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Post Info TOPIC: ESCRS 14th Winter Meeting Budapest 2010


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Date: Wed Feb 24 10:44 PM, 2010
ESCRS 14th Winter Meeting Budapest 2010
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The European Society of Cataract & Refractive Surgeons recently held their winter meeting in Budapest. During the first day of the conference there was a symposium on keratoconus. Topics discussed included genetics, diagnostics, cross-linking combined with excimer surgery, Intacs, and keratoplasty.

http://www.escrs.org/EVENTS/10budapest/main-symposia.asp

Keratoconus remains a mystery. There is a lot of ongoing research into the genetic and environmental background of keratoconus. A gene locus of chromosome 5 is an area of great interest. However, many doctors are of the opinion that multiple genes are involved as well as contributing environmental factors. For example, eye rubbing has been identified in multiple studies as a possible contributing factor.

There was an interesting presentation about combining cross-linking and excimer laser surgery. PRK should be limited to 50 microns of tissue removal and cross-linking can be performed on eyes with a corneal thickness of at least 400 microns. There was a discussion about which treatment should be applied first. Cross-linking after the PRK could possibly result in a change of topography. However, PRK after cross-linking will remove some of the cross-linked tissue.

The symposium was very informative and provided an opportunity to speak with many doctors about keratoconus treatments.

I am currently a 5th year medical student involved in keratoconus research. If anyone has questions about the conference or keratoconus my email address is drgoren@hotmail.com.

Regards,

Peter Goren

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Date: Thu Feb 25 9:22 PM, 2010
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Hi very interesting, did you hear anything about why KC tends to stop at a certain time/age? Could the amount of UV-radiation during the timespan help with natural stiffing of the cornea? Did anyone talk about the ongoing EU trials for KXL (http://www.avedro.com/kerakxl.html)

Eye rubbing seems to be one major component, my KC started rather late 18-19 years but i rember the red eyes and it was so nice to rub the eyes, but the progression was slow or even no progression at all for years and suddenly one eye degraded rapidly without any reason ( didnt itch or rub for that ) It would be so interesting to know how it works :)

Br Henrik.F



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Date: Fri Feb 26 10:58 AM, 2010
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That is an excellent question. The amount of UV-radiation was presented with a question mark. Overexposure to sunlight is one of the environmental factors that has been cited as a risk factor for keratoconus. However, could lower to moderate levels of sunlight actually be beneficial due to the natural cross-linking? This is an area of interest.

Keraflex was not mentioned during the symposium. Doctors I spoke with at the conference said they are aware of the clinical trials and are awaiting the results.

Unfortunately, it is impossible to predict the exact course of KC progression. For some it progresses very rapidly and others can go on for years with minimal change. It was mentioned during the conference that as our genetic and environmental understanding of KC improves it should be possible to identify those at greater risk for progression.

As KC progresses the problems with vision will increase. This can cause eye strain as the eye works harder to focus. It is a natural reaction to rub the eyes when they feel tired or painful.

I recently read an interesting article on the differences between allergic eye rubbing and eye rubbing seen in keratoconus patients.

Here is the link:

http://www.revophth.com/index.asp?page=1_14488.htm

-- Edited by drgoren on Friday 26th of February 2010 11:00:53 AM

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