Eyeworld

November 2016 In the journal ... Immunohistochemical study of corneal inflammation after femtosecond laser clear corneal incisions or manual surgery Lisa Toto, MD, PhD, Claudia Curcio, PhD, Alessandra Mastropasqua, MD, Peter Mattei, MD, PhD, Erminia D'Ugo, MD, Chiara De Nicola, MD, Leonardo Mastropasqua, MD In this study, investigators evaluated cell death resulting from the femtosecond laser or manual incisions using immunohistochemical staining. Using either the manual approach or the femtosecond laser, cuts were made in 90 human cadaver corneas and analyzed for a period ranging from 5 minutes to 4 hours. Included in the 5 groups of corneas was group 1, which was untreated, group 2, which was cut manually, group 3, which was treated with the femtosecond laser using 3.0 micro- joules of energy, group 4 with 6.0 microjoules, and group 5 with 15 microjoules. At the 5-minute mark an increase in levels of interleukin-18 was seen in the femtosec- ond group versus those receiving manual incisions. After 4 hours, there was no sign of IL-18 in any of the samples. Investigators also found that in groups 4 and 5 inter- feron gamma levels were significantly higher than those in the lowest energy fem- tosecond group or those receiving manual incisions. Likewise, with higher energy there was an increase in terminal uridine deoxynucleotidyl nick end-labeling. These levels were significantly higher in group 5 than any of the others. Investigators con- cluded that there is a higher inflammatory corneal response as well as cell apoptosis with the femtosecond laser at higher energies than with manual incisions. Single-step transepithelial photorefractive keratectomy in myopia and astigmatism: 18-month follow-up results Soheil Adib-Moghaddam, MD, Saeed Soleyman-Jahi, MD, Bahram Salmanian, MD, Amir-Houshang Omidvari, MD, Fatemeh Adili-Aghdam, MD, Farsad Noorizadeh, MD, Medi Eslani, MD Investigators in this prospective case series considered how one-step transepithelial PRK fared in the long term for correction of myopia and astigmatism. In the study, 146 myopic eyes, including some with astigmatism, underwent the one-step tran- sepithelial PRK procedure, which included an aberration-free aspherical optimized profile. At the 18-month mark investigators found that 93.84% of eyes attained 20/20 or better acuity, with 97.94% of eyes within 0.5 D of targeted spherical refrac- tion. Improvements were seen in contrast sensitivity under photopic and mesopic conditions. In addition, there was an improvement in spherical, cylindrical and coma aberrations. However, there was an induction of some trefoil aberrations. None of the eyes lost more than one line of corrected distance visual acuity postop- eratively or had more than 2+ degrees of haze. Investigators concluded that based on the 18-month results, when it came to myopia and astigmatism, transepithelial PRK was safe and effective, with improvement in refraction as well as quality of vision. Toxic anterior segment syndrome caused by autoclave reservoir wall biofilms and their residual toxins Andrew Sorenson, MD, Robert Sorenson, MD, David Evans, PhD The aim of this retrospective case series involving 10 patients was to identify what had caused TASS following phacoemulsification that was otherwise uneventful. When investigators cultured the autoclaves at the center where these surgeries were performed between January 1, 2014 and January 15, 2015, they found that on the autoclave reservoir walls were Bacillus species, Williamsia, Mycobacterium mucogenicum, and Candida parapsilosis. They determined that there was prominent biofilm after using scanning electron microscopy on the reservoir wall. Once these autoclaves were replaced there were no subsequent cases reported at the center. However, after examining 23 other autoclaves in the region, investigators found that 18 were also contaminated with bacterial biofilms. They concluded that there was a strong association between autoclave reservoirs and bacterial biofilm con- tamination. Investigators theorized that heat-stable bacterial cell antigens may be transported in steam. They think that despite adherence to manufacturers' cleaning and maintenance guidelines, this suggests that the prevalence of bacterial biofilms on fluid reservoir walls is widespread. To reduce the risk of TASS they call for either prevention or elimination of autoclave fluid reservoir biofilms. November 2016 13 Submit your ASCRS Foundation Resident Excellence Award application T he ASCRS Foundation will again offer 10 $1,000 Resident Excel- lence Awards to enable ophthalmology residents exhibiting exem- plary performance to attend the 2017 ASCRS•ASOA Symposium & Congress in Los Angeles. The categories for consideration include research, patient care, leadership and education. The 2017 Resident Excellence Award includes: • A $1,000 grant to fund travel to the ASCRS•ASOA Symposium & Congress, May 5–9, 2017 • Complimentary 2017 ASCRS•ASOA Symposium & Congress registration • Four nights of complimentary accommodations at a Los Angeles hotel • Invitations to select ASCRS leadership and social events The deadline for the Resident Excellence Awards is December 31. Symposium & Congress in Los An- geles in May 2017. Dr. Charlson will be among those presenting, so don't miss the opportunity to learn about her results. The ASCRS Foundation is currently accepting applications for the 2017 grant period. This is your chance to join Dr. Charlson as a distinguished grant recipient and be one of the 10 $5,000 award winners for 2017. The program is open to practicing ophthalmologists and those in training. The ASCRS Foundation's 2017 grant application is available online, and submissions will be open until December 31. Apply at www.ascrsfoundation. org/grant-application. Learn more about the ASCRS Foundation at www.ascrsfoundation.org. EW Contact information Charlson: emily.charlson@gmail.com Zundel: nzundel@ascrs.org This new monthly column will provide insights into the work of the ASCRS Foundation. The mission of the foundation is to provide humanitarian eyecare to those in need— internationally and domestically—as well as to promote physician education and fund groundbreaking research. The ASCRS Foundation is able to accomplish this work through the philanthropic gifts of members, industry, and those who share a passion for restoring sight. www.ascrsfoundation.org

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