EyeWorld Asia-Pacific December 2012 Issue

December 2012 51 EWAP MEETING REPORTER outstanding lifetime contribution to the field of cornea” was given to Richard Abbott, MD, Mill Valley, Calif., USA. The Association of Eye Banks of Asia (AEBA) Award, presented to “an ophthalmologist or non-ophthalmologist who has made a substantial impact and contribution to the development of eye banking,” was given to Gullapalli N. Rao, MD , Hyderabad, India. The first Saiichi Mishima Award, recognizing “the most outstanding contributions and achievements in scientific research in the field by a clinician or basic scientist in Asia,” was given to Teruo Nishida, MD , Yamaguchi, Japan. Finally, Congress president and chair of the organizing committee, Ma. Dominga Padilla, MD , Manila, Philippines, was nominated to deliver the Asia Cornea Foundation Lecture (Asia), a lecture “honoring an eminent Asian corneal clinician for his/her work in the field of cornea.” Standing on the shoulders of giants Celebrating the meeting’s theme of “Expanding the Realm of the Possible,” Richard L. Abbott, MD , Mill Valley, Calif., USA, delivered a lecture on “Corneal transplantation: The quest for perfection through innovation.” Innovation, said Dr. Abbott, is “to make a change in something established,” distinguished from invention in that it hinges upon a knowledge of prior methods and technology. Dr. Abbott embarked on a fascinating review of the history of ophthalmology, focusing on the groundbreaking work of two giants of modern ophthalmology: Ramon Castroviejo, MD (1903- 1987), and Max Fine, MD (1908- 1989). Dr. Fine, who had been a mentor and sometime colleague of Dr. Abbott, was the first to perform penetrating keratoplasty in the Western United States in 1937, using the technique of square keratoplasty advocated by his friend and rival, Dr. Castroviejo. Having dug up old film reels made by Dr. Fine in the 40s and 60s, Dr. Abbott had the films restored and converted to a digital format, which he then presented to the audience at the opening ceremony of this meeting. The differences between now and then are fascinating and educational: In his life, Dr. Fine worked barehanded—never once performing surgery wearing surgical gloves, believing they impaired his performance. And yet he achieved remarkably clear corneas and good outcomes for the time. Where do you draw the line between using a new technology and what’s good for the patient? There is no definite answer, but, said Dr. Abbott, it is the responsibility of surgeons to ask the question. “Our role is to pick and choose [the best option for our patients],” he said. Innovation is clearly a necessity, but the bottom line, he said, is whether a particular development is good for the patient. Editors’ note: Dr. Abbott has no financial interests related to his lecture. Game changers Since its establishment on March 17, 1994, the Eye Bank of the Philippines (later the Sta. Lucia International Eye Bank of Manila, SLIEB) has grown into a major supplier of corneal tissue for the region. From October 1995 to October 2012, the bank processed 18,272 corneas, of which 14,473 (79%) have been distributed. But in August 2012, tragedy struck. A news report alleged: “Slain teen’s eyes taken for donation without family’s consent.” The allegations grew out of proportion, resulting in a significant drop in the number of corneal tissue the bank was able to collect. In her Asia Cornea Foundation Lecture (Asia), Ma. Dominga Padilla, MD , Manila, Philippines, described the experience. “It is difficult for me even to read the headline today,” she said. The experience led her to contemplate the various “game changers” that allowed her and her colleagues to build the SLIEB to its stature before the incident, in the midst of a culture in which even the most outrageous allegations (“Eye Snatchers!” “Skulls cracked open to collect eyes!”), after 17 years of good work, could cause such significant damage. These factors include the International Federation of Eye and Tissue Banks (IFETB), legislation, the support of airline and courier services, the development of lamellar keratoplasty, media, and the establishment of the Asia Cornea Society and the Association of Eye Banks in Asia. The experienced combined with the recognition of these factors led Dr. Padilla to a number of lessons she shared with her audience at this meeting, among them: 1. “Presumed consent” remains a valuable way to ensure an adequate supply of tissue, but the frequent education of partners and checking of details are important to ensure the system works. 2. Learn to utilize social media. In the months following the allegations, a virtual war has raged between what Dr. Padilla called “responsible media” and the “irresponsible media” that created the conflict. Practical advice, but in the end, the incident highlights the cultural difficulties faced by eye bankers, who Dr. Padilla praised as the unsung heroes of corneal surgery. Editors’ note: Dr. Padilla has no financial interests related to her lecture. Destigmatizing corticosteroids Ophthalmologists today have a number of options for managing ocular surface and corneal inflammatory disease, including nonsteroidal anti-inflammatory drugs (NSAIDs), antihistamines, mast cell stabilizers, combination antihistamine/mast cell continued on page 52