Eyeworld

EW FEATURE 54 Treating the cornea before cataract surgery • May 2017 vision with PROKERA, but Dr. Don- aldson pointed out that Bio-Tissue now offers PROKERA Clear. The PROKERA Clear may be very useful in a monocular patient that cannot afford to compromise vision in their only eye. The central portion of the PROKERA Clear is devoid of amniot- ic membrane to preserve vision. If a patient won't tolerate PROKERA be- at least 6 weeks, especially in the setting of prior epithelial defects, to allow epithelial remodeling to take place, checking measurements serially to make sure keratometry values were stable before proceeding with surgery. Dr. Donaldson also noted that after having the amniotic membrane product applied for a week, she directs her patients to then continue their prior ocular surface regimen, which might include artificial tears and other medical therapy. Putting amniotic membrane in the context of the bigger picture, Dr. Donaldson said cataract surgery requires a partnership with the patient in order to achieve our very best outcomes. "They have to understand that cataract surgery is a once-in-a-life- time experience per eye, and we need to make the investment in time and effort to choose the best IOL possible," she said. "We want to do everything we can in our power to optimize the surface and optimize the choice of lens that's going into their eye because it's going to last forever. Once you create this part- nership with the patient, they don't get frustrated with taking the extra time to do this…Fortunately, with all the technology—the imaging technology, the therapeutic tech- nology, and the diagnostic technol- ogy—that we have nowadays, we can use those things to help patients understand better so that they can take part in this treatment process to make their cataract surgery out- comes the best possible." EW Editors' note: The physicians inter- viewed have financial interests with Bio-Tissue. References 1. Thomas J. Human amniotic membrane transplantation: Past, present, and future. Ophthalmol Clin N Am. 2003.16:43–65. 2. Rahman I, et al. Amniotic membrane in ophthalmology: Indications and limitations. Cambridge Ophthalmological Symposium. Eye. 2009;23: 1954–61. 3. Vlasov A, et al. Sutureless cryopreserved amniotic membrane graft and wound healing after photorefractive keratectomy. J Cataract Refract Surg. 2016;42:435–43. 4. Paolin A, et al. Amniotic membranes in oph- thalmology: Long term data on transplantation outcomes. Cell Tissue Bank. 2016;17:51–8. Contact information Desai: desaivision@hotmail.com Donaldson: KDonaldson@med.miami.edu Gupta: preeya.gupta@duke.edu cause of the ring, Dr. Donaldson said she'll use another form of bandaged contact lens, though it won't be as therapeutic. When to take measurements? While amniotic membrane products lead to "rapid re-epithelialization without scarring or haze" in a week or less, Dr. Desai said, it can take up to 4 weeks for the epithelial remod- eling to complete. The physicians interviewed for this article varied slightly on when they would take measurements for IOL power cal- culations. Dr. Desai said biometry could be completed a month after "Prokeratectomy," while Dr. Don- aldson said she'd wait 3–4 weeks, and Dr. Gupta said she would wait (800) 367-8327 DuPont, WA 98327 info@lacrimedics.com • www.lacrimedics.com ©2017 Lacrimedics, Inc. 1 ASCRS Clinical Survey 2015. Global Trends in Ophthalmology and the American Society of Cataract and Refractive Surgery. Don't let 41% of your patients with OSD go untreated, especially when they need something more than artifi cial tears. Lacrimedics' VisiPlug® is FDA approved for the treatment of the Dry Eye components of varying Ocular Surface Diseases (OSD), after surgery to prevent complications due to Dry Eye Disease, and to enhance the effi cacy of topical medications. VisiPlug® – Provides approximately 180 days of occlusion so you can better manage your patients' treatment plans. Don't let 41% of your patients 41% of refractive or cataract surgery patients have ocular surface dysfunction levels requiring some treatment beyond artifi cial tears! 1 0.4mm 0.5mm Optimizing continued from page 52

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