Eyeworld

EW MEETING REPORTER 82 December 2017 Reporting from the 2017 American Academy of Ophthalmology (AAO) annual meeting, November 11–14, New Orleans intraocular refractive surgery, with presenters sharing the latest research and making a case for the various options. Eric Donnenfeld, MD, Rockville Centre, New York, shared his perspective on why LASIK is the best option for laser refractive sur- gery, describing published research on the procedure and debunking what he called common myths and misconceptions. Jodhbir Mehta, MD, Singapore, presented on the different patient groups that would benefit from small incision lenticule extraction (SMILE), while Margue- rite McDonald, MD, Lynbrook, New York, described how epi-Bowman keratectomy with a disposable, handheld device that removes the epithelium in strips as atraumati- cally as possible has "transformed surface ablation" with recent results comparable to LASIK. genetic condition, Dr. Marshall said. Genetic corneal dystrophies are all linked to the activation of trans- forming growth factor beta. Laser refractive surgeries trigger a reac- tion that upregulates transforming growth factor beta and exacerbates genetic conditions that go along with it. With the advent of the gene-ed- iting tool CRISPR/CAS9, which Dr. Marshall described as "micro-scis- sors," defective base pairs, like those that cause corneal dystrophies, can be snipped out. "With CRISPR tech- nology, we have the potential for correcting those genetic areas," Dr. Marshall said. When it comes to personalized medicine with genetics, Dr. Marshall said refractive surgeons have the op- portunity to be at the forefront of it. Two sessions highlighted corneal refractive surgery and Subspecialty day covers wide breadth of corneal, lens-based refractive surgery The annual meeting of the Interna- tional Society of Refractive Surgery (ISRS) began with a keynote lecture from John Marshall, PhD, London, titled "The Role of Personalized Medicine in Refractive Surgery." The history of personalized medicine began in 1953 with the identification of DNA as a double- helix structure. Just over 30 years later in 1985, the first eye gene was identified, linked to retinitis pig- mentosa, and nearly two decades later, the entire human genome was mapped. With this, the opportunity for genetic diagnostics and gene re- placement therapy became available. Why should refractive surgeons care about genetics and personalized medicine? Cornea-based laser sur- gery will exacerbate any underlying Reporting from the 2017 AAO annual meeting David Karcher, executive director of ASCRS, was honored with a Distinguished Service Award for his impact on the profession of ophthalmology through his leadership of the organization. Source: Larry Young Photography

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