Eyeworld

FEB 2012

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

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February 2012 EW MEETING REPORTER 101 belt-and-suspenders technique to gain the benefit of an autograft as well as amniotic membrane," Dr. Hovanesian said, adding that this technique gives him less than 1% re- currence. DMEK or DSEK? Descemet's membrane endothelial keratoplasty (DMEK) will eventually replace DSEK (Descemet's stripping endothelial keratoplasty) as the corneal transplant of choice because patients are less likely to get corneal graft rejection with the first proce- dure, said Thomas John, M.D., clinical associate professor of oph- thalmology, Loyola University Chicago, Maywood, Ill.DMEK, how- ever, remains a more technically challenging procedure that surgeons are lagging behind to adopt."What is [slowing its adoption] is the surgi- cal technique," Dr. John said. "With DMEK we are just transplanting the Descemet's membrane and endothe- lium to the patient's cornea, which is about 12-15 µm, much like the plastic wrap we use in the kitchen." In DSEK, some stroma is re- moved along with the endothelium and Descemet's membrane. "DMEK is a substitution procedure, whereas DSEK is an additive procedure," Dr. John said. "In DSEK we're actually adding tissue, so the cornea becomes thicker." Corneal thickness in DMEK goes back to normal after 3.8 months, and follow-up shows that it lasts up to 2 years, Dr. John re- ported. "DMEK provides faster, bet- ter vision," he said. Dr. John suggested staining the donor tissue and stroma during DMEK. "It's good to allow us to view the Descemet's membrane better," he advised. Beyond crosslinking for keratoconus Corneal collagen crosslinking may be an effective prophylactic treat- ment before refractive surgery, ac- cording to one surgeon who gave an update on the status of the proce- dure in the U.S. and abroad. "Obvi- ously we all want to know there's no significant change in refractive out- come in these patients," said Rajesh K. Rajpal, M.D., medical director and founder, See Clearly Vision Group, McLean, Va., and clinical as- sociate professor of ophthalmology, Georgetown University, Washing- ton, D.C. Dr. Rajpal reported preliminary data from Turkey, with 6- and 12- month follow-up showing excellent vision in patients who had LASIK or LASIK with crosslinking, termed LASIKXtra. "There's still a lot of data that needs to be collected, but we're seeing very positive results so far," Dr. Rajpal said. Dr. Rajpal also ad- dressed the epithelium-on vs. ep- ithelium-off debate."The potential benefits of doing the treatment with epithelium on are certainly faster re- covery, less likelihood of haze, and less discomfort, but also patients can get right back to their normal visual functioning," he said. "This is cer- tainly the way treatments are going to be performed in the future." Saturday, January 21 Why wait for toric ICLs? Col. Scott D. Barnes, M.D., chief, U.S. Army, Warfighter Refractive Sur- gery, Fort Bragg, N.C., has stopped telling his patients with astigmatism to wait until toric phakic IOLs are commercially available in the U.S. He has found that implanting the Visian Implantable Collamer continued on page 102 SAVE THE DATE: IF YOU ARE A DRIVER OR AN EARLY ADOPTER OF NEW OPHTHALMIC SURGICAL TECHNOLOGIES/TREATMENTS. "13*- THE OPHTHALMOLOGY INNOVATION SUMMIT (OIS) @ ASCRS Will unite thought leaders in anterior segment with a focus on facilitating ophthalmic surgical innovation. PROGRAM STEERING COMMITTEE William Link, PhD Managing Director Versant Ventures Gilbert Kliman, MD Managing Director InterWest Partners ŵŵĞƩ d ƵŶŶŝŶŐŚĂŵ :ƌ D WŚ DW, Partner Clarus Ventures Jim Mazzo WƌĞƐŝĚĞŶƚ ďďŽƩ DĞĚŝĐĂů KƉƟĐƐ /ŶĐ ^ƌ sŝĐĞ WƌĞƐŝĚĞŶƚ ďďŽƩ Laboratories ZŝĐŚĂƌĚ > >ŝŶĚƐƚƌŽŵ D &ŽƵŶĚĞƌ Θ ƩĞŶĚŝŶŐ Surgeon Minnesota Eye Consultants THE AUDIENCENCE NCLUDES: INCL Innovators/Entrepreneurs Ve e Venture Capitalists and I ublic C FO MORE i Si ORR MORE INFORMAT CONTACT: Craig Simakk International Business Forum, Inc. 516) 307-0743 or cr cr tional Business F (516) 307-0743 or craig@ibfconferences.com fe WWW.O P H T H A LMOLO G Y SUMMIT . COM Presented by R ATION eneurs, Surgeons, Academia, sts and Industry Leaders fro Private and Publiic Companies. emia, om t $)*$"(0 *- DON'T MISS THE YEAR IN R THE OPHTHALM TION SH MISS : REEVIEW: Ophthalmic Surgical Innovation Progress THE OPHTHALMOLMOLOGY INNOVANNOVVATION SHOWC HOWCASE: Private C ompany Technology Presentations CASE STUDIES ON SUC ST Br oma Sur TORIES AND LESSONS LEARNED: ringing new tecchnolog ies in Minimally Invasive Glaucom ASE STUDIES O ON SUCCESS echnolog ESSONS LEARNED: ma Surgery to Market

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