Eyeworld Daily News

19 EW SHOW DAILY ASCRS•ASOA Symposium & Congress, New Orleans 2016 is that of metabolic changes in the anterior chamber due to the pres- ence of air or gas. EW Rocha, MD, Charleston, South Carolina. Because of the docking problems, an incomplete flap was created. "You don't need to be a hero," said Dr. Rocha, adding that the take-home message is to stop and plan on a surface ablation pro- cedure going forward. Fernando Trindade, MD, Belo Horizonte, Brazil, shared the nearly 20-year saga of a highly myopic patient who had to have 4 surgeries related to various ocular problems. When first seen in the late 1990s, the 20-year-old female was –20 D, and she received an anterior cham- ber IOL. Although surgery was uneventful and the results initially seemed promising, a few months later she developed a retinal detach- ment in both the operated eye and the fellow phakic eye. The patient was treated again, but then she re- turned with a pupil distortion. One year and 4 months after her first surgery, she had an IOL exchange from the anterior chamber IOL to a posterior chamber IOL. The patient was lost to follow up but returned to the clinic for rou- tine care 10 years after she was orig- inally seen. In 2011, she developed an anterior subcapsular cataract; her cataract was removed in 2013. The patient was last seen in June of this year and is doing well. One lesson from this case is that a phakic IOL is not a perma- nent solution, Dr. Trindade said. "The best visual acuity for her was after cataract surgery," he said. "It's debatable, but maybe refractive lens exchange is a better approach than something temporary." Yet another perspective on challenging cases is that from the laboratory side, as shared by Lili- ana Werner, MD, Salt Lake City, who shared her lab's investigation of hydrophilic acrylic IOLs that had calcification after DMEK. Some related findings are reported in the literature, she added. The IOLs were explanted after poor quality of vi- sion. "There's increasing evidence in the literature of a distinctive pattern of various hydrophilic acrylic IOL designs following procedures using injections of air or gas," Dr. Werner said. The affected eyes/IOLs often had multiple intracameral injec- tions. Further studies are needed to determine the cause of the calcifi- cation; 1 theory Dr. Werner shared Editors' note: Dr. Rocha has financial interests with Abbott Medical Optics (Abbott Park, Illinois), Alcon (Fort Worth, Texas), and Allergan (Dublin). Dr. Werner has financial interests with Abbott Medical Optics, Alcon, Carl Zeiss Meditec, and other ophthalmic companies. Dr. Trindade has no finan- cial interests related to his comments. I N T R O D U C I N G HAPPINESS IN SIGHT New PROKERA ® Clear helps heal the cornea and maintains visual acuity PROKERA ® Clear goes beyond hydration to: Rejuvenate the cornea Simultaneously reduce inflammation and promote quality healing Treat chronic dry eye cases DEWS level 2, as well as levels 3 and 4 NEW See us at ASCRS Booth 1717 SM-267, Rev 2, 4/5/2016 I N T R O D U C I N G HAPPINESS IN SIGHT New PROKERA ® Clear helps heal the cornea and maintains visual acuity PROKERA ® Clear goes beyond hydration to: Rejuvenate the cornea Simultaneously reduce inflammation and promote quality healing Treat chronic dry eye cases DEWS level 2, as well as levels 3 and 4 NEW See us at ASCRS Booth 1717 SM-267, Rev 2, 4/5/2016

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