Eyeworld Daily News

EW SHOW DAILY 14 ASCRS News Saturday, April 14, 2018 R. Bruce Wallace, MD, New Orleans, and Richard Packard, MD, London, U.K., are Honored Guests of this year's ASCRS•ASOA Annual Meeting. At today's ASCRS Open- ing General Session, they will be honored for their contributions to ophthalmology. R. Bruce Wallace, MD Dr. Wallace is founder and medical director of Wallace Eye Associates, Alexandria, Louisiana. He is a clin- ical professor of ophthalmology at Tulane School of Medicine and at Louisiana State University Medical School. A member of numerous pro- fessional organizations, Dr. Wallace is past president of the Outpatient Ophthalmic Surgery Society, the Society for Excellence in Eye- care, Windsor Nation- al Associates, and the American College of Eye Surgeons. He has served as an editorial board member for Ophthalmology Man- agement, EyeWorld, Review of Ophthalmol- ogy, Video Journal of Ophthalmology, and The 21st Century Surgeon and as a section editor for Cataract and Re- fractive Surgery Today, Ocular Surgery News, and Refractive EyeCare. Dr. Wallace has served as a pri- mary investigator and consultant for a number of investigational IOLs, in- cluding nine multifocal IOLs. He has organized numerous courses for the American Academy of Ophthalmolo- gy (AAO), ASCRS, the Joint Commis- sion on Allied Health Personnel in Ophthalmology, and the American College of Eye Surgeons. Dr. Wallace has served on the Program Committee for the annu- al meeting of the AAO and on the selection committee for the ASCRS Film Festival. He has contributed numerous articles and book chap- ters on refractive cataract surgery. Dr. Wallace has been named one of the 50 Most Influential Ophthal- mologists by Cataract and Refractive Surgery Today. Richard Packard, MD Dr. Packard is director of Arnott Eye Associates, London, U.K. He recently retired as senior surgeon at the in- ternationally known Prince Charles Eye Unit in Windsor. He trained at the Middlesex Hospital, the Hospi- tal for Sick Children Great Ormond Street, the National Hospital for Nervous Diseases, and Moorfields Eye Hospital. In 1979, as senior registrar at Charing Cross Hospital working under Eric Arnott, he first started to perform minimally invasive phacoemulsification for the removal of cataracts. Eric Arnott introduced phaco to Europe in 1973, but very few people there were doing this technique routinely until the late 1980s. In 1981, Dr. Packard pub- lished the first description in the medical literature of the use of a folded soft lens in cataract surgery. Since then he has continued to teach phaco techniques and has been involved in the development of new intraocular lenses, phaco ma- chines, and other instrumentation. Dr. Packard has lectured in 60 countries. He was a board member of the European Society of Cataract and Refractive Surgeons (ESCRS) from 1999–2007, a member of the Cataract Clinical Committee of ASCRS from 2004–2008, and is now on the Program Committee. He is on the Education Committee of ESCRS and runs the Cataract Didactic Teaching Course. In 2004, he was the Gold Medalist of the Austral- asian Society of Cataract and Re- fractive Surgeons. In 2009, he gave the Finlayson Lecture at the Royal College of Physicians and Surgeons of Glasgow. In 2015 he received the Binkhorst Medal from ESCRS. Dr. Packard is on the peer-re- view panel for the Journal of Cataract & Refractive Surgery, Eye, the British Journal of Ophthalmology, and the Asia-Pacific Journal of Ophthalmology, and regularly contributes to oph- thalmic journals. He was chairman of the Editorial Board of OSN Europe from 2014–2015. He is the designer of the Windsor knife and the Pack- ard phaco tip. The ASCRS Opening General Session will take place today from 10 a.m.–12:00 p.m. in the Convention Center, Level 3, ballroom AB. EW Honored Guests bring their expertise to this year's meeting R. Bruce Wallace, MD Richard Packard, MD 51-year-old male patient who had no prior surgery but had a history of poor vision in his left eye and was becoming contact lens intolerant. The patient said his left eye wasn't functioning at all, and he wanted LASIK in the right eye. Dr. Baartman said it was deter- mined that the patient had unilater- al ectasia, and progression was sus- pected by his history. Dr. Baartman asked panelists what they would offer this patient. Many agreed that they would do crosslinking in the left eye and would delay action on the right eye, noting that some pro- cedure may be necessary later on. Dr. Baartman said that an Intacs (Addition Technology, Des Plaines, Illinois) was inserted in the left eye of the patient with simultaneous crosslinking. After 6 months, a PRK was performed in the right eye. The second session of Cornea Day was titled "Smoke or Fire?" and highlighted inflammatory eye dis- ease and infectious eye disease. This session was moderated by Francis Mah, MD, La Jolla, California, and Elmer Tu, MD, Chicago. Victor Perez, MD, Durham, North Carolina, shared tips for evaluating patients with corneal ulceration. First, he stressed the im- portance of stepping away from the slit lamp during the clinical exam. Getting a clinical history and talking to the patient is important. Dr. Perez also said to review medications, do an external examination, and do a full ophthalmic exam. Use your pattern recognition skills as well. His second step for evaluation of patients with corneal ulceration was to know the common diseases "where you live." It's also important to know the common diseases in your population of patients. Sonal Tuli, MD, Gainesville, Florida, presented "When Fluoro- quinolones Fail: Diagnostic Ap- proach to Atypical Corneal Infec- tions." Atypical corneal infections could be categorized as those where the appearance is not typical, where there is no response to typical antimicrobials, or where the resolu- tion is not typical (with relapses or recurrence). What should you do if the infection is atypical? Looking at the eye and doing a clinical exam may be helpful. If there are patterns, you could save time, money, and eye, she said. Dr. Tuli also mentioned the use of culture or smears, which could allow for identification, as well as sensitivities. The culture would ide- ally be taken before treatment, but could be valuable even if the patient is on antibiotics. She said that using an in vivo confocal microscope could be help- ful in these cases, noting that skills are required to perform and inter- pret it. Corneal biopsy may also be a useful option. Dr. Tuli suggested using a 3-mm dermal punch. She said to do partial thickness trephi- nation and dissect. Scrape the base of the biopsy and undersurface of the button, then send the button to pathology. When all else fails, Dr. Tuli not- ed that sometimes it may be useful to take the patient off everything; this could actually help the patient improve. EW Editors' note: Drs. Shamie has financial interests with a number of ophthalmic companies. Drs. Baartman, Khandel- wal, Perez, and Tuli have no financial interests related to their comments. Cornea continued from page 12

• Cover