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147 October 2016 EW MEETING REPORTER mean time for occurrence is around 8 months after surgery. Additional- ly, Dr. Larkin added that refractive problems may not be apparent until suture removal many months after surgery. Meanwhile, complications in DALK, DSEK, and DMEK usually occur immediately postop or within a week after surgery. Early PK complications may include Urrets-Zavalia syndrome, epithelial toxicity and persistent disparity between the symptoms and examination. We see patients who complain bitterly of symptoms, you examine them, and you can't find too much wrong. Is this going to be helpful to that sort of situa- tion?" David Spalton, MD, London, the session's chairperson, asked Dr. Schmetterer. Dr. Schmetterer said OCT could help in these cases because, unlike other measurements that are not reproducible, OCT is. "Here you have a solid measure that has high reproducibility. It has been shown to have an association with the symptoms, but you cannot expect that the correlation will be perfect," he said. Nino Hirnschall, MD, Vienna, Austria, spoke of the various uses of OCT from a biometric standpoint. It could help improve success in axial length scans, especially in the 5% of patients who have not had success- ful PCI scans, he said. It can also be used to evaluate a patient's fixation and perform a check of the macula. Its application in IOL position- ing, though not available yet, is an exciting and likely possibility, Dr. Hirnschall said. OCT could also be used to improve toric IOL calcula- tions by predicting postoperative tilt of the IOL as well as measuring the surface of the posterior cornea. "I think OCT is definitely the future of ocular biometry," Dr. Hirnschall said. Modern corneal transplantation An ESCRS/EuCornea symposium focused on the topic of modern corneal transplantation with presen- tations on penetrating keratoplasty (PK), deep anterior lamellar kerato- plasty (DALK), Descemet's stripping automated endothelial keratoplasty (DSAEK), Descemet's membrane endothelial keratoplasty (DMEK), complications of corneal transplan- tation, and regrafting. Frank Larkin, MD, London, highlighted early complications of corneal transplantation and recogni- tion and treatment. Complications that have the biggest influence on long-term function after PK occur after the first month post surgery, he said, adding that for rejection, the epithelial defects, atopic sclerokerati- tis, and recurrent infection. Early DALK complications could include double anterior chamber or interface infection. Complications following DSEK that may need to be addressed are partial graft de- tachment or dislocation and acute glaucoma. Other DSEK problems could be intraocular infection and hemorrhage. Meanwhile, possible problems post-DMEK could include partial graft detachment or disloca- tion, inverted graft, and pupil block glaucoma. Primary graft failure, or no evidence of endothelial function within 1 month of transplant, could be a problem post-DSEK and post- DMEK. However, it's often difficult to accurately define this problem on account of possible unrecognized surgical complications, and Dr. Larkin recommended amending the 2015 ASOA EHR Satisfaction Survey Results* 1. EyeMD EMR scored higher on Overall System Functionality than any other vendor. 2. EyeMD EMR users report experiencing less hidden costs than any other vendor. 3. Users are more likely to recommend EyeMD EMR than any other vendor. *Based on recent customer satisfaction survey conducted on behalf of the ASOA. ASOA survey results represent opinion only, and are not in any way intended for use as a ranking tool. A COMPLETE EMR WITH NO HIDDEN COSTS? Yes, it's true! EyeMD Electronic Medical Records is your complete EMR solution. Designed specifically for ophthalmologists, it gives you all of the features and functionality you need 1 , with no hidden costs 2 . Every installation includes built-in DICOM imaging, server monitoring, diagnostic machine integrations, and no-cost seamless integration with more than 80 practice management systems. We are consistently rated very high in customer satisfaction and, according to the 2015 ASOA EHR survey, customers are more likely to recommend our product than any other vendor 3 . Choose EyeMD EMR. The full-featured EMR/EHR solution for ophthalmologists. Call 1-877-2-EYE-EMR to schedule your free demo today! www.EyeMDEMR.com | (877) 2 EYE EMR ON E O F T H E F AS TES T GRO W I N G P R I VA TE CO M P A N I ES I N T H E U SA T H R EE YEAR S I N A RO W ! Attending AAO 2016? Visit us at Booth #557 continued on page 148

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