Oct 25, 2022 — Michael Szkarlat, Senior Partner Development Director
Oct. 25, 2022 — We were joined by Dr. Daniel Montenegro of the Eye Centers of South Florida for our October 2022 webinar. Dr. Montenegro led a data-focused walk-through of the considerations for performing DSAEK transplants in eyes with concurrent glaucoma.
Dr. Montenegro begins with a discussion about how increased endothelial cell loss (ECL) in patients with glaucoma drainage devices (GDD) or other previous glaucoma surgeries leads to earlier than normal graft failure. He does a quick review of the proposed mechanisms for this ECL before diving into some research on the topic and a discussion of the U.S. Food and Drug Administration’s role in monitoring these glaucoma devices.
Dr. Montenegro then does an overview of why DSAEK is preferrable in these eyes when compared to more conventional PKP along with a brief history of advances in EK surgery over the last 20+ years. Going back to the research, he dives further into the protein composition of aqueous humor in eyes with GDD and how this relates to ECL in these eyes. He also touches on the positioning of the GDD as it relates to graft failure rates in PKP.
Up next is a case report of a DSAEK transplant for endothelial decompensation following a trabeculectomy in an eye with severe edema resulting in a very limited view into the anterior chamber. Dr. Montenegro shows photos and describes each step of the surgery along with the reasoning for his approach. We are then taken back to the research once again looking at graft survival for the first vs. second DSAEK transplants in eyes with Ahmed valve implants.
Dr. Montenegro wraps up the webinar with an in-depth review of the advantages of DSAEK vs. PKP for these patients along with the challenges that these cases present. He then reviews some of the potential future treatments for endothelial cell dysfunction before summarizing some of the take home messages from the presentation. This is then followed by a lively question and answer discussion from the audience!
Key takeaways include:
About Daniel Montenegro, MD
Daniel Montenegro, MD is a board-certified ophthalmologist specializing in the medical and surgical management of cataract as well as corneal and external diseases. Dr. Montenegro grew up in Venezuela and is fluent in both Spanish and English. He completed his college education at Barry University in Miami, FL and went on to complete 3 years of research at the National Institutes of Health (NIH). He completed his medical education and graduated with summa cum laude honors at the Universidad Central del Caribe in Puerto Rico. He was elected into the Alpha Omega Alpha honor society for his academic achievements.
After medical school, he completed his ophthalmology training at the Kresge Eye Institute in Detroit, MI. He then went on to pursue a cornea and external diseases fellowship at the Dean McGee Eye Institute in Oklahoma City, OK.
Before joining Eye Centers of South Florida, he was a faculty member at the Kresge Eye Institute and the John D. Dingell VA Medical Center. He served as a mentor for future generations of ophthalmologists and provided care for our country’s Veterans. He directed a busy cornea service providing medical and surgical care for corneal diseases including corneal dystrophies, corneal ectasias (i.e. keratoconus), corneal ulcers, corneal scars, ocular surface tumors and dry eyes.
Dr. Montenegro performs full-thickness, partial thickness, and endothelial keratoplasty corneal transplants. He also has a strong interest in cataract refractive surgery and evolving intraocular lens implant technologies.
Dr. Montenegro chose ophthalmology as his profession because he embraces the complexity of the eye and its relationship with your health. He is a member of the American Academy of Ophthalmology and the American Society of Cataract and Refractive Surgery.
During his free time, Dr. Montenegro enjoys reading books, exercising and spending time with his wife Ana Carolina and two children, Daniel and Clara.
Eversight's free webinars are a great way for you to connect, learn and train digitally with leading ophthalmologists and researchers from around the world. We invite you to RSVP for scheduled webinars and browse our recording library.
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