasia, the posterior 250 microns (μm) of corneal stroma should not be violated. The treatment of highly myopic eyes necessitates the removal of significant amounts of corneal tissue. The iDESIGN System calculates the estimated residual bed depth using the pachymetry and intended flap thickness entered by the user. Actual flap thicknesses may vary. If the estimated residual stromal bed is ≤ 320 microns, an in-the-bed pachymetric measurement should be performed. ADVERSE EVENTS: Possible adverse events include loss of best spectacle corrected visual acuity (BSCVA), serious Transient Light Sensitivity Syndrome, serious primary open angle glaucoma, miscreated flap, melting of the flap, severe glare, and severe dry eyes. Complications can include corneal edema, epithelial ingrowth, diffuse lamellar keratitis, foreign body sensation, and pain. ©2015 Abbott Medical Optics Inc. iLASIK, iDESIGN, iDESIGN Advanced WaveScan Studio, WaveScan, and STAR S4 IR are trademarks owned by or licensed to Abbott Laboratories, its subsidiaries or affiliates. PP2015OTH0316 Dr. Asbell examines a patient. Source: Penny Asbell, MD