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20 EW SHOW DAILY Monday, April 22, 2013 ASCRS Symposia Pardon the ophthalmology ... by Michelle Dalton EyeWorld Contributing Writer T aking its hat off to sports cable network ESPN, the ASCRS Cornea Committee presented "Pardon the Oph- thalmology," hosted by moderators Edward Holland, MD, Cincinnati, and Terry Kim, MD, Durham, N.C. In this highly interactive sympo- sium, Drs. Holland and Kim presented various corneal abnormalities as seen on slit lamp, topography, or optical coherence tomography Download this new eBook for Corneal Cross-linking, Compliments of Download the First Two Chapters Now: www.avedro.com/kxl-book (iPad, iPhone, Kindle, Nook, or PC) Visit us at ASCRS in Booth #2502 SUBJECTS COVERED: The History of Corneal Collagen Cross-linking; New Science and Future Directions; Cross-linking for Corneal Ectatic Disorders, Including Guidelines & Special Cases; Combination Procedures; Cross-linking for Infectious Keratitis; Cross-linking with Refractive Surgery: Lasik Xtra, PRK Xtra, AK Xtra; Cross-linking in Your Refractive Surgery Practice; Cross-linking for Refractive Correction. MA-00227 Rev A. (OCT) and had panelists debate how they would diagnose and treat. An audience response system ensured the audience was an equal participant. Panelists were: John A. Hovanesian, MD, Laguna Hills, Calif.; A. John Kanellopoulos, MD, Athens, Greece; Francis M. Mah, MD, La Jolla, Calif.; Neda Shamie, MD, Los Angeles; Christopher E. Starr, MD, New York, and David T. Vroman, MD, Charleston, S.C., with a special appearance by ASCRS president Eric D. Donnenfeld, MD, Rockville Center, N.Y. The moderators started with several "funny Ks" cases, including epithelial basement membrane dystrophy (EBMD), Salzmann's nodules, meibomian gland dysfunction (MGD), and forme fruste keratoconus (FFKC). "Unless you're specifically looking for EBMD, it's hard to notice," Dr. Shamie said. "But it does need to be treated before cataract surgery." "EBMD will wreak havoc on your IOL calcs," Dr. Vroman said. Panelists and audience members agreed superficial keratectomy is an easy treatment. In cases of Salzmann's, treat with superficial keratectomy "and then wait at least a month before doing your IOL calculations," Dr. Kim said. Dr. Kanellopoulos is also using autologous serum to treat these nodules. MGD "will impact your topography," Dr. Holland said. Numerous treatment options were discussed, but the general consensus is MGD must be treated before cataract surgery. In FFKC, if the patient is stable, most would combine phaco with a toric lens, but if the FFKC has progressed, collagen crosslinking followed by phaco is recommended. "Never do laser vision correction or a limbal relaxing incision because you're destabilizing the cornea," Dr. Starr said. Dr. Vroman added knowing the contact lens status of the patient is helpful as well. Panelists, audience members, and moderators all value different diagnostics for guttata: Dr. Kanellopoulos said pachymetry is his most important tool, "especially the early morning readings." But Dr.