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Singapore Friday, July 12, 2013

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Friday Singapore 2013 ASCRS SYMPOSIUM, February 2011 SAN DIEGO 2011 EW DAILY NEWS 7 Doctors highlight challenges and complications By Ellen Stodola EyeWorld Staff Writer dering if penetrating keratoplasty (PK) or peripheral lamellar keratoplasty combined with cataract surgery or cataract surgery alone would be ideal. Another issue was choosing the correct IOL power because of Boris Malyugin, MD, PhD, discusses a complicated case where he had to choose between a number of possible procedures to treat a patient. Cornea and Refractive challenges and complications were discussed T he final session of Cornea Day focused on "Cornea & Refractive Challenges—The Best of the Worst!" Surgeons in the session discussed some of their greatest challenges or worst complications over the last year. Cordelia Chan, MD, Singapore, discussed issues with Epi-LASIK, namely problems with stromal incursion. "It's not surprising that more recently a more heart-wrenching complication in my practice is not in LASIK but in Epi-LASIK," she said. Looking at Epi-LASIK over a three-year period from July 2008 to June 2011, she said the stromal incursion rate was 0.73%. Though this is less than 1 percent, Dr. Chan said it still seemed high to her. She was interested in researching stromal incursion rates and found a Chinese group where the rate was 0.33% and a Korean study where it was much higher at 2.2%. "Stromal incursion may actually be underreported," she said. "Especially if it's small and in the periphery." To prevent Epi-LASIK stromal incursion, Dr. Chan said it's very important to check patients' corneas preoperatively. She said there needs to be particular caution if there is any sign of scarring, and there can be no scar that reaches Bowman's membrane because this would put a patient particularly at risk for stromal incursion. "Suction, of course, in any cornea refractive procedure is very important," Dr. Chan said. She said the management of a stromal incursion will depend on the extent, and it also depends on the location and whether or not it's peripheral or central. Boris Malyugin, MD, PhD, Moscow, discussed corneal challenges that a cataract surgeon may have in a practice. In his specific case, he had to choose the best surgical tactic for treating an ectatic corneal disorder in a patient admitted with vision complaints who already had complete loss of the second eye from trauma. The eye had an extremely thin ectatic cornea scar and low visual acuity. To treat this patient, Dr. Malyugin was having issues in finding the best strategy for the procedure, won- Correction Detlev Breyer, MD Detlev Breyer, MD, Germany, (pictured at left) was misidentified in an article in Thursday's Show Daily. We regret the error. Dr. Breyer presented "The New Generation of Multifocality: Introducing the trifocal AT LISA tri 839MP" at a Zeiss event Thursday night. The new AT LISA tri 839MP is an innovative trifocal optic that offers excellent intermediate vision. conflicting keratometry data. Dr. Malyugin said the cornea was flat on the slit lamp, but keratometry and topography were showing a steep cornea. Ultimately, he decided to proceed with phaco. EWAP

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