Eyeworld

EW MEETING REPORTER 78 Reporting from the 2018 ASCRS•ASOA Annual Meeting, April 13–17, 2018, Washington, D.C. that the paper indicated that this increase may be due to a decrease in corneal higher order aberrations, treatment centered on the corneal apex vs. the center of the pupil, and epithelial remodeling. He also noted that a retrospective, multicenter clinical trial of topography is under- way with 11 investigative sites to further evaluate full data sets. The other papers he presented were "Clinical Outcomes and Vector Analysis in Myopia Patients with High Astigmatism with Small-In- cision Lenticule Extraction and Corneal Wavefront-Guided Transep- ithelial PRK" and "Contralateral Eye Comparison of Quality of Vision in Wavefront-Guided and Wavefront- Optimized LASIK." During the panel discussion, Dr. Thompson said that "to be a comprehensive refractive surgeon, it amazes me the technology that it takes." The first study "was a wonderful study to guide all of us trying to do better topo-guided," he said. EW Editors' note: The physicians have fi- nancial interests with various ophthal- mic companies. This addressed a trial of the XEN Gel Stent (Allergan, Dublin, Ireland). Results showed excellent intraoc- ular pressure reduction (36% at 9 months) and reduction in medica- tions, Dr. Radcliffe said, and all side effects were single digit. Other papers he presented on included "Outcomes of Ab Inter- no Gel Stent Placement With and Without Previous Incisional Glau- coma Procedures," "Stanniocalcin-1 is an Ocular Hypotensive Agent and a Downstream Effector Molecule That is Necessary for the Intraocular Pressure-Lowering Effects of Latano- prost," and "Outflow Facility Effects of Three Schlemm's Canal MIGS Devices." "Glaucoma is firing on all cylin- ders," Dr. Radcliffe said. The final papers presented in the refractive category were shared by Blake Williamson, MD, Baton Rouge, Louisiana. The first paper was "More Eyes with 20/10 Distance Visual Acuity At 12 Months Versus 3 Months in a Topography-Guided Excimer Laser Trial: Possible Contributing Factors." A conclusion from the study was that the number of eyes with BCVA of 20/10 was 20 times great- er at 12 months versus preop after receiving topography-guided LASIK treatment. Dr. Williamson noted surgery, is independent from the lens status, has no reductions of the visual field, is not affecting distance vision, is reversible, and is afford- able. From the study, paper authors concluded that the SML seems to increase near vision without affect- ing distance vision. Patient selection is key, and some postoperative visual training is needed. Sharing some of the best cornea papers was Dr. Hovanesian. The first was "Femtosecond-Assisted Cross- linking vs. Conventional Crosslink- ing: Proof of Concept of the Deeper the Better." This sought to compare femtosecond laser-assisted crosslink- ing outcomes with conventional procedures and to prove the concept that deeper stromal crosslinking bet- ter dampens progression of ectasias. The paper's conclusions were that crosslinking of the posterior corneal stroma deeper than 250 µm could be achieved with femto- second laser-assisted crosslinking better than any other conventional procedures, favoring an effective stabilization of keratoconus in terms of preventing steepening and further thinning of the cornea, as proof of "the deeper the better" concept. Femtosecond laser-assisted cross- linked corneas clinically remained stable with no progression after 2 years. During panel discussion, Dr. Holland said that he found femto- second crosslinking to be an aggres- sive approach but also noted that "if you don't stop progression of ectasia, they will need keratoplasty." He thinks that a technique that can make penetration deeper is worth- while. Dr. Donnenfeld noted that he has some concerns with the method to get the riboflavin deeper in the cornea and said it's important to ensure you're not damaging the cor- nea when attempting to get deeper penetration. Nathan Radcliffe, MD, New York, presented the best glaucoma patients, first highlighting "Evalua- tion of Ab Interno Subconjunctival Drainage Device in the Management of Glaucoma: Nine-Month Results." May 2018 View videos from ASCRS•ASOA 2018: EWrePlay.org Robert Weinstock, MD, describes a femtosecond capsulotomy with toric orientation marks. Sponsored by

• Blank Page
• Blank Page (1)