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July 2012 EW CORNEA 29 example, prior immunologic rejec- tion or deep corneal vascularization. The patient should have an intact fornix with good ability to wear a contact lens." An additional patient burden is the lifelong topical antibi- otic use and continued follow-up to monitor for endophthalmitis, infectious keratitis, and corneal tissue melt, she said. High-risk eyes (those with Stevens-Johnson syndrome, toxic epidermal necrolysis, ocular cicatri- cial pemphigoid, or chemical burns with active ocular surface inflamma- tion) are not good candidates for the KPro, Dr. Chan said. "OSST would be a better first- line strategy," Dr. Chan said. Dr. Aldave disagreed, saying the most common indications for the KPro are patients with combined LSCD and corneal opacification, followed by those patients where a normal corneal transplant has a poor chance of success, such as Stevens-Johnson syndrome, mucous membrane pemphigoid, or severe chemical injuries. "In those cases, I don't even try other means of visual rehabilita- tion," he said. Future advances Dr. Chan noted advances including the development of biosynthetic corneal material, ex-vivo expansion of endothelial cells, the increased use of the femtosecond laser to assist with corneal transplants, and "con- tinued modification to the Boston type 1 keratoprosthesis such as using a titanium back plate to reduce de- velopment of retroprosthetic mem- brane formation" will help surgeons provide better outcomes. "Alternate sources of stem cells, such as the cultured oral mucosal epithelial transplantation, where cells are taken from inside some- one's mouth, grown ex-vivo, and then transplanted back to the sur- face, is what's really exciting. If those cells can behave like corneal epithelial cells, then you have an infinite source of cells—take another biopsy from inside the cheek. There would be no need for immunosup- pression," Dr. Aldave said. EW References 1. Biber JM, Skeens HM, Neff KD, Holland EJ. The Cincinnati Procedure: technique and out- Summit Chairman: Meeting Co-Chairs: comes of combined living-related conjunctival limbal allografts and keratolimbal allografts in severe ocular surface failure. Cornea. 2011; 30:765-71. 2. Sejpal K, Aldave AJ. The Boston Keratoprosthe- sis in the management of corneal limbal stem cell deficiency. Cornea. 2011;30:1187-1194. Editors' note: Drs. Aldave and Chan have no financial interests related to this article. Contact information Aldave: 310-206-7202, aldave@jsei.ucla.edu Chan: 416-603-5401, clara.chan@gmail.com 4TH ANNUAL O NOVEMBER 8, 2012 Chicago Marriott Downtown Magnifi cent Mile advancement of ophthalmic products, drugs, and devices. 2011 Attendee Demographics The Ophthalmology I adv 625 Delegates from 31 States and 17 Countries Represen ted the Following Categories: gy Innovation Summit (OIS) unites l eaders i rs in the Te Testimonials Emmett Cunningham, Jr., MD, PhDD, MPH Partner larus V , Clarus Ventures Advisory Board Members: Gilbert Kliman, MD Managing Director InterWest Partners Managing D est P William J. Link, PhD PhD Managing Director e Versant Ventures re Anthony P lobal H of O enen y . Adamis, MD VPP,, Global Head of Ophthalmology Genentech Mark Blumenkmenkranz, MD Proffessor & Chairman, Department of Ophthalmology d Univ epar Stanfor d Unniversity REGISTER TODAY RECEIVE $100 OFF! David A. Karcher Executive Director ASCRS utiv Michael Kaschke, MD Prre Carl Zeiss AG esident & CEO arl Zeiss A Richard Lindstrom, MD MD Founder & Attending Surgeon ending S Minnesota Eye Consultants K. Angela Macfarlanene Preresident & CEO ForSight Labs orSigh Sabri Markabi, MD Chief Medical Officer Sr . Vice President R&D Alcon Laboratories, Inc. al O esiden e , Inc Jim Mazzo President re Abbott Medical Optics Inc. Senior Vice President Abbott Laborra ptics Inc re esiden atories Use D iscount Code: EYEWORLD * Y Your r registrra ation t type is contingent upon v ve ificerriification b by IBF * *Disccount is not combinable with any other prny other prromotional offffe Produced By: American Ac ademy of Ophthalmology David W. Parke II, MD Executiv e VPP, , CEO an A adem , MD Samir Patel, MD President & CEO OphthoTech Te Calvin Roberts, MD Executive VPP, CMO Bausch and Lomb utiv ausch and L Ellen Strahlman, MDn, MDD, MHSc Sr . VPP,, Office of the CEO GlaxoSmithKline e of the CEO lax Scott M. Whitcup, MD EVPP, R&D and CSO Allergan, Inc. ffers. * Brook Byyers Partner Kleiner Perkins Caufield & Byers erk ins C Tom Dunlapp esiden YA President and CEO HOYA Surgical Optics al O Eugene DeJuan, MD D Partner neF g OneFocus Ventureses Professorr, UCSF Ve re David Guyer, MD Partner fe SV Life Sciences FOR MORE INFORMATION AND TO REGISTER VISIT: WWW.OISAAO.COM