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2013 ASCRS•ASOA San Francisco Daily News Monday

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Treat the Cause "When patients consider their treatment options, they should consider the convenience of a 12-minute treatment and ask themselves how much of their lives are they losing to dry eye and what is it worth to get it back?" Peter J. Polack, MD, FACS Ocala Eye Ocala, FL Visit Booth #2510 MONDAY, APRI L 2 2 IN - B OOTH P RE SE N TATION S Time Faculty 11:00 am - 11:30 am 12:00 pm - 12:30 pm 1:00 pm - 1:30 pm 2:00 pm - 2:30 pm Clifford Salinger, MD Brandon D. Ayres, MD William Hines, MD John Hovanesian, MD Edward Holland, MD, and Terry Kim, MD, present cases at the "Pardon the Ophthalmology" symposium. Holland countered that having a high number (600-650) doesn't mean anything without a baseline comparison, so he bases his treatment on symptoms. For Dr. Mah, it's all about the slit lamp findings and the stromal edema present. If there is an incidence of toxic anterior segment syndrome (TASS), Dr. Vroman said "it's a disaster you have to solve before you go back into the OR." TASS will occur rapidly after cataract surgery, which is the best way to differentiate it from endophthalmitis, Dr. Kim said. Dr. Mah added that steroids will often resolve the problem, "but find a source that can provide bisulfate-free meds." Francis W. Price Jr., MD, Indianapolis, was the keynote speaker and discussed Descemet's membrane endothelial keratoplasty (DMEK) compared to Descemet's stripping (automated) endothelial keratoplasty (DS(A)EK). "DSEK has become the standard of care, but we've found DMEK is our standard of care simply because it's a superior procedure," he said. "DSEK changes people's lives. They're able to work within one to three weeks. We're finding with DMEK patients are seeing 20/20 to 20/40 on postop day two." To those who say DMEK is a difficult procedure to learn, Dr. Price recalled when ophthalmology began the move from extracap to phaco, "everyone said how hard phaco was—at first. When DSEK came out, people said that was hard, too." He said patience, practice, and fluidics are the key to successful DMEK, and that thicker donor tissue (from older eyes) is easier to manipulate and unfold. Overall, he said, there is <1% graft rejection rate with DMEK, 12% with DSEK, and 18% with penetrating keratoplasty. In his 900 DMEK procedures, he's had only six rejections. "I think we need to start rethinking the causes of graft rejection," Dr. Price said. EW Scan for a schedule of TearScience activities or visit tearscience.com LipiFlow is a registered trademark of TearScience, Inc. Copyright © 2013 TearScience, Inc. All rights reserved. 13-ADV-099

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