JAN 2018

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

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Page 17 of 102

UPDATE 15 In the journal Comparison of macular parameters after femtosecond laser-assisted and conventional cataract surgery in age-related macular degeneration Tim Enz, MD, Livia Faes, MSc, Lucas Bachmann, MD, Michael Thiel, MD, Jeremy Howell, MD, Sophie Boehni, MD, Mario Bittner, MD, Martin Schmid, MD In this retrospective case series, investigators compared how patients with AMD fared after femtosecond laser-assisted versus conventional cataract removal. Included here were 140 eyes of 110 consecutive AMD patients who underwent cataract removal between January 2010 and December 2015. Investigators found that central macular thickness, central macular vol- ume, visual acuity, and the number of needed anti-VEGF injections postoperatively were the same in both groups. However, with aid of optical coherence tomography, which was used in 33 eyes, investigators found that in the femtosecond group at the 2-week postoperative mark there was a significantly lower central macular volume. Investigators concluded that the femtosecond laser-treated eyes were less likely to have subclinical macular edema during early follow-up, which for those with macular vulnerability could be a benefit. Otherwise both groups fared equally over the wet AMD postoperative treatment course. Histopathological trabecular meshwork remodeling after cataract surgery detected with an advanced image analyzer Pablo Zoroquiain, MD, Christina Mastromonaco, Msc, Matthew Balaszi, PhD, Jade Lasiste, MD, Sultan Aldrees, MD, Nabil Saheb, MD, Miguel Noel Burnier Jr., MD Using advanced image analyzer technology, investigators in this retrospective case series compared the trabecular meshwork and ciliary processes of pseudophakic versus phakic eyes. Included here were 35 pseudophakic and 25 phakic eyes. Investigators found that for those in the pseudophakic group the trabecular meshwork area was larger, with a trend of larger trabecular space in this group noted. Another difference was for those in the pseudophakic group, the scleral spur to inner uveal trabecular portion was longer than in the phakic one. There was a correlation between this and the larger trabecular meshwork area found. There was also a higher degree of fibrosis detected in the ciliary processes in the pseudophakic group. Investigators concluded that in the pseudophakic eyes there were significant trabec- ular meshwork changes and more fibrosis in the ciliary processes. They think this bolsters the idea that after cataract surgery, remodeling of the trabecular meshwork is involved in lowering IOP. Direct measurement of anterior corneal curvature changes attributable to epithelial removal in keratoconus Mohammed Ziaei, FRCOphth, Jay Meyer, MD, Akilesh Gokul, Boptom (Hons), Hans Vellara, Boptom (Hons), Charles McGhee, FRCOphth What happens to eyes with moderate to severe keratoconus that undergo epithelial debride- ment? In a recent prospective case series, investigators took 30 eyes of 30 patients with mod- erate to severe keratoconus and compared the tomography of the corneal epithelium and Bowman's layer. They determined that the central and midperipheral corneal zones, which went from 0 to 7 mm, were significantly thinner following epithelial removal. The central zone decreased by 21 microns and the midperipheral by 35 on average. Meanwhile, the anterior axial flat keratometry increased by 1.71 D, the steep K by 2.14 D, and the maximum K by 2.13 D. Likewise, following epithelial debridement, corneal astigmatism grew by 1.11 D and total corneal power by 2.03 D, while asphericity decreased by a mean of 0.31. Investiga- tors concluded that in cases of moderate to severe keratoconus, after epithelial debridement Bowman's layer became significantly steeper than the epithelium. This means that the mag- nitude of anterior corneal keratometry, astigmatism, and prolateness all increased as a result of the epithelial debridement. This suggests that underlying irregularities in Bowman's layer in those with keratoconus are smoothed by corneal epithelium. January 2018 Dr. Crandall surveys a crowded waiting room in Salama, Guatemala, during a Moran Eye Center charitable cataract surgery mission. Dr. Crandall, his wife, Julie, and others visited Kenya in conjunction with Weill Cornell to teach local physicians and perform surgeries. Source (all): Alan Crandall, MD said Stephen Lane, MD, co-chair of the ASCRS Foundation. The award will be made each year at the ASCRS•ASOA Annual Meeting, and a $50,000 prize will be granted in the recipient's honor to a charitable ophthalmology organi- zation of his or her choice. Dr. and Mrs. Chang hope the $50,000 grant will not only help fund the great work being done now but allow the honoree to publicly highlight a deserving charitable organization before ASCRS' vast international audience. "As the world's population ages, the backlog of cataract blindness in developing countries will continue to climb," Dr. Chang said. "There are proven, cost-effective solutions that need to be scaled and many dedicated individuals and organi- zations that merit our collective support." EW Contact information Chang: dceye@earthlink.net Fine: hfine@finemd.com Furlong: roger@furlong.org Koch: dkoch@bcm.edu Lane: sslane@associatedeyecare.com Zundel: nzundel@ascrs.org

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