Eyeworld

83 December 2017 EW MEETING REPORTER as you need to go back and forth among the images to read them. "That's 10 minutes of your time to figure out what's going on," he said. The use of OCT-A for retinal disease also needs more prospective clinical trial data, and reimbursement is lim- ited. Audience members were able to vote, and 77% agreed that OCT-A is not yet ready for mainstream clini- cal imaging. Editors' note: Dr. Baumal has financial interests with Genentech. Dr. Csaky has financial interests with Genentech, Regeneron Pharmaceuticals, and other ophthalmic companies. Cornea and Eye Banking Forum This year's R. Townley Paton Award Lecture was given by Michael Nor- dlund, MD, Cincinnati, and was ti- tled "Reflections on the Success and Future of Eye Banking." He shared experiences from the last 16 years of his work with the Eye Bank Associa- tion of America (EBAA). Prior to eye banking it was the surgeon's responsibility to take care key because patients receiving the KPro tend to have more vitreoreti- nal complications and high rates of endophthalmitis and sterile vitritis, Dr. Lim said. Editors' note: Dr. Lim has financial in- terests with Genentech (San Francisco), Regeneron Pharmaceuticals (Tarrytown, New York), and other ophthalmic companies. Is OCT-A ready to be used regularly for retinal imaging? OCT angiography (OCT-A) has several advantages for mainstream clinical use, according to Caroline Baumal, MD, Boston, speaking on the pro side of a debate on the topic. There are many published papers about OCT-A each year, and it is better for patients than fluorescein angiography, she thinks. "There's no dye, no patient risk, and it will save you time," Dr. Baumal said, adding that OCT angiography takes 2–3 minutes per patient compared with 20–30 minutes for fluorescein angiography. Presenting the cons, Karl Csaky, MD, Dallas, noted that OCT-A can take time to interpret, records—which Dr. Ferris described as "far from ready for prime time"— and the IRIS Registry organized by the AAO. Although large observa- tional databases may not be useful for clinical trials, they will provide new directions for research, Dr. Ferris said. Editors' note: Dr. Ferris has no financial interests related to his presentation. Complex RD management: Scleral buckle alone or with PPV? It's the surgeon's choice whether to perform scleral buckle alone for a complex retinal detachment or do a scleral buckle along with a pars plana vitrectomy, said Richard Kaiser, MD, Cherry Hill, New Jersey. There have been mixed results in previous studies, but an analysis of data from the IRIS Registry obtained information from all patients who had a primary retinal detachment repair procedure from January 2013 to September 2017 (102,503 eyes) as well as eyes with a second retinal detachment repair procedure. The success rate of both approaches was nearly the same—87.9% for scleral buckle alone and 86.8% for pars pla- na vitrectomy plus scleral buckle. Editors' note: Dr. Kaiser has financial interests with PanOptica (Bernardsville, New Jersey). Combined KPro, PPV, and glaucoma tube can lead to better outcomes Patients receiving the Boston kera- toprosthesis (KPro, Massachusetts Eye and Ear Infirmary, Boston) and having a pars plana vitrectomy as well as a glaucoma tube had re- duced overall complications, lower endophthalmitis trends, and better rates of visual acuity, said Jennifer Lim, MD, Chicago. The quest for better outcomes with a KPro are William Wiley, MD, Cleveland, tackled the question of when an intraocular refractive surgery should be considered. In general, lens removal should be considered when it's not functioning, he said, but during his presentation, Dr. Wiley discussed the importance of consid- ering the patient's age and refractive condition as well. An older high myope would be a good candidate for clear lens removal, but a younger high myope would be better off with a phakic IOL. Without an FDA-ap- proved phakic IOL for hyperopia, Dr. Wiley said clear lens surgery is an option for these patients, but physicians should be aware of the possibility for choroidal effusion. Editors' note: Drs. Marshall, Donnen- feld, and Mehta have financial interests related to their presentations. Dr. McDonald has no financial interests related to her presentation. Schepens Lecture focuses on clinical trial advancement for diabetic retinopathy In the late 1960s, the largest use of seeing eye dogs was for patients who were blind from diabetic retinop- athy, said Frederick Ferris, MD, director of the Division of Epide- miology and Clinical Applications and former clinical director of the National Eye Institute, Bethesda, Maryland. Now, with the help of many clinical trials, patients with diabetic retinopathy have a growing number of treatments to help save their vision. In the Charles L. Schep- ens, MD Lecture at the AAO Retina Subspecialty Day, Dr. Ferris outlined how clinical trials for diabetic reti- nopathy have evolved. He addressed the value of the Diabetic Retinop- athy Clinical Research Network trials, of which seven are currently in follow up. The future of diabetic retinopathy treatment research will include the use of electronic medical continued on page 84 View videos from AAO 2017: EWrePlay.org Carol Shields, MD, discusses the utility of genetic testing for retinoblastoma.

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