7^th European Ophthalmology Congress December 05-06, 2016 Madrid Spain

Biography:

Henry Klassen completed his MD and PhD degrees at University of Pittsburgh; Residency at Yale Eye Center and; Fellowship at Moorfields Eye Hospital/Institute of Ophthalmology in London. He is an Associate Professor of Ophthalmology and Director of the Stem Cell & Retinal Regeneration Program at University of California, Irvine. He is also Founder of jCyte, a startup company formed to commercialize retinal progenitor cell-based technology for use in retinal conditions

Abstract:

Throughout my career, I have been working on the development of a cell-based therapeutic for retinal degenerative diseases. Although unconventional and interdisciplinary, this project was long accommodated within the academic setting. However, as translational momentum continued to build, I found it necessary to confront the need for a corporate entity to carry forward aspects of the work that are not necessarily compatible with the role and organization of traditional academic institutions. Faced with this situation, one approach is to find an industrial partner. The other is to create one, which is what I did. The entity thus created, jCyte, is a virtual startup and spinoff of UC Irvine, where I continued on as faculty in ophthalmology. Despite the inherent administrative complexity, this hybrid academic-corporate arrangement has definite near-term advantages, including utilization of previously developed resources and overall expenses. Looking forward, jCyte has two paths of growth, either to develop into a stand-alone, bricks and mortar entity, or to be acquired by a pharmaceutical company with interests and experience in the eye.

Biography:

Ahmed Mohamed Kamal Elshafei is an Assistant professor of Ophthalmology and Head of Oculoplastic Unit in Ophthalmology department, Faculty of Medicine, Minia University, Egypt. In 2004, he completed his Fellowship of Royal College of Surgeons (FRCS) in Glasgow, UK. In 2003, he was MD in Ophthalmology Faculty of Medicine at Minia University, Egypt. He completed his MSc in Ophthalmology in Faculty of Medicine at Minia University, Minia, Egypt and MBBCh in Medicine and Surgery at Minia University, Minia, Egypt. From 1993-1994, he was an Intern of General Medicine and Surgery; from 1994-1997, he was Resident of Ophthalmology; from 1998-2003, he was Assistant Lecturer of Ophthalmology and; from 2003-2008, he was a Lecturer of Ophthalmology at Minia University, El-Minia, Egypt.

Abstract:

Aim of this study is to study etiology, clinical findings and outcomes of management of cases of orbital cellulitis treated in Minia University Hospital in Upper Egypt over the period of six years from July 2009 to July 2015. 102 patients diagnosed to have orbital cellulitis were admitted to the hospital and treated on inpatient basis from July 2009 to July 2015. All patients were subjected to full ophthalmological examination, systemic evaluation and ENT consultation. Axial and coronal CT scan and orbital echography were done for all patients. All patients received medical treatments and 20 patients needed surgical intervention. The source of infection was paranasal sinusitis in 66 patients, trauma in 14 cases, panophthalmitis in six patients, dental infection in two cases and no definite source was detected in 14 cases. Sub-periosteal abscess (SPA) developed in 16 patients. The final best corrected visual acuity improved in 58% of the cases, decreased in 4% and remained unchanged in 38% of cases. No intracranial complication was recorded. Good presenting visual acuity and appropriate medical treatment together with early surgical intervention in cases of SPA are important factors to achieve favorable outcomes in orbital cellulitis. All cases with SPA had paranasal sinusitis and contrary to previous studies, superior SPA location was the most common followed by the medial location.

Biography:

Haci Koc completed his PhD at Eagean University and Post-doctoral studies at Istanbul Training Hospital, mostly associated with Vitreoretinal Surgery and Anterior Segment Surgery. He has published almost 25 papers in Medical journals

Abstract:

Statement of the Problem: Pterygium is defined as a degenerative ocular surface disorder. It is characterised by fibrovascular growth of bulbar conjunctiva and subconjunctival tissue extending onto cornea. Pterygium results in slight irritation, cosmetic blemish, slight hyperemia and impairment of vision. Pterygium surgery still poses problems for surgeons and patients in terms of postoperative discomforts, postoperative complications and recurrences.

Methodology & Theoretical Orientation: To minimize these problems various techniques are suggested for pterygium surgery. Limbal conjunctival autograft is currently the most popular technique. Fibrin glue is widely used due to many reasons like easy fixation of graft, short operation time and reduction in complications and postoperative discomforts. But at the same time, it has also disadvantages like high cost, the risk of infections and inactivitation by iodine preparations. Suturing is most common fixation technique for conjonctival autograft. But it has disadvantages like increased operating time, inflammation, buttonhole, necrosis, giant papillary conjonctivitis, scarring and granulom formation.

Results: However, in our study we noticed our surgery time longer compare to the other studies both with fibrin and suture groups. Despite this, surgery time in fibrin group was shorter than suture group. Similar to the other studies, we found that high cost in fibrin glue group was a common point.

Conclusion & Significance: Both of fibrin glue and sutured conjunctival autograft technique are safe and effective methods for pterygium surgery. Surgery time in fibrin glue method is shorter than sutured method and it has high cost than suture method. Fibrin glue technique is considered to be more preferable for surgeons and patients due to the fact that it has shorter surgery times and there are less recurrence and postoperative discomforts despite its high cost.

Biography:

Hossam E Elbarbary completed his Graduation in 2001; Master’s degree in Ophthalmology in 2006; MD and PhD in 2011 at Alexandria University, Egypt. He is a Lecturer and Staff university member in Ophthalmology department at Alexandria Medical School. He is a Consultant of Orbit, Lid and Lacrimal Surgery at Alexandria University Hospitals.

Abstract:

This presentation will highlight and review the basic principles and important concepts for any orbital surgeon. Before undertaking any surgery in the orbit, a thorough knowledge of the normal eye lid and orbital anatomy is essential. Thorough understanding of CT and MRI is a must. One should also understand the instrumentation needed for any orbital surgery. The key to safe surgery is good surgical exposure. Adequate hemostasis needs to be ensured during orbital surgery. Many approaches can be used to gain access to the orbit. The different types of incisions and approaches will be demonstrated. The approaches can be anterior orbitotomy, lateral orbitotomy, transnasal endoscopic approach, transantral approach and transfrontal orbitotomy.

Biography:

Ivan Fiser completed his Graduation at Charles University in Prague in 1985 and Surgical Retinal training in 1993. He has been working as a Director of Vitreoretinal Service at 3^rd Medical Faculty in Prague and at Lexum Eye Clinic. He completed his PhD in 2007. He has published more than 20 papers in journals and was the co-author of five textbooks. He has presented over 200 talks at home and abroad. He is a member of the board of the European Vitreoretinal Society and a previous member of the board of the Czech Vitreoretinal Society.

Abstract:

Introduction: Vitrectomy helps in all kinds of vitreous opacities. We broke the concept that the typical patient with vitreous floaters is a young anxious engineer.

Methods: We analyzed 83 eyes of 63 patients who underwent vitrectomy for vitreous floaters (asteroid hyalosis, PVD and floaters only) between 2010 and 2015. 47 were male, 36 were female eyes. Their mean age was 60 years, ranging from 22 to 82; the median was 61. The mean follow-up was 15 months (from 1 to 83 months) and the median was nine.

Results: The patients were extremely satisfied with the result in 14 cases, satisfied in 66 cases and three eyes felt more or less the same. 42 eyes were pseudophakic and 41 phakic; 17 phakic eyes later underwent cataract surgery. Surprisingly, the group of “angry young men with invisible opacities” was very small; only four eyes of four patients were young males; a detailed analysis will be presented.

Take home message: All kinds of vitreous opacities benefit from vitrectomy. Although young men with minimal opacities stressed by their floaters, due to their clamant complaints seem to be a huge group, they surprisingly represent a minority. 

Biography:

Mohamed Farouk Sayed Othman Abdelkader completed his MD degree and he is a Lecturer of ophthalmology in the Faculty of Medicine at Minia University, Egypt.

Abstract:

Aim: Aim of this study is to evaluate the efficacy, cosmetic results and safety of transconjunctival tucking of the levator aponeurosis for correction of simple congenital ptosis.

Design: Prospective interventional non comparative case series study was done in Ophthalmology department at Minia University Hospital.

Patient & Methods: 30 eyelids of 26 patients suffering from simple congenital ptosis with fair to good levator muscle function (≥5 mm lid elevation) were subjected to transconjunctival tucking of levator aponeurosis. All patients were subjected to history taking and full ophthalmological examination. The degree of ptosis was evaluated using Marginal Reflex Distance 1 (MRD1). Levator muscle function was evaluated while fixing the eyebrow. Pre and postoperative digital photographs were used for documentation.

Results: Anatomical success was achieved in 26 eyelids (86.7%). Under-correction was present in four eyelids (13.3%). No case of overcorrection was encountered. Under-correction was associated with more severe ptosis and less levator muscle function. Good cosmetic outcomes were obtained in the majority of cases. A part from under-correction, no significant postoperative complications occurred during the study.

Conclusion: Levator aponeurosis tucking using posterior transconjunctival approach is safe and effective for correcting simple congenital blepharoptosis with good cosmetic outcomes. This technique is especially useful for mild and moderate cases of congenital ptosis associated with fair to good levator muscle function.

Biography:

Graduated from Minia university.excellent with honor and spent 3 years as resident and I got the master degree

Honorary fellowship of oculoplastic at Barts and the London school of medicine

Clinical attachment at Chelsea Westminster hospital ,London

MD degree in 2009.Lecturer of ophthalmology in Minia university,egypt

With my colleague we used a novel technique of gold weight implantation to manage thyroid related lid retraction and published in in ophth plastic and reconstructive surgery journal

Abstract:

Aim of this study is to compare direct brow lift and trans-blepharoplasty browpexy for management of brow ptosis as regard to cosmetic results, complications and patient satisfaction. In a surgical intervention prospective comparative study, 40 brows of 24 patients with brow ptosis were divided into two groups, group A: included 20 brows underwent direct brow lift and group B: included 20 brows underwent trans-blepharoplasty browpexy. Preoperative evaluation included general and ophthalmological history taking, brow evaluation, any associated dermatochalasis, ocular examination, cranial nerve examination, visual field assessment and photographic documentation.

Biography:

Svetlana Anisimova completed her Graduation from Moscow Medico-Stomatological University in 1980. From 1980 till 1995, she worked as Ophthalmo Surgeon in Glaucoma and Cataract departments in Moscow. Her topic of research is “Non-penetrating deep sclerectomy with collagen device”. In 2006, she completed her PhD and topic of her research work entitled “New approaches to surgical treatment of glaucoma and cataract in the outpatient clinic”. From 2006-2014, she worked as an Associated Professor at Post-graduated Medical Institute in Ophthalmological department.

Abstract:

Background: The problem of cataract treatment in patients with coexisting glaucoma attracts attention of ophthalmologists for many years. Most of them prefer combined surgery in these cases because both intraocular pressure (IOP) can be normalized and visual acuity can be improved. But at the same time this kind of surgery is a more difficult procedure, because of specific changes of glaucoma eye. Non-penetrating deep sclerectomy (NPDS) has less complications and is more adapted for this combined surgery. The presence of trabecular-Descemet’s membrane during NPDS can provide anterior chamber stability and increase the safety of phacoemulsification. The first experience of femtosecond laser assistance in cataract surgery proved that it can decrease the trauma of phacoemulsification, because of less mechanical strength on lens zonullar. This is very actual in eyes with glaucoma because of dystrophic changes leading to pseudo-exfoliation syndrome and lens subluxation.

Aim: The purpose of this work was to evaluate the effectiveness and safety of femto assisted phacoemulsification with NPDS in cases of glaucoma and cataract combination

Materials & Methods: All the patients were divided into groups according to the procedure performed: Phacoemulsification- 269 eyes; femto assisted phacoemulsification- 461 eye; phacoemulsification with NPDS; xenoplast drainage implantation- 11 eyes; femto assisted phacoemulsification with NPDS and; xenoplast drainage implantation- 53 eyes. Before and after the surgery, the standard ophthalmology examinations were performed. Besides this OCT (if it was possible according to ophthalmoscopy) and ORA examinations were performed. Intraoperative IOP evaluation was performed manually with Tono-pen. According to ESCRS recommendation, all patients before the operation received antibiotics, non-steroid antibiotics, ICA and mydriatics. Phacoemulsification was performed on Stellaris PC, and femto laser assistance (capsulorhexis, fragmentation and incisions) on Victus femtosecond laser. Intraocular lens implanted were en-Vista, Technis, AcryStyle and Hoya. Postoperatively all patients received combined steroid and antibiotic drops, non-steroids and kerato-protectors. As hypotensive medication in treating of postoperative hypertension in all cases, ICA was used.

Results: Vision acuity before operation in average was: One group- 0.13; two group- 0.23; three group- 0.24 and; four group- 0.14. One month after operation, it was 0.67; 0.72; 0.66 and 0.68 correspondingly. There was no difference between IOP levels in first two groups one day after the surgery was, so adding femto laser assistance to standard phacoemulsification procedure didn't change IOP level in early postop period. Femto laser assistance in all cases decreased the intraocular working time. During standard combined procedure, it was from 24 to 35 minutes, and with femto-laser assistance it reduced to 16-22 minutes. There were no cases of hemorrhage intraoperative complications. In groups of combined surgery IOP normalized by 5-10 days after the surgery. At IOP level of 17-20 or in cases of far advanced glaucoma, all patients constantly received hypotensive instillations medication. Xenoplast drainage never gives any inflammatory reaction or in-capsulation. IAG-laser goniopuncture was effective 2-12 months after surgery.

Conclusions: Combined phacoemulsification and NPDS with xenoplast drainage implantation is safe and effective procedure for combined treatment of cataract and glaucoma. Femto assistance in cataract surgery is a safe procedure which reduces the intraocular operation time and doesn't lead to intraoperative and postoperative complications increase.

Biography:

Mahmoud Aly Rageh completed his MSc in Ophthalmology at Cairo University in 1983. He was a Fellow at Hugonnier Center Lyon University, France in 1984. He completed his MD in Ophthalmology at Cairo University in 1992. He has published more than 20 articles in different scientific journals. He supervised many theses for the fulfillment of the MSc and MD degrees. He is a former Head of Pediatric Ophthalmology Unit at Research Institute of Ophthalmology, Cairo, Egypt.

Abstract:

Surgical management of strabismus due to thyroid eye disease is challenging and confusing. The aim of surgical treatment is to restore binocular single vision in the primary and reading positions. Frequently incomitance persists in other different positions of gaze despite of using conventional, adjustable or intraoperative relaxed muscle positioning techniques. A 25 year old male presented with a vertical diplopia due to a severe hypotropia affecting the right eye. He gave a history of thyroid disease dating since five years. Examination revealed a right hypotropia of 40 degrees with total inability to raise his eye and defective abduction. Moderate upper lid retraction and exophthalmos was recorded. The presentation shows the management of those cases using nonconventional surgical techniques to reach postoperative comitance in all positions of gaze.

Biography:

Abstract:

Introduction: Microperimetry is a clinical innovation to evaluate the retinal sensitivity. In this study, we explored the inter-ocular retinal variations of retinal sensitivity in the macular area in patients with pathological myopia.

Methods: A transversal study was designed in which the macular sensitivity (Expert exam protocol) of MAIA^TM microperimeter was employed to evaluate the functional variations of 10° in macular areas in patients affected by pathological myopia using 37 points strategy, in a sample of 36 persons aged between 13 and 60 years (spherical equivalent from -6.00 to -16.00 diopters). Inter-ocular asymmetry values were determined and compared with previous published tolerance values by means of a paired t test, and the interocular differences were calculated as the 2.5th and the 97.5th percentiles.

Results: The interocular difference tolerance limits for central sensitivity of the macula was 7.28 dB in patients affected by pathological myopia. Statically significant differences were found between males and females in the asymmetry of the central ring and the second ring of retinal sensitivity (SC and S2). There was a significant positive correlation between the retinal sensitivity and the spherical equivalent, and a weak correlation between the retinal sensitivity and the fixation level. Also we encountered significant positive correlation in retinal sensitivity between the central ring and the third ring (SC and S3).

Conclusions: A general reduction in the central retinal sensitivity in eyes with pathological myopia is expected to be more marked with increasing ametropia. Considering inter-ocular asymmetry in central retinal sensitivity should help understand better the retinal features of patients with pathological myopia, for which establishing normative percentile values should prove a useful tool.

Biography:

Magnus Theodorsson is a Foundation Year 2 Doctor working in Hillingdon Hospital, London. A keen interest in medical education, ophthalmology and modern teaching methods drew them to this project. The study was led by Mr. Nadeem Ali, Consultant Ophthalmic Surgeon at Moorfields and St. George’s Hospital, in order to trial a more enjoyable and approachable technique of teaching. The team hope to expand this project and gain further insight into how today’s medical students and trainees can learn most effectively in an extra-curricular manner.

Abstract:

Aim: Numerous different teaching methods are used across medical institutes globally; however there is increasing evidence highlighting the benefits of informal teaching over the traditional techniques. These range from the more established problem-based learning, to various uses of multimedia, all of which aim to elicit the best teaching potential from any given topic. This project assesses the response of viewers to informal-style videos, whether it is thought to have any educational benefit and warrant further exposure to this teaching format.

Methodology:  London-based Ophthalmology Consultants were filmed in 7 concise question-and-answer teaching videos on common eye conditions. Each topic was systemically covered, from diagnosis and investigation, to management. The video series was published online without viewing restriction, and also advertised to 4^th and 5^th year medical students at St. George’s, University of London. A feedback survey was provided with each video, targeting an audience of medical students, junior doctors and General Practice trainees.

Findings: The 7-video series generated a total of 3262 online views, and 184 feedback surveys were completed. The majority of responses (71%) were by medical students. 87% of responses listed this method as an ‘entertaining way to learn’, with 69% strongly agreeing this ‘improved their understanding’ of the watched topic. 63% of reviewers agreed this information was of an appropriate level and 82% strongly agreed that they would like other medical topics to be covered in this style.

Conclusion: The potential of this method when utilising the internet is emphasised by the large return in viewership. Further feedback information is needed from an expanded project of this type in order to ascertain how significantly this teaching approach can impact on medical education. However, the response to this series indicates there is a positive role for video-recorded Ophthalmic teaching amongst today’s undergraduate and postgraduate trainees.

Biography:

Abstract:

Background: Radial keratotomy (RK) incisions carry the risk of being full thickness an
have a high risk for producing serious infections in addition to its other complications.

CASE REPORT A 45 year old lady who presented with endophthalmitis two weeks after RK. A full thickness RK incision resulted in endophthalmitis that was efficiently treated with vitrectomy and injection of intravitreal antibiotics. Though the infection was controlled, the eye ended up in phthisis bulbi with NLP vision.

CONCLUSION
RK carries the risk of serious ocular infections in addition to its other complications. Safer techniques such as laser refractive surgery should replace RK today.

Biography:

Andreas Mitsios is a GMC registered Physician. He completed his MBBS at Medical School of University of Thessaly in Greece. Currently, he serves as a Community Doctor in medical center of Farkadona in Central Greece and he intends to specialize in Ophthalmology in UK. He is particularly interested in “Medical retinal disorders like diabetic retinopathy and age related macular degeneration” and currently, he is leading a diabetic retinopathy screening programme and other associated preventive actions aiming to increase patient awareness and education in relevant conditions.

Abstract:

Diabetic retinopathy screening programme in a local community in Greece based on available evidence from relevant screening programmes originally implemented in the United Kingdom. Diabetic retinopathy is a major complication of poorly controlled glucose control and constitutes the most common cause of vision loss among people with diabetes and a significant cause of blindness worldwide. Moreover, it represents a diagnostic challenge for the clinician in terms of appropriate classification and early detection, factors that can potentially impact on available treatment options. The goal of our scientific team was to establish an annual screening programme for patients with diabetes mellitus in order to timely diagnose diabetic retinopathy and appropriately refer patients for specialized treatment. During the time period between January and May 2016, we have examined 225 patients with diabetes mellitus. We have used a standardized form to obtain medical history in addition to a questionnaire specific to quality aspects of screening for diabetes mellitus complications. The fundoscopy was performed with the use of a slit lamp together with a Volk Digital Wide Field lens. The clinical assessment of the patients and classification of the observed clinical findings were based on guidance published by Public Health England in line with the scope of the NHS diabetic eye screening (DES) programme. The results of our project support our initial expectations that models of validated clinical practice could certainly be incorporated in the health care delivery of other countries and successfully enhance patient experience and provision of care.

Biography:

Abstract:

Aim of this study was to describe the types of adult strabismus presenting to the Republican Clinical Hospital - a tertiary care center of Republic of Moldova.

Methods: We retrospectively reviewed the medical records of 143 cases of adult strabismus consulted in our eye clinic over a period of 5 years (2005-2015).

Results: There were 64 males and 79 females, the age varied between 18-58 years. 49 patients  (34,26%) were with esotropia, 73 patients (51,04%) with exotropia,  4 pacients with vertical deviations (2,8%) , 11 (7,7%) with paralitic strabismus and  6 (4,2%) with restrictive strabismus.

89 cases (62,24%) from all this 143 patients were childhood strabismus that was either untreated (44,94%)  or insufficiently treated  (16,85%), or consecutive  (38,20%). The remaining patients have adult-onset strabismus.

The main complain of these patients were cosmetic and psychological (78,32%) followed by functional (21,68%),

Of the 112 (78,32%) patients who were advised surgical correction 99 individuals consented to undergo surgery. 21 patients refused any surgical intervention despite counseling, while surgery was not advised in 10 cases due to the presence of conditions such as Duane’s retraction syndrome with orthophoria (1), restrictive strabismus due to thyroid ophthalmopathy in acute phase (2), strabismus due to posttraumatic changes (chronic uveitis, microphthalmos (2), and paralytic strabismus of acute onset (5).

Conclusion: Whether strabismus in adults occurs secondarily or because it was not previously treated in childhood, it causes specific concerns, such as cosmetic, functional, psychological and professional.

Biography:

Abstract: