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Expert: no single surface procedure ‘will win out’
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SAN FRANCISCO – A new trend, dubbed “comprehensive refractive surgery” is here to stay, according to the chief medical editor of Ocular Surgery News.
![Richard L. Lindstrom, MD [photo]](/images/commonart/lindstrom.jpg) Richard L. Lindstrom |
Dr. Lindstrom was a panelist during Cornea Day, jointly sponsored by the Cornea Society and the American Society of Cataract and Refractive Surgery.
“I don’t believe any one procedure will win out,” he said.
George O. Waring III, MD, believes lamellar surgery “will continue to lead” as the procedure of choice, he said.
“LASIK is almost like a household word now, patients know it and like it,” he told attendees.
Richard Yee, MD, however, believes surface ablation will become the procedure of choice. It will catch on, “because we can re-treat haze. We can modulate haze and minimize pain.”
José L. Guell, MD, PhD, said he advocated phakic IOLs in patients with thinner corneas.
In an informal poll, program moderator Michael W. Belin, MD, asked the several hundred attendees to raise their hands if they have had a refractive procedure. About 100 attendees raised their hands. Dr. Belin asked those people to raise their hands if they had a lamellar procedure. The overwhelming majority underwent lamellar procedures, followed by a few who had undergone a surface procedure, and very few who had a phakic lens implantation.
More presentations from Cornea Day at ASCRS are highlighted in the remainder of this article. These items appeared first on OSNSuperSite.com as daily reports from the meeting.
First Cornea Day ‘a complete success’
The first Cornea Day held in conjunction with the ASCRS meeting was deemed a success.
Jointly sponsored by the Cornea Society and ASCRS, the day attracted several hundred attendees. The subspecialty day was held prior to the official ASCRS conference.
Michael W. Belin, MD, one of Cornea Day’s program moderators, said, “As the president of the Cornea Society, I would like to welcome [attendees] to Cornea Day. This is the first Cornea Day to be combined with ASCRS.”
He continued, “If you look around the room, you will see it is a complete success.”
Keratoprosthesis surgery can be alternative to regrafting
Image: Archer ME, OSN |
Permanent keratoprosthesis surgery can be an effective alternative to regrafting a patient with a failed penetrating keratoplasty, according to one surgeon experienced with the technique.
Sadeer B. Hannush, MD, presented results of a study conducted with the Boston Keratoprosthesis. Since January 2003, he said, 141 of these keratoprostheses have been implanted at 17 sites. He said an average of 2.24 prior corneal transplants had been performed in the eyes in which the Boston device was implanted. Preoperative visual acuity was 20/400 in these patients, Dr. Hannush said.
After a mean 33 months of follow-up, he said, visual acuity was 20/30, with 95% retention of the device.
Dr. Hannush said that, in the past, cost and complication rates had been disadvantages of the Boston Keratoprosthesis procedure.
“Many of these concerns have been successfully addressed,” he said, but long-term follow-up is still necessary.
Dr. Hannush said, however, that when a patient has no light perception and uncontrolled IOP, keratoprosthesis surgery is not advised.
Bee and wasp sting injuries: manifestations and effects
Hymenoptera sting injury is common in rural India, and clinicians should be educated regarding the many manifestations of this phenomenon, according to a poster presentation during the ASCRS general meeting.
Nibaran Gangopadhyay, MD, recommended that physicians become familiar with the varied manifestations after ocular injury caused by bee or wasp stings.
In his case series, two patients from a rural area of India consecutively presented with bee and wasp stings in the cornea. One patient, a 25-year old male, developed immediate corneal epithelial defect and sterile infiltrate followed by severe inflammation, which led to endothelial dysfunction and cataract from venom toxicity. The corneal scar and cataract led to severe visual deficit in this patient, Dr. Gangopadhyay said.
The other patient, a 13-year old boy, suffered a wasp sting on the peripheral cornea and subsequently developed symblepharon formation, limbal ischemia, secondary yeast infection, corneal endothelial dysfunction and significant visual loss. Medical treatment seemed unlikely to prevent long-term complications and visual disability.
“Knowledge on various manifestations enriches understanding, leading to prompt and proper treatment, to limit the serious consequences,” Dr. Gangopadhyay said.