EyeWorld Asia-Pacific December 2012 Issue

50 EWAP MEETING REPORTER December 2012 Reporting live from the Asia Cornea Society’s 3rd Biennial Scientific Meeting, 28-29 November 2012 M ANILA, DAY 1—The first day of the Asia Cornea Society’s 3rd Biennial Scientific eeting held here kicked off with a symposium sponsored by the Cornea Society, followed by an opening ceremony in which the ACS bestowed a number of awards, including the Asia Cornea Foundation Medal Lecture and the Asia Cornea Foundation Lecture (Asia). Femto keratoplasty—future or fad? But is the use of the femtosecond laser really the future for keratoplasty, or merely a fad? Anthony J. Aldave, MD , Los Angeles, Calif., USA, contemplated the question. Dr. Aldave enumerated the advantages of femtosecond laser keratoplasty, including greater wound strength and wound configuration with better donor- host interface match. Using the laser also means ACS 2012: ‘Expanding the Realm of the Possible’ by Chiles Aedam R. Samaniego EyeWorld Asia-Pacific Senior Staff Writer the possibility of earlier suture removal, which has resulted in significantly better measurements of topographic astigmatism at 6 months. However, this advantage disappears at 1 year; apparently, he said, suturing technique remains the main determinant for post-op topographic astigmatism. Still, he said, widespread adoption is limited by the disadvantages: the cost, the risk of intra-op complications including suction loss, and the fact that many patients are not candidates for the procedure owing to anatomic factors. It therefore remains to be seen whether femtosecond laser keratoplasty is indeed the future, or just a fad. The thinner the better? In the evolution of keratoplasty, there has been a rapid transition from PK to endothelial keratoplasty (EK), said Edward J. Holland, MD , Cincinnati, Ohio, USA. EK has achieved broader acceptance by having had its early disadvantages of an increased rate of primary donor failure and endothelial cell loss mostly addressed, but current disadvantages include visual outcomes that are still not on par with cataract surgery, and endothelial cell loss remains higher than would be ideal. In other words, said Dr. Holland, EK is “doing better, but not as well as we would like.” The procedure continues to evolve, and one direction the procedure is headed toward is using thinner tissues. There used to be a bias toward thicker tissue that was easier to manage, but surgeons have since found that thinner tissue results in better visual acuity. What’s more, the development of donor insertion devices such as the Busin glide and Tan EndoGlide (Angiotech, Vancouver, BC) have made thin tissues more manageable. The next trend, said Dr. Holland, is Descemet’s membrane EK (DMEK), which eliminates stroma from donor tissue to create the thinnest donor tissue possible. However, donor preparation is even more difficult, there is an increase in endothelial cell loss, and there is the risk of rebubbling. In the future, he said, new methods for donor preparation need to be developed, and prospective studies need to compare DMEK with thin EK to establish the true value of the procedure. Editors’ note: Drs. Aldave and Holland delivered their lectures in a symposium sponsored by the Cornea Society. They have no financial interests related to their lectures. ‘Expanding the Realm of the Possible’ “The pursuit of education in the cornea subspecialty remains a most important mission of the Society,” said Donald Tan, MD , Singapore, president of the Asia Cornea Society. To this end, the organizing committee has put together a “stimulating scientific program delivered by over 70 eminent international and regional corneal opinion leaders” around the theme of “Expanding the Realm of the Possible.” At the opening ceremony of this year’s meeting, the 3rd Biennial Scientific Meeting of the Society, the ACS presented a number of awards: The Asia Cornea Foundation Medal, a medal lecture and the Society’s most prestigious award “presented to a corneal specialist in recognition of an