Eyeworld Daily News

39 EW SHOW DAILY ASCRS•ASOA Symposium & Congress, Los Angeles 2017 es, according to Roberto Bellucci, MD, Verona, Italy, who uses corneal crosslinking in cases of infectious keratitis. He uses both the standard Dresden and the accelerated cross- od include Acanthamoeba keratitis, Staphylococcus epidermidis, and Pseu- domonas aeruginosa. He suggested stopping quinolones, avoiding fluo- rescein stains, and considering viral keratitis a contraindication. When host keratocytes penetrate the donor graft (10% of cases), keratoconus can recur, even after a decade, necessi- tating a repeat graft or the use of intracorneal segments, he explained. Cesar Carriazo, MD, Barranquilla, Columbia, thinks that corneal lifting may be a promising new approach to treat keratectasia, the protrusion of a thin, scarred cornea. As refrac- tion is limited even after crosslink- ing, it is vital to develop a refractive technique that does not reduce the optical zone or induce HOAs. The technique can be done with excimer using a crescentic mask or femtosec- ond laser that uses a special software for crescentic resection. This innova- tive idea produces a physiologic cor- neal shape and involves crescentic keratectomy and corneal flattening. At 30 months of follow-up, Dr. Car- riazo reported a 400 µm difference in the anterior chamber depth and significantly improved visual results. Toric marking was the topic addressed by Samaresh Srivastava, DNB, Ahmedabad, India, who thinks that manually marking the cornea may be less precise than au- tomated options and more difficult to perform due to patient discomfort and eye movements. He said the head and chin positioning were key for getting accurate toric markings. The panel felt that anatomy over function was always the "great debate," and that some techniques, while good in concept, were not as good in reality. They agreed that doing both a manual and automated marking was wisest and oftentimes went with their manually marked axes when in doubt. EW Editors' note: Drs. Barrett, Carriazo, and Garg have financial interests related to their comments. Drs. Bellucci, Kohnen, and Srivastava have no finan- cial interests related to their comments. INDICATIONS AND USAGE PROLENSA ® (bromfenac ophthalmic solution) 0.07% is a nonsteroidal anti-infl ammatory drug (NSAID) indicated for the treatment of postoperative infl ammation and reduction of ocular pain in patients who have undergone cataract surgery. IMPORTANT SAFETY INFORMATION ABOUT PROLENSA ® • PROLENSA ® contains sodium sulfi te, a sulfi te that may cause allergic type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people. The overall prevalence of sulfi te sensitivity in the general population is unknown and probably low. Sulfi te sensitivity is seen more frequently in asthmatic than in non-asthmatic people. • All topical nonsteroidal anti-infl ammatory drugs (NSAIDs), including bromfenac, may slow or delay healing. Concomitant use of topical NSAIDs and topical steroids may increase the potential for healing problems. • There is the potential for cross-sensitivity to acetylsalicylic acid, phenylacetic acid derivatives, and other NSAIDs, including bromfenac. Use with caution in patients who have previously exhibited sensitivities to these drugs. • There have been reports that ocularly applied NSAIDs may cause increased bleeding of ocular tissues (including hyphemas) in conjunction with ocular surgery. Use with caution in patients with known bleeding tendencies or who are receiving other medications which may prolong bleeding time. • Use of topical NSAIDs may result in keratitis. Patients with evidence of corneal epithelial breakdown should immediately discontinue use of topical NSAIDs, including bromfenac, and should be closely monitored for corneal health. Patients with complicated ocular surgeries, corneal denervation, corneal epithelial defects, diabetes mellitus, ocular surface diseases (e.g., dry eye syndrome), rheumatoid arthritis, or repeat ocular surgeries within a short period of time may be at increased risk for corneal adverse events which may become sight threatening. Topical NSAIDs should be used with caution in these patients. Post-marketing experience with topical NSAIDs suggests that use more than 24 hours prior to surgery or use beyond 14 days post-surgery may increase patient risk for the occurrence and severity of corneal adverse events. • PROLENSA ® should not be instilled while wearing contact lenses. The preservative in PROLENSA ® , benzalkonium chloride, may be absorbed by soft contact lenses. Lenses may be reinserted after 10 minutes following administration of PROLENSA ® . • The most commonly reported adverse reactions in 3%-8% of patients were anterior chamber infl ammation, foreign body sensation, eye pain, photophobia, and blurred vision. Please see brief summary of full Prescribing Information for PROLENSA ® on adjacent page. References: 1. PROLENSA Prescribing Information, April 2013. 2. Data on fi le, Bausch & Lomb Incorporated. 3. Baklayan GA, Patterson HM, Song CK, Gow JA, McNamara TR. 24-hour evaluation of the ocular distribution of (14)C-labeled bromfenac following topical instillation into the eyes of New Zealand white rabbits. J Ocul Pharmacol Ther. 2008;24(4):392-398. PROLENSA is a registered trademark of Bausch & Lomb Incorporated or its affi liates. © Bausch & Lomb Incorporated. All rights reserved. Printed in USA. PRA.0188.USA.15 The PROLENSA ® Effect POWERED FOR PENETRATION Advanced Formulation to Facilitate Corneal Penetration 1-3 pH e ffect Hal og en a ti on e ffect BAUS2534 PROLENSA Journal Ad OSN 4/C Island Page Live: .25" from trim File Format: PDF/X-1a Carling Communications 3/9/2016 PROLENSA ® delivers potency and corneal penetration with QD dosing at a low concentration 1-3 BAUS2534 PROLENSA Journal Ad OSN 4/C Island Page Live: .25" from trim File Format: PDF/X-1a Carling Communications 3/9/2016 Trim: 7.190" x 9.75" Bleed: 7.44" x 11" Drs. Bellucci, Holland, and Barrett share pearls for optimizing outcomes. linking methods, saying that when dealing with an infection, it may be wise to limit the crosslinking to the ulcer area. Other infections that he successfully treated with this meth-

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