Eyeworld Daily News

EW SHOW DAILY 12 Saturday, May 6, 2017 by Vanessa Caceres EyeWorld Contributing Writer T he incorporation of corneal crosslinking (CXL) into a practice requires some care- ful consideration of several factors, including educa- tion, said Sumit "Sam" Garg, MD, Irvine, California, addressing attend- ees during Cornea Day's afternoon sessions. Surgeons should remind patients that CXL is not refractive surgery and that they will maintain their current visual status after the procedure. Patients should also know that there likely will be initial steepening followed by flattening and that 1% to 2% of those having CXL can experience complications. The ideal CXL candidate is young, able to lay still, has a clear vi- sual axis, and can see well in glasses, Dr. Garg said. Patients who are not good candidates usually are older and have scarring and very thin corneas. There are also practice manage- ment concerns when adding CXL, according to Nicole Fram, MD, Los Angeles. For example, you'll want to educate your staff about what CXL is, who is a candidate, and what fi- nancial considerations are involved. "The financial [aspect] is huge," Dr. Fram said. Consider where you will per- form CXL; two typical locations would be a laser suite or a short procedure room. Make sure to train at least two technicians on how to work with CXL procedures, in case one technician is sick and unavail- able. Block out 90 minutes for each CXL case, and always work with a sterile technique. This is important because there is a risk for bacterial keratitis, she said. Some novel uses of CXL go- ing forward include for infection, pellucid marginal degeneration, LASIK Xtra, and for pseudophakic bullous keratopathy, said Kristiana Neff, MD, Ladson, South Caroli- na. Other uses that researchers are beginning to explore include small incision lenticule extraction (SMILE, Carl Zeiss Meditec, Jena, Germany), leaking blebs, and scleral CXL for myopia. The use of CXL in these novel capacities requires more long- term study in larger cohorts, Dr. Neff said. As part of a series of presenta- tions focusing on dry eye disease, Deborah Jacobs, MD, Boston, addressed the pain syndrome that occurs in some patients, even if they have few clinical symptoms of dry eye. Dr. Jacobs discussed the difference between nociceptive and neuropathic pain, noting that patients with neuropathic pain and dry eye may be perceived as "crazy" because they have minimal symp- toms. Research is ongoing for the best diagnostic criteria for dry eye as a pain syndrome, Dr. Jacobs said. The use of biologicals to treat dry eye will continue to grow in the future, said Bennie Jeng, MD, Baltimore. He discussed autologous serum for dry eye and how far it has evolved in the past decade. Cornea Day presenters focus on CXL, dry eye IOS (Apple) Android Complimentary shuttle service will be provided between the Los Angeles Convention Center and official ASCRS•ASOA hotels listed here. Look for your route number in top right of bus windshield. Check the sign in your hotel lobby for additional information. For shuttle information or to pre-schedule ADA pick-up call 877-884-2455 for more information. Shuttle managed by ETS Please download the ETS NextShuttle App to track your next shuttle pick-up. 2017 OFFICIAL HOTEL SHUTTLE ROUTES Hotel Pickup Location 1-RED Travel time to Convention Center: 15 minutes HOTEL INDIGO ACROSS 9TH STREET AT FRANCISCO ST FREEHAND LOS ANGELES ON OLIVE STREET AT 8TH STREET OMNI LOS ANGELES CURBSIDE LOBBY HILTON CHECKERS CURBSIDE LOBBY Millennium Biltmore At Hilton Checkers, Curbside Lobby 2-YELLOW Travel time to Convention Center: 15 minutes WESTIN BONAVENTURE CURBSIDE LOBBY ENTRANCE The LA Hotel Downtown At Westin Bonaventure THE STANDARD HOTEL ACROSS FLOWER AT 6TH STREET SHERATON LOS ANGELES CURBSIDE LOBBY O HOTEL CURBSIDE LOBBY 3-BLUE Travel time to Convention Center: 20 minutes DOUBLETREE LOS ANGELES CURBSIDE LOBBY ENTRANCE MIYAKO HOTEL CURBSIDE LOBBY ENTRANCE 4-GREEN Travel time to Convention Center: 25 minutes THE LINE HOTEL CURBSIDE LOBBY ENTRANCE THE MAYFAIR HOTEL CURBSIDE LOBBY ENTRANCE 5-ORANGE Travel time to Convention Center: 15 minutes RADISSON HOTEL AT USC CURBSIDE LOBBY ENTRANCE 6-BROWN Travel time to Convention Center: 50 minutes SHERATON UNIVERSAL CITY BUS ZONE – NEXT TO PARKING GARAGE Hilton Universal City At Sheraton Universal City THE GARLAND HOTEL CURBSIDE LOBBY AT DRIVEWAY 7-TEAL Travel time to Convention Center: 50 minutes HILTON GARDEN INN HOLLYWOOD CURBSIDE LOBBY ENTRANCE LOEWS HOLLYWOOD CURBSIDE HIGHLAND LOBBY Hollywood Roosevelt At Loews Hotel, Highland Lobby W HOLLYWOOD CURBSIDE HOLLYWOOD BLVD 8-SALMON Travel time to Convention Center: 50 minutes INTERCONTINENTAL CENTURY CITY CURBSIDE LOBBY ENTRANCE BEVERLY HILTON CURBSIDE WILSHIRE FOUR SEASONS BEVERLY HILLS CURBSIDE 3RD STREET SOFITEL LOS ANGELES CURBSIDE LOBBY W – WALK HOTELS JW Marriott The Luxe Hotel Ritz Carlton Courtyard Los Angeles Residence Inn LA Live BOLD denotes official shuttle pickup location. May serve as pickup location for other hotels listed. Shuttle Service to Los Angeles Convention Center May 4–9, 2017 Dr. Neff discusses new uses for CXL. continued on page 14

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