37th APACRS Annual Meeting Final Program

FILM FESTIVAL

FF3-18 Successful Management of Intraocular Bleed With Intense Corneal Blood Staining in a Haemophiliac Child

Geeta BEHERA India

A two-and-a-half-year-old boy, a known case of haemophilia A, was referred with hyphaema in the right eye following blunt trauma one week back. Despite evacuation after administering Factor VIII, there was rebleed with very high IOP (60mmHg), leading to corneal blood staining. Intraoperative ultrasound biomicroscopy (UBM) and B-scan sonography revealed a thick hyperreflective membrane in the anterior chamber and vitreous haemorrhage on EUGA. An optical penetrating keratoplasty with anterior vitrectomy was performed 3 weeks later, followed by a pars plana vitrectomy with scleral fixated intraocular lens placement after one month, under cover of Factor VIII (surgery video). Subsequent examinations recorded a visual acuity of 6/19, with Lea symbols in the right eye, a clear corneal graft, and a normal fundus examination. FF3-19 DALK for Beginners: Mastering stromal dissection techniques Krishnaja MANDAVA India Paradigm shift to lamellar corneal transplantation with constant evolution in surgical technique noted. DALK is the most performed anterior lamellar keratoplasty involving recipient corneal dissection barring the DM endothelium complex which minimizes graft rejection, improving graft survival rates and eliminates the risk of intraoperative complications of an open sky surgery as in PK. Air, fluid and viscoelastic assisted, manual dissection and groove and peel are the stromal dissection techniques. Mastering the art of lamellar dissection is fascinating but, has steep learning curve, limiting its practice among young budding corneal surgeons. This video reviews and highlights the stromal dissection techniques, their indications, challenges encountered, tips to overcome them, thereby educating the novice corneal surgeons attain In this film, we’ll highlight small modifications to enhance DMEK surgery. Proactively exchanging a hydrophilic IOL can mitigate the risk of IOL opacification. An air-filled syringe can aid visualization and keep the AC formed during descemetorhexis. A special syringe can deliver the graft in a more controlled manner to the AC. Every DMEK surgeon will learn great tips to apply in their next case. FF3-21 Down the Rabbit Hole: Animal models to study regenerative solutions for keratoconus Charuta J PURANIK India Widened scope of regenerative medicine, warrants creation of repeatable & measurable animal models for corneal ectasia without use of chemicals. We describe 2 pre-clinical models that permit safe introduction of biomaterials or scaffolds. Methods: Model1(in-vivo):3 eyes of 3 New Zealand white rabbits underwent stromal depletion and ~150 microns of corneal stroma was excised using trephination, lamellar corneal dissection techniques and reposition of superficial cap with 5 month follow-up. Model 2(ex-vivo): 250 microns of corneal sculpting was done using excimer laser on research grade tissue mounted endothelium side up on an artificial anterior chamber. RESULTS: Model 1 achieved progressive stromal thinning on spectral domain OCT and Model 2 showed features akin to advanced keratoconus on OCT. CONCLUSION: Our surgical models with morphological changes akin ectatic disorders can be used for regenerative solutions. FF3-22 Circular Keratotomy Combined With Corneal Compression Sutures to Correct High Corneal Astigmatism Chareenun CHIRAPAPAISAN Thailand This video shows a novel technique, “Circular Keratotomy” combined with compression suture to correct high corneal astigmatism. A patient with corneal scar, which the topography demonstrated 10.3 D of astigmatism, requested for the vision correction. A circular keratotomy was performed 50% of corneal depth using a Barron trephine. The overall corneal curvature was suddenly changed. An intraoperative keratoscope was used to guide the compression sutures along the flat axis until the corneal shape appeared round. Post-operation, the corneal astigmatism was reduced to 2.3 D with the manifest refraction of +0.50-1.00x 30°. Circular keratotomy combined with corneal compression sutures is a simple and practical technique that can be effectively and safely performed to correct high corneal astigmatism. proficiency in lamellar corneal dissection. FF3-20 Small Tweaks for Big DMEK Results Bruno TRINDADE Brazil

110