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November 2014 Issue

Hawaiian Eye 2015

Look for our booth at Hawaiian Eye, held January 17-23, 2015 at the Grand Wailea Resort, Maui, Hawaii. Visit their website for more information.

 

sightlife.org: Better. Stronger. Faster.

SightLife has a new online presence. The new SightLife.org has an updated design to better tell our story and the stories of the donor families and recipients we’ve helped around the world. It’s easier to navigate, clearer to understand and can work across desktop, tablet and mobile devices. 

A new Resources tab on the navigation menu has specific information for the different groups we serve. Visit the section for surgeons and their staff for information about ordering tissue, research, events and much more.

An “Order Tissue” link is conveniently located at the top of every page. This connects you to all of your ordering options. You can also still access our online ordering system at mysightlife.org.

 

On the move

SightLife Seattle headquarters is moving in late December.  Our new address will be:

1200 6th Ave, Ste 300
Seattle WA 98101

There will be no service interruptions, nor delays in tissue requests or deliveries throughout the moving process.

The new location allows more efficient access to our building for recovery technicians and couriers. This cuts down on precious time between recovery and transplantation, necessary to ensure the best possible outcomes for cornea transplant recipients.

Our phone numbers will remain the same. We we will still offer 24-hour customer service at 877-682-8502.

 
A tour of the lab.

Banking on Irvine

In 2013, SightLife opened a state-of-the-art eye bank laboratory in the Gavin Hebert Eye Institute at the University of California, Irvine. This expansion has brought more high-quality local tissue to corneal surgeons and their patients throughout Southern California.office space

Corneas from Southern California donors are delivered to and distributed from the new eye bank. SightLife’s highly trained professional staff evaluates and processes tissue quickly, resulting in better outcomes for cornea recipients and researchers.

Each cornea is evaluated twice: First a pre-cut evaluation, to determine endothelial cell count and validate the integrity of the cornea, then a post-cut evaluation, to ensure the integrity of the endothelium and the evenness of the cut. This results in the highest quality tissue for surgeons and their patients.

The lab offers the latest in tissue processing technology, including DMEK, DSAEK and Femtosecond Laser Assisted Keratoplasty (FLAK).laser

For more information, contact Christina Psalms, Director of Business Development, at Christina.psalms@sightlife.org, or call 909.248.5847

Irvine Laboratory Location
850 Health Sciences Road, Ste. 2020, Irvine, CA 92617

 

SightLife at AAO

We partnered with Ocular Systems to present three education sessions at October’s annual meeting. Here are some of the highlights.

  • Kevin Lavery, MD, of Portage, MI, spoke about his experience with the EndoSerter endothelium insertion device for DSAEK cases. Following a short learning curve, he now performs DSAEK without sutures and with minimal trauma to the graft.
  • Experts from SightLife’s Global Programs answered questions about best practices in building eye banking infrastructure in places where none exists.
  • Innovative surgeon Brandon Ayres, MD, of Bala Cynwyd, PA, shared his ‘paper airplane’ folding approach to Descemet’s Membrane Endothelial Keratoplasty (DMEK). This approach—folding tissue in a triangular form, endothelium-side inward-- has become his benchmark for achieving consistently faster surgeries and good results for his patients.

Contact us if you have further questions for the presenters, or if you want to learn more about these education sessions.

 
90 days

Changes for 2015

On October 31, The Centers for Medicare and Medicaid Services (CMS) finalized their payment rules for 2015. The rules include changes to the global periods of surgical procedures performed for Medicare-covered patients.

Starting with claims submitted in 2017, the global period will be reduced from 90 days to zero days. Regular postoperative care that falls within 90 days of a procedure will now be billed separately, rather than included in the professional reimbursement that covers a surgical procedure. This is significant for ophthalmology.

Follow-up services are generally included in a surgeon’s professional fee, even though ophthalmologists and technicians other than the original surgeon often provide theses services. Historically, Medicare has prepaid for services that fall within the 90-day period. When the new rules take effect, and follow-up charges are billed under a separate insurance claim, this prepayment is likely to be excised from surgical reimbursement. Overall reimbursement rates will be reduced.

The 2015 rules reflect the long-term CMS strategy of migrating away from fee for service. Prior to release, the rules were subject to a two-month comment period that garnered thousands of responses from the medical community. The new rules integrate CM’s strategic objectives while attempting to minimize disruption of services.

Reimbursement rates for surgical procedures done in 2015 have not yet been released. CMS typically releases that information within two weeks of finalization of the new rules.

 
DSEK course

Surgeon training update

SightLife, in partnership with L.V. Prasad Eye Institute (LVPEI), hosted an intensive Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK) Training Course in Hyderabad from September 27-30. Dr. Pravin Vadavalli, Dr. Sunita Chaurasia, Dr. Muralidhar Ramappa, and Dr. Jagadesh Reddy, all faculty of LVPEI, led the course. Three practicing corneal surgeons and four senior corneal fellows attended.

Group photo

The four-day program kicked off with lectures and case studies designed to improve each surgeon’s ability to diagnose indications, discuss different techniques and assign the treatment with the greatest chance of success. A wet lab followed, helping participants develop surgical skill in DSAEK. The next two days focused on preoperative review of patients, live surgeries, and management of surgical complications.

After observing live surgeries, each participant completed two procedures under the guidance of course faculty. Their work was judged using the International Council of Ophthalmology’s OSCAR for DSAEK evaluation tool.

DSEK post op exam

On the final day of the course, the group came together for an in-depth feedback session and discussion on how SightLife can support the surgeons’ continued professional development. Currently, course faculty use CyberSight as a mentoring tool to help the surgeons incorporate DSAEK into their practices across India.

The next DSAEK course will be held in December at LVPEI in Hyderabad and will be led by Dr. Pravin Vadavalli, Dr. Roberto Pineda, Dr. Audrey Talley-Rostov and Dr. Jay Rudd.

For more information, or to get involved, please contact Josie Noah, Director, Global Surgeon Training Programs, at josie.noah@sightlife.org or +1-781-258-8122.

 

Sharing stories, giving thanks

When Kathy Murphy looked into the eyes of Rev. Art Lillicropp, she saw more than a caring gaze. She saw the generous gift from her husband, John.

An avid fisherman and hunter who’d give you the shirt off his back, John Murphy died on November 8, 2013, from surgery complications while battling cancer. Two days later, John’s donated tissue was used as Art underwent corneal transplant surgery. The graft gave Art sight in his left eye and restored his ability to see the faces of the people he comforts as manager of Spiritual Care Services at Kaiser Permanente South Sacramento.

SightLife’s program that supports donor families and recipients helped Art and Kathy connect. They exchanged letters, then, on October 29, Kathy and her adult son Travis traveled to Sacramento to meet Art in person--just days before the first anniversary of John’s death.

Kathy and Travis brought photos of John and shared vivid memories of family adventures. Art hugged them in gratitude and promised he’d never forget the man who gave him back his sight. “I am so proud to know that part of John lives on,” he said.

Afterwards, Kathy and Travis accompanied Art to the Donor Tree Lighting Ceremony at Kaiser Permanent South Sacramento, an event Art started in 2013 to celebrate organ and tissue donors and recipients.  There, Kathy and Travis received a handmade quilt honoring John’s gift of sight. They also met Kaiser Permanente surgeon Dr. Samuel Lee, who performed Art’s transplant.

“It was great to meet Kathy and Travis, to reflect, and to appreciate that each cornea has a story,” said Dr. Lee. He noted that surgeons don’t always think about the tissue donor, focused as they are on achieving a safe and successful surgery for their patients.

“In America, we have such great access to transplant tissue that it is easy to take it for granted. Meeting the donor family completes the circle—I know my patient’s story and now I know his donor’s story, too.”

“It’s good to be reminded that this is a big deal.”

 

Recommended Reading: Supreme Court to Hear Challenge to ACA

The US Supreme Court accepted a case for their spring docket regarding federal Affordable Care Act (ACA) subsidies granted to expand Medicaid in states regardless of whether or not they implemented a healthcare exchange marketplace. If determined to be unlawful the subsidies would end earlier than scheduled, which may destabilize the ACA overall. A decision is expected in June of 2015. Read more »

 

Recommended Reading: Histological Analysis of a Cornea Following Experimental Femtosecond Laser Ablation

Researchers at Wakayama Medical University imaged corneal flaps created with microkeratome and femtosecond (FS) lasers. They found a smoother stromal bed in microkeratome cuts versus FS laser cuts when flaps were lifted mechanically. What this means for surgical outcomes is unclear, and requires further investigation. Read more »

 

Recommended Reading: Corneal Nerve Alterations After Descemet Membrane Endothelial Keratoplasty: An In Vivo Confocal Micr

With light microscopy, researchers measured the regrowth of subbasal corneal nerve structures after Descemet Membrane Endothelial Keratoplasty (DMEK) and found that nerves return to their preoperative density and function within 4 to 10 months after initial diminishment due to surgery. Read more »

 

Recommended Reading: New Therapeutic Modality for Corneal Endothelial Disease Using Rho-Associated Kinase Inhibitor Eye D

Drs. Koizumi, Okumura, Ueno, and Kinoshita of Kyoto Prefectural University report on the development and testing of eye drops containing a compound that inhibits the clustering of cells in the corneal endothelium. In a small trial of patients with Fuchs’-related corneal edema, their treatment resulted in long-term thinning and clearing of the cornea in cases of central edema, and less so in diffuse edema. Read more »