Eyeworld

Cornea Society News – published quarterly by the Cornea Society 6 Management of chronic and recurrent anterior segment disorders Dr. Lass said that much of his work in clinical trials has been driven by a love for arts and music, admiration for artists' dedication to their craft, and the parallel with science. Dr. Lass discussed the three ran- domized clinical trials sponsored by the National Eye Institute over its 50-year history that have had a tremendous impact on eye banking and keratoplasty practice, including the Collaborative Corneal Transplantation Studies, the Cornea Donor Study, and the Cornea Preservation Time Study. He noted that randomized clinical trials remain the "gold standard" for evaluating kerato- plasty performance and can produce robust and high quality data to test a hypothesis. Dr. Lass spoke about future direc- tions for study in corneal transplan- tation. He stressed the importance of continuing to seek federal funding for interventional studies with high impact. He suggested use of the IRIS Registry to explore questions suitable for registry data and the formation of a separate, dedicated corneal surgeon registry to advance comparative effectiveness and simple interventional studies. CN Editors' note: Drs. Kuo and Lass have no financial interests related to their presentations. What affects recurrence rates? Dr. Kuo said factors include different sur- gical techniques, bias in case selection (cosmetic indication vs. topographic or vision changes), postoperative care, different geographic locations, and sur- geon ability. She highlighted studies that demonstrate the influence of surgeon ability and learning curve. In surgery for recurrent pterygi- um, the scleral surface may be scarred. Therefore, one should resist the urge to clear the sclera of scarring to avoid the risk of scleral thinning. Other features of operating on recurrent pterygium include less bleeding from cut Tenon's edges, evidence of prior tissue retrieval from the superior bulbar conjunctiva, and more scarring around/more anterior insertion of medial rectus. Dr. Kuo said that if using mitomy- cin-C, avoid application to bare sclera or medial rectus. Use a large-sized graft and adequately anchor graft edges. She stressed good clearance of subconjunc- tival fibrovascular tissue when sealing the gap between the conjunctiva and Tenon's capsule where the pterygium was excised. Suture or otherwise anchor the graft to the recipient conjunctiva and sclera to prevent vascularization or regrowth of Tenon's. The Castroviejo Lecture, presented by Jonathan Lass, MD, Cleveland, was titled "Advances With Randomized Clin- ical Trials in Corneal Transplantation." I n a session co-sponsored by the Cornea Society at the 2017 American Academy of Ophthalmology (AAO) annual meeting, presenters discussed management of chronic and recurrent anterior segment disorders. The session also included the Castroviejo Lecture. Irene C. Kuo, MD, Wilmer Eye Institute, Baltimore, discussed man- agement of recurrent pterygium. She highlighted the fact that the peer-review literature includes multiple definitions of "recurrence" and several ways to ascertain recurrence: slit lamp, imag- ing, and a web-based grading system of cosmesis. When analyzing the literature or one's results, it is important to look at the time frame of postop follow-up. Cornea Society/ Vista annual dinner Registration and call for papers to open January 5 T he Cornea Society is pleased to announce that this year's Cor- nea Society/Vista Young Phy- sician Dinner & Case Presen- tations will be held on Sunday, April 29 at 6:30 p.m. in Honolulu during the 2018 Association for Research in Vision and Ophthalmology (ARVO) annual meeting. For many attendees, the Vista program is the highlight of the ARVO meeting. The program serves as a ven- ue for young or aspiring corneal spe- cialist to present interesting, unusual, or complex cases in a congenial envi- ronment and be able to openly discuss the cases with prominent corneal specialists. The program has been very popular in the past, and individuals will be admitted with advance regis- tration only. The program tends to fill to capacity. There is no charge for the program. Young physicians, fellows, residents, and new Society members will be given preferential booking. You do not have to send an abstract to register for the Cornea Society/Vista dinner. Registration and the call for papers opens January 5. CN Dr. Lass presents the 2017 Castroviejo Lecture during the Cornea Society-sponsored symposium at the AAO Annual Meeting.

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