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EW SHOW DAILY
ASCRS•ASOA Symposium & Congress, Los Angeles 2017
covering the procedure.
"That worries me because of
the progression in some cases," Dr.
Durrie said. EW
Editors' note: This event was co-spon-
sored by Avedro and the Cornea Society.
for—and save payers money.
In the meantime, some patients
have told Dr. Durrie that they are
waiting for their insurer to begin
The most common adverse
events were corneal haze but some
also had eye pain, reduced visual
acuity, and blurring. Most of those
problems resolved within a month.
"It's pretty much what we're
used to from the PRK and PTK
studies," Dr. Lindstrom said. "It's our
responsibility as corneal surgeons to
get that epithelium to heal; we have
a lot of tools to make that happen."
Dr. Lindstrom described the
surgery as straightforward. His pearls
include the need for careful coun-
seling of the patient on the critical
importance of ocular surface disease;
knowing that the procedure is not
a "wow factor" treatment but one
that provides long-term benefit;
and treating both eyes, with greater
importance on treating the eye with
better vision.
Eric Donnenfeld, MD, Rock-
ville Centre, New York, who has
performed about 3,000 cases, said
surgeons need to discuss the on-la-
bel use of the treatment and tell
patients if they intend any off-label
uses.
"It's not a good idea to use an
unapproved product when there is
an approved option," Dr. Donnen-
feld said.
Dr. Donnenfeld noted that it is a
lengthy procedure, and he allots 90
minutes to 2 hours to perform it.
He urged surgeons to create a
Center of Excellence, notify local
support groups for keratoconus
that it is available, and set patients'
expectations carefully. He noted that
increased hyperopia is common for
the first month postop before the
cornea eventually steepens.
Another tip was to have some-
one in the practice focus on social
media outreach because many who
need the treatment are talking to
each other on social media every
day.
Ophthalmologists should reeval-
uate keratoconus patients to see if
they are progressing.
Part of his outreach is offering
to perform the procedure for free if
patients cannot afford it.
Dan Durrie, MD, Kansas City,
Kansas, said surgeons agreed it is a
medically necessary procedure but
more work was needed to convince
all insurers of that.
Dr. Durrie said the procedure
can decrease the number of corneal
transplants—which insurers pay
