KERATOCONUS TESTING CONSENSUS STATEMENT: Understanding the Incidence and Impact of Keratoconus in Corneal Refractive Surgery & Reviewing New Standards to Preemptively Identify These Patients

By: Eric D. Donnenfeld, MD; S. Barry Eiden, OD, FAAO; Melissa Barnett, OD, FAAO, FSLS, FBCLA; Ashley Brissette, MD; Mile Brujic, OD, FAAO; Gloria Chiu, OD, FAAO; John D. Gelles, OD; Terry Kim, MD; Richard Lindstrom, MD; Andrew S. Morgenstern, OD, FAAO; Neda Shamie, MD; William B. Trattler, MD; Elizabeth Yeu, MD

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This course has expired. You can still review the content but course credit is no longer available.

Supplement Credits: 1.5

This continuing medical education (CME/CE) activity captures content from two roundtable discussions.

ACTIVITY DESCRIPTION
World class leaders assembled to discuss and vote on best practices and guidelines for understanding the incidence and impact of keratoconus in corneal refractive surgery and reviewing new standards to preemptively identify these patients. Topics of discussion included defining the fundamental etiology and progression of keratoconus, identifying the prevalence and demographics of keratoconus in various patient populations, diagnosing keratoconus and the importance of early detection using genetic testing, as well as the impact of keratoconus on patient and refractive surgery practices. The results of that discussion are summarized in this supplement.

TARGET AUDIENCE
This certified CE/CME activity is designed for ophthalmologists and optometrists.

Expiration Date: Friday, July 21, 2023

Release Date: July 26, 2021

This activity is supported by an unrestricted educational grant from Avellino.

Learning Objectives

Upon completion of this activity, the participant should be able to:

Define etiology and progression of keratoconus, understand how refractive surgery can exacerbate these conditions, and review the impact this has on visual outcomes and quality of life
Describe the prevalence of the refractive surgery patients developing keratoconus in various patient populations
Identify the accuracy of various conventional and new genetic testing metrics for identifying refractive surgery patients who may be at risk for developing keratoconus
Recommend diagnostic work-up protocols and pre-emptive testing indications for various groups of refractive surgery patients to maximize the diagnosis of keratoconus suspects
Review treatment options for refractive surgery candidates who have or are likely to develop keratoconus

Accreditation and Designation Statement

ACCREDITATION STATEMENT
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Evolve Medical Education LLC (Evolve) and The Fundingsland Group. Evolve is accredited by the ACCME to provide continuing medical education for physicians.

DESIGNATION STATEMENT

Evolve Medical Education designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™.
Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Evolve Medical Education LLC (Evolve) is an approved COPE administrator.
Sponsored by:
This activity, COPE Activity Number , is accredited by COPE for continuing education for optometrists.
This course is approved for 1.5 hours CE.
Course Approval: 73479-AS
Activity Approval: 122198

Participation Method

In order to obtain credit, proceed through the program, complete the post-test, evaluation and submit for credit.

Course Viewing Requirements

Supported Browsers:
Internet Explorer 11 for Windows
Edge (recent versions; Chromium-based) for Windows
Google Chrome (recent versions) for Windows, Mac OS, iOS, Android, or Linux
Mozilla Firefox (recent versions) for Windows, Mac OS, iOS, Android, or Linux
Safari (recent versions) for Mac OSX, or iOS

Hardware Requirements:
4GB+ RAM
Recommended internet speed 5Mbps+

Faculty and Disclosures

Eric D. Donnenfeld, MD

Ophthalmic Consultants of Long Island and Connecticut
Trustee, Dartmouth Medical School
Clinical Professor of Ophthalmology
New York University
New York, NY

S. Barry Eiden, OD, FAAO

Program Director
President and Medical Director
North Suburban Vision Consultants
Deerfield, Illinois
Co-founder of the International
Keratoconus Academy of
Eye Care Professionals

Melissa Barnett, OD, FAAO, FSLS, FBCLA

Principal Optometrist
University of California, Davis, Eye Center
Sacramento, CA

Ashley Brissette, MD

Assistant Professor of Ophthalmology
Cornea, Cataract, and
Refractive Specialist
Weill Cornell Medicine
New York-Presbyterian Hospital
New York, NY

Mile Brujic, OD, FAAO

Partner
Premier Vision Group
Bowling Green, OH

Gloria Chiu, OD, FAAO

Associate Professor of Clinical
Ophthalmology
USC Roski Eye Institute
University of Southern California
Keck School of Medicine
Los Angeles, CA

John D. Gelles, OD

Director
Specialty Contact Lens Division
Cornea and Laser Eye Institute (CLEI)
and the CLEI Center for Keratoconus
Teaneck, New Jersey
Assistant Clinical Professor
Rutgers New Jersey Medical School
Newark, NJ

Terry Kim, MD

Professor of Ophthalmology
Duke University School of Medicine
Chief, Cornea and External Disease Division
Director, Refractive Surgery Service
Duke University Eye Center
Durham, NC

Richard Lindstrom, MD

Program Director
Founder and Attending Surgeon
Minnesota Eye Consultants
Minneapolis, MN

Andrew S. Morgenstern, OD, FAAO

Vision Center of Excellence
Walter Reed National Military
Medical Center
Bethesda, MD

Neda Shamie, MD

Partner
Cornea, Cataract, and Refractive Surgeon
Maloney-Shamie Vision Institute
Los Angeles, California
Clinical Associate Professor
University of Southern California
Keck School of Medicine
Los Angeles, CA

William B. Trattler, MD

Cornea, Cataract, and
Refractive Surgeon
Center for Excellence in Eye Care
Miami, Florida
Clinical Associate Professor
Herbert Wertheim College of
Medicine at Florida
International University
Miami, FL

Elizabeth Yeu, MD

Virginia Eye Consultants
Medical Director, CVP Mid-Atlantic
Cornea, Cataract, External Disease, and Refractive Surgery
Assistant Professor, Department of Ophthalmology
Eastern Virginia Medical School
Norfolk, VA

DISCLOSURE POLICY
It is the policy of Evolve that faculty and other individuals who are in the position to control the content of this activity disclose any real or apparent conflicts of interest relating to the topics of this educational activity. Evolve has full policies in place that will identify and mitigate all conflicts of interest prior to this educational activity.

The following faculty/staff members have the following financial relationships with commercial interests:

Eric D. Donnenfeld, MD, has had a financial agreement or affiliation during the past year with the following commercial interests in the form of Consultant: Alcon Vision, Allegro, Allergan, Avellino, Bausch + Lomb, Carl Zeiss Meditec, CorneaGen, Covalent, BVI, Blephex, Dompé, ELT Sight, EyePoint Pharmaceuticals, Foresight, Glaukos, Ivantis, Johnson & Johnson Vision, Kala Pharmaceuticals, Katena, Lacripen, LensGen, Mati Therapeutics, MDBackline, Merck, Mimetogen, Nanowafer, Novabay, Novartis, Novaliq, Ocular Innovations, Oculis, Odyssey, Omega Ophthalmics, Oyster Point Pharma, Pfizer, Pogotec, Ocuhub, Omeros, PRN, RegenerEyes, ReTear, RPS, Shire, Strathspey Crown, Sun Pharmaceutical Industries, Surface, Tarsus, Tearlab, Tearscience, Thea, TLC Laser Centers, Veracity, Versant Ventures, Visionary Venture, and Visus. Stock/Shareholder: Avedro, CorneaGen, Covalent, ELT Sight, EyePoint Pharmaceuticals, Glaukos, Ivantis, Lacripen, LensGen, Mati Therapeutics, MDBackline, Mimetogen, Novabay, Ocuhub, Ocular Innovations, Oculis, Orasis Pharmaceutical, Pogotec, RegenerEyes, ReTear, RPS, Strathspey Crown, Surface, Tarsus, TearLab, Veracity, Versant Ventures, Visionary Ventures, and Visus.

S. Barry Eiden, OD, FAAO, has had a financial agreement or affiliation during the past year with the following commercial interests in the form of Consultant/Speaker’s Bureau: Avellino, Glaukos, Oculus, and Oprovve. Grant/Research Support: Oculus.

Melissa Barnett, OD, FAAO, FSLS, FBCLA, has had a financial agreement or affiliation during the past year with the following commercial interests in the form of Advisory Board: Azura, Bruder, Cooper Vision, Dompe, Everyday Contacts, EyeEco, Mojo Vision, Novartis, Ocusoft, Oyster Point, Percept, and Raayonnova. Advisory Board/Consultant: Visus Therapeutics. Advisory Board/Speaker's Bureau: AAB, Acculens, Allergan, Bausch + Lomb, Contamac, Gas Permeable Lens Institute, JJVC Vistakon, RVL Pharmaceuticals, Scleral Lense Education Society, Synergeyes, Tangible Science, Tarsus. Speaker's Bureau: BCLA, Science Based Health, Sjogren's Syndrom Foundation, and STAPLE Program.

Ashley Brissette, MD, has had a financial agreement or affiliation during the past year with the following commercial interests in the form of Consultant: Alcon Vision, Allergan, Bruder, Carl Zeiss Meditec, Eyevance, Kala Pharmaceuticals, and Ocular Therapeutix. Grant/Research Support: Alcon Vision.

Mile Brujic, OD, FAAO, has had a financial agreement or affiliation during the past year with the following commercial interests in the form of Consultant: Akorn, Alcon Vision, Allergan, Bausch + Lomb Health, Blephex, Contamac, CSEye, Eyevance, Horizon Therapeutics, Kala Pharmaceuticals, Novartis, Sun Pharmaceutical Industries, VMax Vision, and Zea Vision. Speaker’s Bureau: Allergan, Bausch + Lomb Health, Kala Pharmaceuticals, Novartis, Optovue, Sun Pharmaceutical Industries, and Zea Vision. Grant/Research Support: Contamac.

Gloria Chiu, OD, FAAO, has had a financial agreement or affiliation during the past year with the following commercial interests in the form of Consultant: Avedro/Glaukos and Visionary.

John D. Gelles, OD, has had a financial agreement or affiliation during the past year with the following commercial interests in the form of Consultant and Speaker’s Bureau: Avedro, Avellino, Boston Sight, Blanchard Labs, Bausch + Lomb, Contamac, Glaukos, Oculus, Synergeyes, and Visionix. Devices: Boston Sight, Blanchard Labs, Oculus, and Ovitz. Grant/Research Support: Avedro, Avellino, Alcon Vision, CorneaGen, Glaukos, Oculus, and Ovitz. Speaker’s Bureau and Advisory Board: Gas Permeable Labs Institute and International Keratoconus Academy.

Terry Kim, MD, has had a financial agreement or affiliation during the past year with the following commercial interests in the form of Consultant: Aerie Pharmaceuticals, Alcon Vision, Allergan, Avedro, Avellino Labs, Azura Ophthalmics, Bausch + Lomb, CorneaGen, Dompé, Eyenovia, Johnson & Johnson Vision, Kala Pharmaceuticals, Novartis, Ocular Therapeutix, Oculis, Omeros, Presbyopia Therapies, Sight Sciences, Simple Contacts, Surface, and Carl Zeiss Meditec. Stock/Shareholder: Avellino Labs, CorneaGen, Eyenovia, Kala Pharmaceuticals, Ocular Therapeutix, Omeros, Presbyopia Therapies, and Simple Contacts.

Richard Lindstrom, MD, has had a financial agreement or affiliation during the past year with the following commercial interests in the form of Consultant: Acufocus, Aerie Pharmaceuticals, Alcon Vision, Allegro, Bausch Health, Johnson & Johnson Vision, Kala Pharmaceuticals, Imprimis, Surface Ophthamics, Novartis, and Ocular Therapeutix.

Andrew S. Morgenstern, OD, FAAO, has had a financial agreement or affiliation during the past year with the following commercial interests in the form of Consultant: American Optometric Association. Grant/Research Support: International Keratoconus Academy. Speaker’s Bureau: Alcon Vision, Allergan, Glaukos, and Johnson & Johnson Vision.

All quotes from Dr. Morgenstern are his personal opinion only. It does not reflect the opinion of the US Department of Defense, Defense Health Agency, Department of Veterans Affairs or any other US governmental organization or agency.

Neda Shamie, MD, has had a financial agreement or affiliation during the past year with the following commercial interests in the form of Consultant: Alcon, Allergan, Avellino, Glaukos, Staar Surgical, and Tarsus.

William B. Trattler, MD, has had a financial agreement or affiliation during the past year with the following commercial interests in the form of Consultant: Alcon Vision, Bausch + Lomb, Carl Zeiss Meditec, CXLO, Johnson & Johnson Vision, and Oculus. Speaker’s Bureau: Alcon Vision, Carl Zeiss Meditec, Johnson & Johnson Vision, and Oculus. Stock/Shareholder: Avedro, CXLO, and Trefoil.

Elizabeth Yeu, MD, has had a financial agreement or affiliation during the past year with the following commercial interests in the form of Consultant: Alcon Vision, Allergan, Avedro, Bausch + Lomb, BioTissue, Beaver Visitec, BlephEx, Bruder, CorneaGen, Dompé, Expert Opinion, EyePoint Pharmaceuticals, Guidepoint, Johnson & Johnson Vision, Kala Pharmaceuticals, LENSAE, Merck, Mynosys, Novartis, Ocular Science, Ocular Therapeutix, Ocusoft, Omeros, Oyster Point Pharma, Science Based Health, Shire, Sight Sciences, Sun Pharma, Surface, Thea, Tarsus, TopCon, TearLab, Visus Therapeutics, and Zeiss. Grant/Research Support: Alcon Vision, BioTissue, Ocular Science, TopCon, and TearLab. Stock/Shareholder: BlephEx, CorneaGen, Melt, Ocular Science, Oyster Point Pharma, and Tarsus.

The Evolve staff and planners have no financial relationships with commercial interests. Diane Angelucci, writer, and Nisha Mukherjee, MD, peer reviewer, have no financial relationships with commercial interests.

Disclaimer

OFF-LABEL STATEMENT
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The opinions expressed in the educational activity are those of the faculty. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

DISCLAIMER
The views and opinions expressed in this educational activity are those of the faculty and do not necessarily represent the views of Evolve, The Fundingsland Group, Cataract & Refractive Surgery Today, Modern Optometry, or Avellino.