Cornea Society News

SUM 2012

Cornea Society is an organization advancing the treatment of corneal disease

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Cornea Society News A C o r n e a S o c i e t y p u b l i c a t i o n S u m m e r 2 0 1 2 V o l 8 , N o . 3 Presenters were tasked with looking beyond clinical presentations such as Schirmer's test, tear breakup times, or conjunctival/corneal staining to biomechanical markers to diagnose ocular surface dysfunctions. Richard S. Davidson, MD, Aurora, Colo., said the LipiView Ocular Surface Interferometer (TearScience, Morrisville, N.C.) allows for close monitoring of the lipid levels in tear film over time and can be combined with the LipiFlow treatment system for meibomian gland dysfunction. "After a 20-second measurement time, it is able to quantify the lipid level of tear film," Dr. Davidson said. Reza Dana, MD, Boston, argued that the osmolarity test would reign in this arena. Osmolarity testing with the TearLab Osmolarity System (TearLab Corp., San Diego) is currently available to test for subclinical dry eye. Speakers debate hot topics at 2012 Cornea Day T he morning sessions of Cornea Day (co-sponsored by the Cornea Society and ASCRS) began with Graham D. Barrett, FRACO, Perth, Australia, declaring incision security during phaco "depends largely on the construction and the size of the incision and is unlikely to be dramatically improved by femtosecond technology." Prof. Barrett added the technology "may not be ready for prime time." Conversely, Robert J. Cionni, MD, Salt Lake City, said his group found the technology to be "superior in effective lens position predictability," and in his practice, "63% of our patients are now opting for astigmatic correction" with the femtosecond cataract laser. For the more advanced corneal surgeon, Michael Snyder, MD, Cincinnati, discussed his techniques for iridoprosthesis (none of the iris devices are approved for use in the U.S.); three manufacturers in Europe make the devices (Ophtec, Groningen, the Netherlands; Morcher, Stuttgart, Germany; and HumanOptics, Erlangen, Germany). "Damaged irises can be successfully repaired, and when significant amounts of iris are missing, implants can be very helpful," he said. The second morning session featured a he said/she said format, with topics ranging from penetrating keratoplasty versus deep anterior lamel- lar keratoplasty to Descemet's stripping endothelial keratoplasty versus Descemet's membrane endothelial keratoplasty. Ocular surface transplant controversies discussed were limbal stem cell versus keratoprosthesis and pterygium surgery (conjunctival auto- continued on page 3 graft versus amniotic membrane). In the latter discussions, Ed Holland, MD, Cincinnati, cited several advantages of ocular surface transplant, including its use in severe conjunctival disease. "It's not a matter of which technique is bet- ter," he said, "but which is best indicat- ed for the patient." Dr. Holland's preference is to perform ocular surface transplantation first and then move to a keratoprosthesis if necessary. Anthony Aldave, MD, Los Angeles, countered, saying the Boston keratoprosthesis "provides superior visual outcomes" to allogeneic keratolimbal transplantation and avoids immunosuppression issues. With dry eyes and ocular surface disorders being top complaints from patients, the rush is on for a diagnostic test that will definitively diagnose the disease. In one of the afternoon sessions, four clinicians debated what they felt would be the primary diagnostic test for dry eye in the next 5 years. Graham D. Barrett, FRACO, shares his views on femtosecond technology

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