EyeWorld Asia-Pacific September 2016 Issue

EWAP CORNEA 59 September 2016 Join the largest subspecialty society representing the fields of cornea and external disease. Member Benefits • Cornea : The Journal of Cornea and External Disease • Annual Meetings: Select discounted registration at membership events and educational programs • VideoEd: A weekly broadcast of clinical videos recorded live at national and international cornea meetings • K era -net: The online forum for the exchange of clinical and scientific information • Cornea Society News : Quarterly newsletter sent to all Society mem bers CorneaSociety .org Save the Date July 8-9, 2020 World Cornea Congress VIII Singapore 2020 For information & updates ... corneacongress.org/2020 conversation with their patients about these antibiotics. In fact, the published investigation indicated that most studies demonstrated a benefit to antibiotics, although they were not a panacea. Dr. Wladis reiterated that the article published by him and his coauthors did not contain a single statement suggesting that oral antibiotics should not be used until a larger study is conducted to supply more data. “Instead, we sought to point out that these large studies have not been done and that they represent a fertile area of research to help patients who are in need,” Dr. Wladis said. “I reach for oral antibiotics for my patients almost every day, but I do think physicians need to have very open conversations with patients that there isn’t a tremendous body of evidence that shows in a very significant way that these antibiotics knock out every aspect of meibomian gland disease,” he said. “Physicians need to have open and honest conversations with their patients about which benefits they can expect and the fact that there might be some benefits that are out of reach with these agents.” EWAP References 1. Bron AJ, et al. The contribution of meibomian disease to dry eye. Ocul Surf . 2004;2:149–65. 2. Wladis EJ, et al. Oral antibiotics for meibomian gland-related ocular surface disease: a report by the American Academy of Ophthalmology. Ophthalmology . 2016;123:492–96. Contact information Holland: eholland@holprovision.com Perry: hankcornea@gmail.com Wladis: tedwladis@gmail.com missed. Dr. Perry criticized the idea of a meta-analysis as a whole. “It’s a disturbing trend that people will put several articles together and call it a meta-analysis rather than doing their own study and trying to create a better, more efficacious, more rigorous approach to a problem than using a hodge- podge of 87 articles that were written,” Dr. Perry said. Both Drs. Perry and Holland said they think the article was implying physicians should not use these antibiotics until a prospective study is done. “When you first look at the abstract, you get a sense that maybe there are several studies that showed a failure of oral antibiotics for the treatment of MGD, which is not true. It’s just there haven’t been prospective trials,” Dr. Holland said. “Of course, we’d love to have multiple, large, prospective clinical trials to prove everything we do in medicine is validated, but we don’t often have that,” he continued. “Sometimes we have to go by our clinical experience. Our clinical experience—and anyone who takes care of this disease— would tell us that macrolides are very effective treatment for meibomian gland disease.” Dr. Wladis said this study is not advocating for the discontinuation of these antibiotics, but rather for a well-designed prospective study to occur to provide hard data on the topic. Until then, he said physicians should have a