Eyeworld

11 EW ASCRS NEWS September 2017 World view The art and science of crosslinking F DA approval of corneal collagen cross- linking ushered in one of the most important treatments for strengthening the cornea in patients with keratoconus or ectasia after laser vision correction. In this issue of EyeWorld, experts share their knowl- edge and experience with the current state of this important technology. Peter Hersh, MD, Rajesh Rajpal, MD, and J. Bradley Randleman, MD, give a nice overview of the current and future states of crosslinking. Michael Raizman, MD, John Berdahl, MD, and Sam Garg, MD, discuss the art and science of patient selection including those patients not suited for this procedure. Crosslinking's impact on corneal transplant volumes is also covered nicely. A great debate continues on epithelium-on versus epithelium-off cross- linking. Considerations for invasiveness, healing time, and clinical effective- ness are important. Matthias Elling, MD, and Doyle Stulting, MD, speak about the current state of both techniques and what to consider. Improving the efficiency of crosslinking through increased UV light energy power and decreased treatment times are of interest to us all. But we do not want to sacrifice clinical effectiveness. John Kanellopoulos, MD, and Chris Rapuano, MD, discuss these issues as we strive for a consensus on how to diagnose and treat this variable disease. William Dupps, MD, Matthias Elling, MD, and Anders Behndig, MD, talk about the exciting potential of using corneal collagen crosslinking to treat refractive error, called photorefractive intrastromal crosslinking (PiXL, Avedro, Waltham, Massachusetts). We can all agree that a refractive corneal procedure that strengthens the corneal would be a welcome addition to our world. Updates in this exciting arena as well as how crosslinking is being used to strengthen LASIK procedures are covered. Finally, Edward Holland, MD, and Alan Carlson, MD, discuss one of the most important aspects of treating keratoconus and ectasia patients: behavioral issues. They focus on eye rubbing and other mechanical causes of corneal weakening such as sleep position. For patients to achieve maximum effect from corneal strengthen via crosslinking they need to address any- thing they may be doing to weaken their cornea. Without addressing these issues, the treatment effect can be lessened or even nullified. I hope you enjoy this issue of EyeWorld, and thank you to all the physi- cians for taking the time to share their expertise. EW Vance Thompson, MD, Refractive editor The official publication of the American Society of Cataract & Refractive Surgery A S C R S September 2017 Vol. 22 • No. 9 Publisher Donald Long don@eyeworld.org Editorial Editor Amy Goldenberg amy@eyeworld.org Managing Editor Stacy Jablonski stacy@eyeworld.org Senior Staff Writer/Digital Editor Ellen Stodola ellen@eyeworld.org Staff Writer Liz Hillman liz@eyeworld.org Production Graphic Designer Julio Guerrero julio@eyeworld.org Graphic Design Assistant Susan Steury susan@eyeworld.org Production Manager Cathy Stern cathy@eyeworld.org Production Assistant Carly Peterson carly@eyeworld.org Contributing Writers Stefanie Petrou Binder, MD Berlin, Germany Vanessa Caceres Bradenton, Florida Rich Daly Arlington, Virginia Lauren Lipuma Washington, D.C. Michelle Stephenson Roanoke, Virginia Senior Contributing Writer Maxine Lipner Nyack, New York Advertising Sales ASCRSMedia 4000 Legato Road Suite 700 Fairfax, VA 22033 703-591-2220 Fax: 703-591-0614 eyeworld@eyeworld.org www.eyeworld.org Paul Zelin paul@eyeworld.org Jaclyn Talon jaclyn@eyeworld.org Classified Sales Cathy Stern cathy@eyeworld.org EyeWorld Special Projects and Events Jessica Donohoe jessica@eyeworld.org Shelly Dixon shelly@eyeworld.org Anne Le anne@eyeworld.org ASCRS Publisher: EyeWorld (ISSN 1089-0084) is published monthly by ASCRS Ophthalmic Services Corp., 4000 Legato Road, Suite 700, Fairfax, VA 22033-4055; telephone: 703-591-2220; fax: 703-591-0614. Printed in the U.S. Editorial Offices: EyeWorld News Service, 4000 Legato Road, Suite 700, Fairfax, VA 22033-4055; toll-free: 800-451-1339, 703-591-2220; fax: 703-591-0614; email: eyeworld@eyeworld.org. 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