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2014 ASCRS•ASOA Boston Daily News Monday

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TECNIS ® Toric IOL www.TECNISToricIOL.com 1-877-AMO-4-LIFE TECNIS ® For your peace of mind. EW SHOW DAILY 3 ASCRS•ASOA SYMPOSIUM & CONGRESS, BOSTON 2014 ASCRS News Today Science and Medicine continued from page 1 '60 minutes' continued from page 1 to its function. The rungs of the ladder of the double helix are made up of nucleobases A, T, C, and G. "If you are to split the double helix into two then you have all the informa- tion on both strands to replace the missing strands," he said. "That is what happens every time a cell di- vides and replicates." What all this boils down to is that humans want to know how we work and how characteristics are passed from generation to generation, particularly how diseases are passed from generation to generation. During the mid-1980s, the first diseases with genetic bases were identified, Dr. Rutherford said. Most labs were focused on single diseases or small groups of genetic diseases, but around the 1990s, many geneti- cists realized this was not the best way of making progress because they were competing with each other. The NIH and other organizations decided to sequence the entire human genome, the Human Genome Project, and Dr. Rutherford called this "one of the greatest scien- tific endeavors of this or any age." There were some surprises that the Human Genome Project yielded, Dr. Rutherford said. "There didn't appear to be nearly enough genes," he said, adding that the number that humans have is 22,000. "What this meant was we didn't quite under- stand how human genetics works," he said. "Until this point, we thought we understood how human genetics works," he said, but we weren't even aware of what wasn't known. We've spent the last decade filling in those gaps. "We've been trying to find sim- plistic answers to complex questions for as long as we've been looking at how humans work. Instead we should be reveling in the bounty of our sophistication and continue to try to understand how we work as a species." Finally, he used a graphic to illustrate the genetic component of ancestors. The bottom represented the individual, and moving back generations, black spots became evi- dent. This shows that there are gaps because there are ancestors who have contributed no DNA to the in- dividual at present. "By the time you get to 11 generations back, around half of your ancestors did not con- tribute any DNA to you right now," he said. EW be performed, according to Dr. Tan. He mentioned a number of proce- dures: penetrating keratoplasty (PK), endothelial keratoplasty (EK), Descemet's stripping endothelial keratoplasty (DSEK), and deep ante- rior lamellar keratoplasty (DALK). Recent studies of PK have looked at donor age, but it was found that it has minimal effect on graft survival. What's most surpris- ing was the substantial endothelial cell loss after PK. DALK is being studied and a number of articles have found it to be better than PK, but the major problem with DALK is the learning curve, Dr. Tan said. The field of corneal transplanta- tion is rapidly evolving with the revolution of selective lamellar ker- atoplasty, Dr. Tan concluded. This looks to be the future of corneal transplantation, but PK will always be needed, he said. Dr. Brown took attendees back to a time when "eye drops ruled glaucoma." There were a number of problems with eye drops because compliance is terrible and there is a recurring expense, as well as a number of side effects. He questioned whether glau- coma should be treated as a surgical disease, noting that this can't be the case with trabeculectomy and tubes because of the complications associated with these procedures. There could be changes coming in the next few years, though, and Dr. Brown said there are new indica- tions for glaucoma surgery. There are also a number of MIGS devices that are being introduced and seeking approval, and new combinations of devices will start to be seen. Currently MIGS is only indi- cated for combination with cataract surgery for mild to moderate cases, but Dr. Brown believes that soon it will have standalone indications that can be used for advanced cases of glaucoma. Dr. Steinert said there has been a major decline in the U.S. market for refractive surgery. Despite this decline, Dr. Steinert said many surgeons believe that there will be growth. Various factors can influence the demand for laser vision correc- tion. In the near term, technology, the economy, consumer perceptions, price/value, and national issues are going to play a role, while in the intermediate term, demographics, psychographics and purchase behavior, right of passage culture, and alternatives to laser vision correction will be major factors. The future market is more promising than current patterns, and it could start to look like the past, Dr. Steinert said. EW Editors' note: Dr. Steinert has financial interests with Abbott Medical Optics and ReVision Optics. Dr. Tan has financial interests with Alcon, Bausch + Lomb, Carl Zeiss Meditec, Moria, Network Medical, and Santen. Dr. Brown has financial interests with Glaukos, Ivantis, Rhein Medical, and Transcend Medical. Dr. Tan spoke about the current state of cornea surgery. Dr. Brown questioned whether glaucoma should be treated as a surgical disease in his talk.

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