EyeWorld India September 2020 Issue

10 EWAP SEPTEMBER 2020 FEATURE OCULUS Asia Ltd. www.oculus.de • info@oculus.hk KLB Instruments Co. Pvt. Ltd KLB Your Professional Dry Eye Assistant OCULUS Keratograph 5M with JENVIS Pro Dry Eye Report: All relevant information at a glance! Dry eye management has never been this easy. The new JENVIS Pro Dry Eye Report helps you perform comprehensive screenings, using the measuring results as a basis for diagnosing dry eye syndrome. The workflow is optimized for time saving and patient friendliness. All results are documented and summarized for you and your patient in a neat and easily understandable printout. unfold, you can get corneal epithelial defects. It’s therefore important to optimize the ocular surface ahead of time to optimize healing postoperatively. Dr. Dhaliwal said that optimizing the surface can A Salzmann’s nodule in the settling of Fuchs corneal endothelial dystrophy; the surgical plan will be to do a lamellar keratectomy at the time of the EK procedure. Patient with MRSA corneal ulcer from infected bullae in endothelial dystrophy; the residual scar measured 65% of the cornea centrally so the decision to do an EK was changed to a PK given corneal disease in all layers of the cornea. Source (all): W. Barry Lee, MD include working on the lids and looking for Demodex or blepharitis. She likes to use tea tree oil wipes, which are available over the counter. Dr. Dhaliwal also recommended a beaded mask, which is a way of getting the meibomian glands to clear. She’ll have patients use an artificial tear spray, which she said is well adopted by those who find it easier to use than getting a drop in the eye. Dr. Dhaliwal uses anti- inflammatories to control dry eye and inflammation ahead of time, particularly topical cyclosporine or lifitegrast. But she added that it depends on the patient. Dr. Rapuano said ocular surface disease, dry eye, and blepharitis may be less of a concern with EK than PK because you’re not disturbing the front layers of the cornea. He said you still want to maximize the health of the surface of the cornea, but PK will disturb it more than EK. With PK, you want to make sure the surface is as healthy as possible. The transplant’s epithelial layer might be unhealthy or gone completely, which could result in a large or total corneal epithelial defect over the transplant. If you have a bad surface and still have to do PK, Dr. Rapuano said to maximize the surface health as best as possible. He also said to ask the eye bank for tissue that has an intact epithelium. During surgery, he added that suturing or gluing amniotic membrane over the surface of the cornea can help, as can using a bandage contact lens or temporary tarsorrhaphy to suture the eyelids partially closed (laterally, so you can get a look in through nasal opening and patients can get medicine in). If dryness is an issue, you can also use punctal plugs, he said. EWAP Editors’ note: Dr. Dhaliwal is Director of Refractive Surgery and the Cornea Service, UPMC Eye Center, Pittsburgh, Pennsylvania. Dr. Lee practices at Eye Consultants of Atlanta, Atlanta, Georgia. Dr. Rapuano is Chief of the Cornea Service, Wills Eye Hospital, Philadelphia, Pennsylvania. None of the doctors declared any competing interests.