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Knowledge Transfer from Across The Pond

Prof. Farhad Hafezi speaks at the Bascom Palmer Eye Institute in Miami, Florida

I was honoured to be invited to the Bascom Palmer Interactive Consultations in Cornea, Cataract and Refractive Surgery 2020, held on February 21–22, 2020 at the Bascom Palmer Eye Institute (BPEI) in Miami, Florida, as a speaker and panel member. I gave four presentations: Cross-Linking Beyond the Dresden Protocol, Therapeutic Excimer Laser Surface Ablation in Keratoconus, PACK-CXL: Using Riboflavin for Infectious Keratitis, and CXL at the Slit Lamp: Access for All. These were all very well received by the attended audience of mainly American ophthalmologists. However, I want to write about some of the other presentations I saw at Bascom Palmer, and why I found them interesting.

Prof. Carol L. Karp presented her ground-breaking work on pioneering the use of an advanced eye imaging technique called high-resolution optical coherence tomography (OCT) for detecting, diagnosing and guiding the removal of tumours on the eye called ocular surface squamous neoplasias. She used her HR-OCT instrument to locate the edges of the tumours (the tumour “margins”) – and remove them. The tissue was removed and processed in the usual way and looked at under the microscope. The good news was that the HR-OCT was as good as traditional methods for defining the extent of the tumour, which should make diagnosis easier, and surgery to remove the tumour easier and faster to perform.

Dr. Mohammed Abou Shousha gave a very interesting talk where he described how he and his colleagues have developed an image processing algorithm using artificial intelligence to detect keratoconus, Fuchs’ Dystrophy or dry eye, which was trained on tens of thousands of OCT images, and Jospeh Tauber from Kansas City gave an excellent talk on dry eye therapeutics, particularly on how effective Xiidra (lifitegrast) has been in his patients.

But the one of most amazing talks was that of Dr. Anat Galor, who presented the topic “Microbiome and Dry Eye”. To make a long story short: harmless bacteria live on the surface of the eye – the “ocular microbiome” – and in people with dry eye, the composition of all the different bacteria in the ocular microbiome is disturbed. But if patients undergo a “Fecal Microbiota Transplant” procedure where healthy donor stool is packaged in capsules (popularly called “poop pills”), not only does the ocular microbiome start to resemble that of patients without dry eye, the symptoms of dry eye start to improve too.

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