EyeWorld Asia-Pacific December 2012 Issue

54 September 2012 EWAP MEETING REPORTER D ce ber 2012 He found that performing the technique results in one of three types of bubbles: Type 1 emerges centrally, forming a well- circumscribed central dome 7 to 8.5 mm in diameter. Type 2 is thin-walled, begins peripherally resulting in a bubble with a much larger diameter. Type 3 mixes the characteristics of the two. With a type 1 bubble, the Descemet’s membrane can be peeled off entirely, histologically intact, without bursting the bubble. Peeling a type 2 bubble, on the other hand, immediately deflates it; what’s more, after peeling, the surgeon can create a type 1 bubble in the remaining tissue. Through subsequent histologic examination, Prof. Dua identified 5 to 8 compact lamellae of type I collagen immediately anterior to the Descemet’s membrane, posterior to the last row of keratocytes. This pre-Descemetic “Dua’s Layer” has several implications, including: a DL-DMEK is likely to be easier to handle and unfold than DMEK; the layer may have a role to play in acute hydrops of keratoconus and in pre-Descemet’s dystrophy; it may influence corneal curvature and biomechanics. Editors’ note: Prof. Dua has no financial interests related to his lecture. ACS and The Cornea Society launch CorneaEd “CorneaEd is, quite simply, ‘cornea education,’” said Donald Tan, MD , Singapore, president of both ACS and The Cornea Society. The two societies, he said, have always had strong missions for education. The website is a joint educational initiative of the sister societies, essentially a registry with links to fellowship programs in the Asia-Pacific and the U.S. The aim is to reach out to young ophthalmologists looking for opportunities to train in the cornea subspecialty. The idea, said Michael Belin, MD , Vice President for International Relations, Cornea Society, is to give young ophthalmologists the opportunity to find programs that will give them experiences they might not otherwise have. This in mind, the two societies hope to select two young ophthalmologists on the corneal fellowship program of their choice. Applications will be available on the website in the first quarter of 2013. For more information and to access the registry, visit www. CorneaEd.org. IKS massive undertaking for ACS The Asia Cornea Society’s Infectious Keratitis Study (ACSIKS) is set to be a major game changer for the region. “Corneal blindness is big in Asia,” said Donald Tan, MD , Singapore, current president of The Cornea Society and the Asia Cornea Society. It’s a fair statement, summarizing the significance of the most important cause of blindness in the region second only to cataract, but it barely scratches the surface, given the full scope and many nuances of the problem. Most corneal disease in the world occurs in Asia, said Prof. Tan. Here, he said, corneal ulceration is a “silent epidemic.” But the challenge of corneal blindness in Asia isn’t confined to magnitude; unsurprisingly for the region, huge variations exist from country to country, such that the problem runs the gamut of the entire spectrum of corneal infections. Epidemiological patterns, for one, differ significantly, said Prashant Garg, MD , Hyderabad, India. For instance, whereas studies have identified contact lens use and ocular surface disease as the major risk factors for microbial keratitis in a developed region like Hong Kong, trauma is the most prevalent cause of infection in India, affecting a correspondingly different age group: most patients in India, said Dr. Garg, fall in the range of 20 to 50 years—the economically productive age group. Wide variations also exist from country to country in terms of pathogen, environmental risk factors, the availability of drugs, antibiotic resistance patterns, access to treatment, and any number of other variables that have yet to be adequately quantified. To this end, the ACS has embarked on the ACSIKS, a multicenter, prospective observational study in 11 study centers in eight major locations (China, India, Japan, Korea, Philippines, Taiwan, Thailand, and Singapore). The study is intended to document the clinical management practices of doctors all over the region, while also collecting microbiological samples from recruited cases. To date, said Prof. Tan, the study has recruited 2,118 cases, with preliminary data analysis of 1,544 of these cases. Preliminary analysis, he said has identified fungal and bacterial pathogens to be the main causes of infectious keratitis in the region. EWAP Editors’ note: ACSIKS is made possible by the support of Alcon (Fort Worth, Texas, USA/Hünenberg, Switzerland), Allergan (Irvine, Calif., USA), Bausch+Lomb (Rochester, NY, USA), and Santen (Napa, Calif., USA). 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