EyeWorld Asia-Pacific September 2021 Issue

FEATURE 14 EWAP SEPTEMBER 2021 by Christina Chintanaphol, PharmD I n the session, “What’s New Ahead in Cornea,” held at the 33rd APACRS–SNEC 30th Anniversary Virtual Meeting, Rajesh Fogla, DNB, FRCSEd, FRCOphth, FACS, India, began by discussing how deep anterior lamellar keratoplasty (DALK) should be considered as the procedure of choice for patients with corneal disease with a healthy endothelium.There are two surgical techniques for DALK: eÝposure of the pre- escemet layer (PDL) (pDALK) and near Descemet membrane (DM) dissection (pdDALK). Dr. Fogla provided tips on how to ensure great success using the big bubble technique and showed his methods through case presentations. “To reach the ideal plane for air injection,” he says, ºlook at the reyection against the air bubble in the anterior chamber and also look at the wrinkles in the posterior layer.” Looking at where we stand today regarding artificial This article was adapted from the ye7orld Ƃsia-*acific daily coverage of the 33rd APACRS–SNEC 30th Anniversary Virtual Meeting, held online from 30 to 31 July 2021. descemet membrane endothelial keratoplasty (DMEK) procedures, it is becoming increasingly more popular to utilize artificial corneas. This is due to an increasing global cornea shortage in which 12.7 million people around the world are waiting for corneal tissue from a donor. Furthermore, donor corneas are too eÝpensiÛe with a costly eye bank infrastructure and special storage and handling requirements. DMEK is also Ûery compleÝ with only 25,000 trained cornea surgeons able to perform this procedure. Gerd Auffarth, MD, PhD, FEBO, Germany, belieÛes that ºan artificial layer could help treat chronic corneal edema temporarily or permanently, especially in countries with limited access to donor tissue.” Dr. Auffarth, in his presentation, introduced the ndoƂrt artificial lamella which works by impeding the transfer of aqueous humor into the cornea and thus decreasing chronic corneal edema. Being made of the same material as an IOL, EndoArt has been tested on humans since 2019 and current pivotal studies are being conducted in preparation for regulatory submission. The innovation of EndoArt has its benefits inclu ding being easy to handle, having a lower cost, not having to wait for donor tissue, and being a less traumatic surgery. Although there are more challenging DMEK cases on the rise, DMEK remains The Big Bubble technique. Source: Rajesh Fogla, DNB, FRCSEd, FRCOphth, FACS What’s New Ahead in Cornea Co-hosted by the Asia Cornea Society at the 33rd APACRS-SNEC 30th Anniversary virtual meeting Donald TAN, Singapore Jodhbir MEHTA, Singapore Shigeru KINOSHITA, Japan Theo G. SEILER, Switzerland Gerd AUFFARTH, Germany Rajesh FOGLA, India Cornea.indd 1 31/08/2021 12:08 PM