Eyeworld

183 April 2017 EW MEETING REPORTER One solution is to manually mark the axis on the limbus prior to performing SMILE. Dr. Ganesh conducted a study to look into the efficacy of limbal marking to compensate for cyclotor- sion. In the study, Dr. Ganesh found the incidence of cyclotorsion after docking to be 88%. Moreover, 17.6% of eyes had from 6–10º of cyclo- torsion while 1.2% had over 10º of cyclotorsion—a significant amount of shift for toric correction. Dr. Ganesh said that it may not be compulsory to compensate in low degrees of astigmatism; however, it is definitely something that needs to be addressed in moderate to high degrees of astigmatism. He therefore recommends man- ual compensation of cyclotorsion for all eyes with high astigmatism of > 1.5 D with any degree of cyclotor- sion and low astigmatism of ≤ 1.5 D with 5º or more of cyclotorsion. Manual limbal marking, Dr. Ganesh said, is a safe, feasible, practical, and effective approach to refining the result of astigmatism correction with SMILE. Results are clinically relevant in high cylinders >1.5 D. Dr. Ganesh's study is the first report on the outcomes with man- ual compensation for cyclotorsion in eyes with clinically significant astigmatism in SMILE. The result, he said, has been the basis for new guidelines put out by Carl Zeiss Meditec (Jena, Germany) for refining astigmatism with the procedure, and the paper will be published in the Journal of Refractive Surgery. EW nose Acanthamoeba keratitis and fungal keratitis and then discussed several studies using IVCM. One study she mentioned looked at IVCM as a stand-alone diagnostic tool and found good intra-observer repeatability. Experienced observ- ers achieved a higher diagnostic accuracy and reproducibility, she noted, and observers were able to diagnose Acanthamoeba keratitis more accurately than other types of keratitis. The accuracy of diagnos- ing Acanthamoeba keratitis was also associated with the duration of the disease, she said. In conclusion, Dr. Patel said that IVCM is a useful adjunctive diagnos- tic tool. However, she did note that you cannot diagnose purely from IVCM images. Clinical history and signs are important, as is imaging the correct location. Astigmatism correction— cornea or lens? Outcomes in astigmatic correction have been shown to depend on the accuracy of axis treatment, said Sri Ganesh, MD, Bangalore, India. Excimer laser platforms can detect and compensate for cyclotorsion through advanced software and eye tracking. Dr. Ganesh spoke at a scientific symposium on "Astigmatic Correc- tion in Refractive Surgery: Cornea or Lens." Today, SMILE might be the most promising new refractive procedure, he said; however, due to the lack of an eye tracker to provide equivalent compensation for cyclotorsion, it is still wanting in terms of astigmatic correction. Corneal Crosslink The world's first Crosslink - pen Most compact portable (high power) 18,30,45 mW/cm^2 CX-360 Table top * Investigational device in US. (under approved IRB protocol)) CW & Pulsed modes Spot size 3 to 12 mm High power 10-50 mW Recharged Battery for Keratoconus & customized PACK (JT Lin, patented, 2014) "Visit us at ASCRS 2017 booth # 2917 CX-100 New Vision Inc. (Taiwan) email: jtlin55@gmail.com www.site.nvi-laser.com ** International dealers needed

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