Day 17 :
- Retina & Retinal Disorders | Cornea & External Eye Disease | Ophthalmology Surgery
Location: Dubai
Chair
Christiane I. Falkner-Radler
Rudolf Foundation Hospital, Austria
Co-Chair
Stefan Mennel
Austria
Session Introduction
Stefan Mennel
LKH Feldkirch, Austria
Title: Binocular occlusion prior to retinal detachment surgery: A tomographic analysis by OCT
Biography:
Stefan Mennel has obtained his Medical degree from the University of Innsbruck, Austria. He has completed his Residency at the LKH Feldkirch in Austria. After two years of Medical Specialist in Feldkirch (Austria), he worked as an Assistant Medical Director at the Philipps University of Marburg, Germany from 2002. In 2008, he became a Professor of Ophthalmology. After working as an interim Director Medical Deputy Head at the University Marburg in 2009 and 2010, he was appointed as the Director of the Department LKH Feldkirch, University Teaching Hospital of the Medical University Innsbruck and Vienna. He assists as a Reviewer in more than 20 peer-reviewed journals and has been serving as an Editorial Board Member of repute. His main research interest is on imaging vitreoretinal structures and experimental research on the blood retinal barrier. His surgical experience comprises vitreoretinal surgery, anterior segment surgery including cataract surgery, glaucoma surgery and corneal transplantation.
Abstract:
Introduction: In previous years binocular occlusion was a routine treatment for acute vitreous hemorrhage and rhegmatogenous retinal detachment (RRD) prior to surgery. In most cases the acute hemorrhage settles enough for successful treatment of the originating pathology. In RRD binocular occlusion diminish sub-retinal fluid to improve preoperative diagnostic and treatment and can prevent a progression of the detachment. The reduction of sub-retinal fluid is still documented by fundus photography and fundus drawings. In this study, we introduced optical coherence tomography (OCT) for this purpose. OCT enables measurement of sub-retinal fluid and to compare similar areas after binocular occlusion.
Methods: 30 patients with RRD that were scheduled for treatment at the following day received OCT at the time of examination and at the following day prior to surgery.
Results: In 18 eyes the macula was attached at the first visit and in none of the cases a macular involvement was determined by OCT at the following day prior to surgery. In 12 cases the macula was already detached. In 11 eyes the retinal elevation decreased and in one case an increase was evident.
Conclusion: This fist study by using OCT to measure sub-retinal fluid and macular involvement in RRD demonstrated binocular occlusion as an effective treatment option to schedule retinal detachment surgery for the following day without the risk of macular involvement in RRD.
Biography:
Talal Althomali is an Associate Professor of Ophthalmology and the Vice Dean of Hospital Affairs at Taif University and a Consultant Physician of Pediatric Ophthalmology at King Khaled Eye Specialist Hospital, Riyadh and King Abdul-Aziz Specialist Hospital, Tertiary and Referral Center in the Western Region, Saudi Arabia. With outstanding educational and research activities, he has excellent experience in surgeries. He is active member of numerous ophthalmology organizations. Actively participated in many ophthalmology meetings including American academy meeting 2014, American Society of Cataract and Refractive Surgeons 2014, European Society of Cataract and Refractive Surgeon 2008-2015, World Congress of Pediatric Ophthalmology and Strabismus 2012 & 2015 and International Ophthalmology Congress 2014, where some of his research was selected to be amongst the top studies.
Abstract:
Introduction: Excimer laser surgeries correct refractive error by corneal tissue ablation, which also lead to the weakening of the biomechanical strength of the cornea and therefore, increase the risk of developing postoperative keratectasia. The incidence of post-refractive surgery ectasia is greatly enhanced by the presence of conditions associated with low residual stromal bed thickness (< 250 µm) either from excessive ablation (high myopia) or thick flap creation, or presence of pre-existing topographic abnormalities such as sub-clinical keratoconus. As the risk of post-refractive surgery ectatic complications, sub-clinical keratoconus is considered as a contraindication to LASIK. There are reports which suggest that patients with preoperative riskf actors could be offered PRK as an alternative to LASIK; however, the risk of progression to keratoconus after PRK still prevails. As such, general consensus has been that excimer laser ablation procedures should be avoided in eyes with sub-clinical keratoconus. In recent years, riboflavin-ultraviolet A (UVA) corneal collagen cross-linking (CXL) has been successfully used to halt the progression of keratoconus. CXL alone has helped in retarding or eliminating the progression of keratoconus and post-refractive surgery ectasia. Additionally, in highly irregular corneas with progressive keratoconus, the combination of topography-guided PRK with CXL has also been found to significantly decrease corneal irregularity and improve visual acuity as well as halt the progression of keratoconus at the same time. The combination of LASIK and accelerated CXL has also been evaluated for reducing the risk for postoperative keratectasia in a population at risk but with no corneal abnormalities and has been found to be safe and effective with respect to refractive outcomes. It has been established that prophylactic collagen cross-linking is safe in routine LASIK cases. Due to the successful use of CXL alone or in combination with topography guided PRK in eyes with manifest keratoconus, there has been a revival of interest about the possibility of performing laser vision correction safely in eyes with sub-clinical keratoconus. In patients with subclinical keratoconus, simultaneous CXL with PRK may offer both spectacle/contact lens freedom and stability of their ectatic disorder at the same time. This paper presents a series of patients with subclinical keratoconus, who have undergone combined, same-day, topography-guided PRK followed by accelerated CXL.
Aim: The purpose of the study was to evaluate the efficacy, safety and stability of visual and refractive outcomes of the combined topography guided PRK with accelerated CXL in eyes with subclinical keratoconus.
Methods: Simultaneous topography-guided PRK with accelerated CXL was performed in 140 eyes of 75 patients (mean age 25.73±5.2 years) with subclinical keratoconus and were followed up at 1, 3, 6 and 12 months. Study parameters included preoperative and postoperative uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction and keratometry (flat and steep).
Results: All refractive and keratometric parameters demonstrated a statistically significant improvement from baseline to postoperative 12 months. UDVA of 20/20 or better was achieved in 90.7% (127/140) eyes and 20/40 or better was achieved in 96.4% (135/140) eyes at last follow-up. Regarding refractive outcomes; 94.3% (132/140) eyes were within ±1.00 D of attempted refractive correction and 82.9% (116/140) eyes had an astigmatism of ≤ 0.25 D postoperatively as compared to 22.9% (32/140) eyes at preoperative levels. Regarding safety, 90.7% (127/140) eyes maintained their preoperative CDVA; 2.1% (3/140) eyes lost 1 line, 3.6% (5/140) eyes lost 2 lines and 3.6% (5/140) eyes lost 3 or more lines of CDVA. Corneal haze was observed in 7.14% (10/140) and corneal ectasia developed in 1 eye (0.7%).
Conclusion: Combining topography-guided PRK with accelerated CXL appears to be safe and effective surgical refractive procedure to offer spectacle-independence in eyes with subclinical keratoconus.
Kristina Mikek
Morela Okulisti
Slovenia
Title: Femtosecond laser or mikrokeratome: What to choose in LASIK?
Biography:
Kristina Mikek has completed her undergraduate education from University of Ljubljana, Medical Faculty, Slovenia. She did Residency in Ophthalmology at University Medical Center Ljubljana, Slovenia (1999-2003), Fellowship in Cataract and Refractive Surgery at Moorfields Eye Hospital, London, UK (2001), Fellowship in Cataract Surgery at University Eye Clinic Antwerp, Belgium (2002), Postgraduate Research, Magister of Science, University of Ljubljana, Slovenia (2002) and Fellowship Laser Refractive Surgery, University Eye Hospital Heraklion, Greece (2003). She has worked as a Consultant Ophthalmologist, Cornea and Cataract Surgery Specialist at University Eye Clinic, Ljubljana, Slovenia from 2003-2006 and she has been working as a Medical Director at Morela Okulisti, Center for Eye Surgery, Ljubljana, Slovenia since 2007.
Abstract:
Purpose: LASIK (laser in situ keratomileusis) is the far most preferred technique in laser refractive surgery with excimer laser. We use femtosecond laser technology for the creation of the flap.
Methods: When we decide for LASIK surgery we have to choose the right patient in terms of the parameters measured at the time of preoperative examinations: the amount of refraction with or without astigmatism and corneal thickness. Besides this, corneal topography and corneal back surface scanned with the Pentacam device are very important. For successful surgery we have to have the right value of the keratometric numbers and the right diameter of the cornea (WTW: White to White). Last but not the least in the decision for LASIK surgery with microkeratome or femtosecond laser in creation of the flap, is the anatomy of the orbit and the eyelids (deep set eyes).
Results: In the presentation, I will present in which patients we can use femtosecond LASIK refractive surgery, where LASIK surgery with the microkeratome is not possible or associated potential complications even in the hands of very experienced refractive surgeons.
Conclusion: Femto LASIK with femtosecond laser technology is far the most sophisticated and successful laser refractive surgery method even in patients, where LASIK surgery with microkeratome is not possible or could be associated with flap related complications during the surgery.
Felipe A Soria
Vissum Corporación Alicante
Spain
Title: MICS with toric intraocular lenses in keratoconus: Outcomes and predictability analysis of postoperative refraction
Biography:
Felipe Soria studied Medicine in the Adventist University in Argentina and did his specialty in Ophthalmology in the Vision Institute of Montemorelos University in Mexico. He made the subspecialties of Cornea, Refractive and Cataract surgery in Vissum Corporation with Dr. Jorge Alio for a period of two years. He has written more than 30 scientific articles and book chapters, and is the Editor of the book Femtosecond Laser Assisted Keratoplasty. He has participated with 40 communications in different international congress across the world. He owns the patent: Use of Mesothelial cells in Tissue Bioengineering and Artificial Tissues.
Abstract:
Aim: To investigate the visual and refractive outcomes, safety, efficacy and stability of cataract surgery in eyes with stable keratoconus.
Methods: 17 eyes (10 patients) diagnosed as stable keratoconus, aged from 34 to 73 years (56.63±12.47), underwent micro-incision cataract surgery (MICS) followed by implantation of toric intraocular lens (IOL). Seven of them were operated bilaterally and three unilaterally. A complete ophthalmological examinationwas performed preoperatively and postoperatively. The main outcome measures were: uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), keratometry and manifest refraction.
Results: Sphere changed from −1.77±6.57D (−11.00 to 7.00) preoperatively to 0.08±0.79D (−1.25 to 1.75) postoperatively (p=0.211), and cylinder changed from −2.95±1.71D (−7.00 to −0.75) to −1.40±1.13D (−3.25 to 0.00) ( p=0.016). UDVA (logMAR) changed from 1.33±0.95 (0.40 to 2.77) to 0.32±0.38 (0.00 to 1.30) (p=0.008) and CDVA (logMAR) changed from 0.32±0.45 (0.01 to 1.77) to 0.20±0.36 (−0.03 to 1.30) (p=0.013). Efficacy and safety indexes were 1.38±0.58 and 1.17±0.66, respectively. Refraction and corneal topography were stable during the follow-up (9.10±5.54 months, 3–15).
Conclusions: MICS surgery using corneal topography data and standard formulas for the calculation of the IOL power is a safe and effective procedure regarding keratometric stability, visual and refractive results.
Radwan Almousa
Chelsea and Westminster Hospital
UK
Title: Mohs micorographic surgery vs. wide excision and late reconstruction for periocular basal cell carcinoma treatment
Biography:
Radwan Almousa has completed his Basic Ophthalmology training from Royal Cornwall Hospital. He has completed 1 year Oculoplastic Fellowship from the National University Health System in Singapore, then another year of Cornea Fellowship from Queen Victoria Hospital in the UK. He is an Ophthalmology Consultant at Chelsea and Westminster Hospital in London. He has published 16 papers in reputed peer reviewed journals and continues to serve as a Reviewer for few ophthalmic journals.
Abstract:
Purpose: To analyze the outcome of basal cell carcinoma (BCC) treatment in a tertiary referral center in the UK.
Methods: Retrospective, comparative, interventional study of patients who underwent surgical treatment of periocular BCC between 2013 and 2015. Patients were divided into two groups; the first group had the BCC removed using Mohs microscopic surgery (MMS), the second group underwent wide excision with later reconstruction. The primary outcome was the recurrence rate in both group, the secondary outcomes were reconstructive technique, lesion site and size, histopathology, and rate of complications.
Results: One hundred forty-six patients (93 female, 53 male) with a total of 151 cases were treated. Median follow-up was 14 (range 6-40) months; median age was 74.4 (range 40.5-99.5) years. The BCC involved mostly the lower lid in 70 cases (46.3%), followed by medial canthus, upper lid, lower lid, brow, and lateral canthus, in 45 (29.8%), 14 (9.2%), 12 (7.9%) and 9 (5.9%) cases respectively. 102 patients had MMS surgery and 49 patients had wide excision. Most of the surgical defects were closed using local flaps (117) and the rest of the cases were closed using direct closure technique (26) and skin graft (8). In the MMS group, the average surgical defect (263.1±344.6 mm), was 3.75 times the original clinical tumor size (70.8±105.8 mm) (P<0.001). Three patients in the wide excision group had a recurrence of the BCC tumor. There was no recurrence in MMS group.
Conclusion: The microscopic BBC tumor is significantly larger than its clinical appearance. MMS is more effective in complete removal of the tumor than wide excision technique with less recurrence rate.
Christiane I Falkner-Radler
Rudolf Foundation Hospital
Austria
Title: 27-gauge vitrectomy for vitreoretinal disorders
Biography:
Christiane I Falkner-Radler is a full time attending Retinal Specialist and Surgeon at the Department of Ophthalmology, Rudolf Foundation Clinic, Vienna since 2008. She has conducted several clinical trials and has published several articles in peer-reviewed journals. Her areas of research interest are vitreoretinal disorders and surgical approaches, including retinal detachment surgery and macular surgery and on new advances in combined cataract and vitreoretinal surgery as well as intraoperative optical coherence tomography. She has presented free papers and posters at several international and national meetings and has been accepted as member in the Retina Society, the ASRS, the Club Jules Gonin, the Euretina, the AAO and the ARVO. In addition, she has completed the SOE-Leadership development program “EuLDP” 2010-2011. She has completed several Observerships with the Department of Ophthalmology at Weill Cornell Medical College, New York.
Abstract:
Purpose: To evaluate anatomic, functional and refractive outcomes after 27-gauge vitrectomy in a prospective study.
Methods: The study was designed to include patients presenting with vitreoretinal disorders (epiretinal membrane [ERM], macular holes, asteroid hyalosis and vitreomacular traction [VMT]) with or without coexisting significant cataract. Exclusion criteria were (1) patients with rhegmatogenous or tractional detachment, (2) previous vitreoretinal surgery and (3) the need for silicone oil tamponade. Surgical conditions using a scaled questionnaire, complication rates, IOP, functional and refractive outcomes were evaluated.
Results: Up to now, 60 patients, 41 females and 19 males with a mean age of 72 years, have completed the 3 months follow-up. The vitreoretinal diagnosis was ERM in 36 eyes, macular holes in 9 eyes, VMT in 2 eyes, and asteroid hyalosis in 13 eyes. 47 eyes cataract surgery was combined with vitrectomy. Intraoperative conditions were graded good to excellent. However, a slightly increased time needed for core vitrectomy was noted and particularly in hyperopic and left eyes the 27 gauge instruments were graded to be more flexible. No wound leakage was found and the IOP was stable in all eyes. Complication rates included a mild postoperative vitreous hemorrhage in one patient which spontaneously resolved during follow-up. Visual acuity improved in all patients and the refractive results in the combined cases were excellent.
Conclusions: These results suggest that 27 gauge vitrectomy with or without combined cataract surgery results in excellent wound architecture and offers promising functional and refractive results.
Sameen Afzal Junejo
Liaquat University of Medical and Health Sciences
Pakistan
Title: Role of oral Rifampcin in central serous chorioretinopathy (CSCR): Study of 31 cases
Biography:
Sameen Afzal Junejo Taken up fellowship FCPS from College of Physicians and Surgeons Pakistan in 1999. Published 27 papers in reputed journals. Interested in anterior segment and adenexia. Introduced new techniques in Phacoemulsification cataract surgery. At present working as Professor Institute of ophthalmology LUMHS-JAMSHORO, Pakistan.
Abstract:
Central serous chorioretinopathy (CSCR) is characterized by accumulation of fluid in between sensory retina and retinal pigment epithelium. Chronic CSCR present with frequent exacerbations and a poor visual prognosis. Various therapeutic measures are available for recent onset and recurrent/chronic CSR. Thus, novel therapies to combat this frustrating disorder are needed. We will present fifteen cases with recent and chronic CSCR treated with oral Rifampcin that completely resolved with 1 month of oral rifampcin therapy. As a cytochrome P450, 3A4 inducer, rifampin is thought to favorably alter the metabolism of endogenous steroids, thereby leading to an improvement in CSCR manifestations. The study of 31 cases of CSCR treated with half adult dose oral Rifampcin will be presented.
Biography:
Irina Mocanu, Romanian Ophthalmogist, graduated from the Bucharest Emergencies Eye Hospital. She has done a fellowship in University of Crete - Institute of Vision and Optics Heraklion, with Prof. Pallikaris. Also she did a fellowship in Advanced Microincision Phacoemulisification in Instituto de la Vision, University of Montemorelos - Mexico, having Dr. Felipe A. Soria as a tutor. Currently, she is doing a research on the effects of intraocular foreign bodies with forensic implications. She works in her own private practice dedicated mainly to anterior segment cases.
Abstract:
Purpose of review: This review outlines the advantages and the differences of femtosecond laser-assisted cataract surgery. (FLACS) following a coaxial or microincision cataract surgery phacoemulsification in the surgical outcomeand greater control of cataract surgery.
Recent findings: FLACS offers minimal tissue damage and extreme precision during corneal incision creation, continuous circular capsulorhexis (CCC) and nuclear fragmentation. It also allows diminishing the mean average ultrasound power to emulsify the nucleus followed by a coaxial or a biaxial procedure. The impact of reduced phacoemulsification energy on the corneal endothelium is an interesting topic that is being investigated. Despite its benefits, this technology has relevant financial issues and a high learning curve.
Summary: FemtoMICS appears to be surgically and statistically more efficient than the Femt-coaxial technique and Femtoincisions prove to be stable and do not change the corneal high order aberration significantly with favourable results of the triplanar configuration.
Mustafa Kamal Junejo
Isra Postgraduate Institute of Ophthalmology
Pakistan
Title: Central corneal thickness and crystalline lens changes after trabeculectomy
Biography:
Mustafa Kamal Junejo has completed his training at the age of 30 years from Aga Khan University Hospital Karachi Pakistan. He did his Membership exam from Royal College of Surgeons of Edinburgh United Kingdom. He is working as Senior Instructor/ Clinical & Academic Coordinator and In charge Cornea & External Eye Diseases Section. He has published more than 10 papers in reputed journals nationally and internationally. His areas of interests are Cornea, External Eye Disease and Refractive surgery, Medical Retina and Glaucoma.
Abstract:
Objectives: To determine changes in central corneal thickness (CCT) and crystalline lens status after Trabeculectomy in Glaucoma patients.
Materials & Methods: We retrospectively reviewed the records of 113 glaucoma patients who underwent trabeculectomy for the assessment of changes in central corneal thickness and crystalline lens status, from January 2013 to December 2014 at Section of Ophthalmology, Aga Khan University Hospital, Karachi. Patients’ characteristics, including demographics presentation, clinical factors and management were assessed from the medical records. Categorical variables were described in terms of frequencies and percentages and continuous variables were described in terms of mean and standard deviation. Data was analyzed using SPSS 19.0
Results: Mean age of patient was 53.3± 12.3 years. Before trabeculectomy, the mean CCT was 524.25 ±38.53 µm. After 12 months of surgery the mean CCT was 521.95±38.25 µm with correlation of 0.855 which was not statistically significant. The crystalline lens status assessment was reviewed in 108 patients because 5 patients were pseudophakic. Out of which 9 patients’ (8.3%) crystalline lens status was changed post 12 months of trabeculectomy keeping the LOCS III grading system as reference.
Conclusion: Central corneal thickness is assessed for accurate measurement of intraocular pressure to properly manage patients of glaucoma. In our study we concluded that there is no clinically significant change in central corneal thickness after drainage surgery so, it is not necessary to measure central corneal thickness after drainage surgery for accurate measurement of intraocular pressure. Crystalline lens status change was noticed in our study in particular to nuclear sclerotic lens changes increasing after trabeculectomy.
Sameen Afzal Junejo
Liaquat University of Medical and Health Sciences
Pakistan
Title: Phacoemulsification, phaco/MICS and ECCE through temporal approach in hard cataracts
Biography:
Sameen Afzal Junejo taken up fellowship FCPS from College of Physicians and Surgeons Pakistan in 1999. Published 27 papers in reputed journals. Interested in anterior segment and adenexia. Introduced new techniques in Phacoemulsification cataract surgery. At present working as Professor Institute of ophthalmology LUMHS-JAMSHORO, Pakistan.
Abstract:
Hard cataract extraction off and on creates problem for a phaco-surgeon and many times during surgery on table the procedure has to be shifted from small incision phaco-emulsification to large incision extra capsular cataract extraction. In this video presentation we will discuss how to perform all small incision cataract extraction techniques safely and comfortably in grade-III hard cataracts.
- Special Session
Session Introduction
Felipe A Soria
Vissum Corporacion Alicante
Spain
Title: Mesothelial cells: A cellular surrogate for tissue engineering of corneal endothelium
Biography:
Felipe Soria studied Medicine in the Adventist University in Argentina and did his specialty in Ophthalmology in the Vision Institute of Montemorelos University in Mexico. He made the subspecialties of Cornea, Refractive and Cataract surgery in Vissum Corporation with Dr. Jorge Alio for a period of two years. He has written more than 30 scientific articles and book chapters, and is the Editor of the book Femtosecond Laser Assisted Keratoplasty. He has participated with 40 communications in different international congress across the world. He owns the patent: Use of Mesothelial cells in Tissue Bioengineering and Artificial Tissues.
Abstract:
Purpose: To evaluate whether mouse adipose tissue mesothelial cells (ATMCs) share morphologic and biochemical characteristics with mouse corneal endothelial cells (CECs) and to evaluate their capacity to adhere to the decellularized basal membrane of human anterior lens capsules (HALCs) as a potential tissue-engineered surrogate for corneal endothelium replacement.
Methods: Adipose tissue mesothelial cells were isolated from the visceral adipose tissue of adult mice and their expression of several corneal endothelium markers was determined with quantitative RT-PCR, immunofluorescence and Western blotting. Adipose tissue mesothelial cells were cultured in a mesothelial retaining phenotype medium (MRPM) and further seeded and cultured on top of the decellularized basal membrane of HALCs. ATMC-HALC composites were evaluated by optical microscopy, immunofluorescence, and transmission electron microscopy.
Results: Mesothelial retaining phenotype medium–cultured ATMCs express the corneal endothelium markers COL4A2, COL8A2, SLC4A4, CAR2, sodium- and potassium-dependent adenosine triphosphatase (Na./K.-ATPase), b-catenin, zona occludens-1 and N-cadherin in a pattern similar to that in mouse CECs. Furthermore, ATMCs displayed strong adhesion capacity onto the basal membrane of HALCs and formed a confluent monolayer within 72 hours of culture in MRPM. Ultra-structural morphologic and marker characteristics displayed by ATMC monolayer on HALCs clearly indicated that ATMCs retained their original phenotype of squamous epithelial-like cells.
Conclusions: Corneal epithelial cells and ATMCs share morphologic (structural) and marker (functional) similarities. The ATMCs adhered and formed structures mimicking focal adhesion complexes with the HALC basal membrane. Monolayer structure and achieved density of ATMCs support the proposal to use adult human mesothelial cells (MCs) as a possible surrogate for damaged corneal endothelium.
- Pediatric Ophthalmology | Neuro-Ophthalmology | Clinical Ophthalmology
Chair
Najeeb Haykal
Gwynedd Hospital, UK
Co-Chair
Talal Althomali
Taif University, KSA
Biography:
Nadim Sradj is an Ophthalmologist and Philosopher. In 1966, he did his MD at the University of Tübingen, Germany; in 1968 he did his MA at the University of Mainz, Germany. He did his postgraduate studies at the Universities of Frankfurt, Main and Gießen, Germany. He has scientific publications and has given lectures in German, English, French and Arabic all over the world. He has participated in many scientific activities in Arabic countries, Argentina, Luxemburg and Russia.
Abstract:
The structural question how the six eye muscles with different insertions on the bulb and different tractive powers do co-operate with each other could not be solved by measurements. Therefore, listing gave an answer by mathematical topology (1845) and demonstrated it by a cardanic suspension. Helmholtz, Hering and others called the abstract hypothesis of listing later on a law. But this so called “law” does not cover all possible eye movements. Our model of a socket joint is a realistic alternative to listing. The consequences will be discussed.
Alexandria Vydrina
MNTK Eye Microsurgery
Russia
Title: Fluorescein angiography for aggressive posterior retinopathy of prematurity
Biography:
Abstract:
32 angiographic examinations of preterm infants with different stages AP-ROP were performed. Fluorescein angiography (FA) was performed by means of retinal pediatric digital video systems RetCam-3 with built-in angiographic unit. The duration of the FA procedure was 2-3 minutes on average. In all cases, the informed consent from parents was obtained. Interpretation of the FA data was conducted in accordance with developed by the author’s clinic-morphometric classification of ROP, providing for division of AP-ROP on different stages, including early clinical stage, manifestation stage and some other stages. No side effect from the injection of fluorescein was shown, in addition to staining of child's urine with yellow color. In fluorescein angiography in cases of AP-ROP at the early clinical stage reperfuse a wide area of the retina due to the complete absence of retinal vessels were identified. The border between vascularized and avascular retina was evident, unlike digital photos, where boundary signs are practically not detected. The absence of a foveal avascular zone was a characteristic feature. In fluorescein angiography in cases of AP-ROP at manifestation stage signs of severe ischemia and proliferative activity were seen foremost. The most important angiographic feature of AP-ROP was a massive loss of retinal capillary bed in the vascularized retina. The main advantage of the FA for AP-ROP is the possibility of detailed visualization of the retinal vasculature, which is not always clearly visible on the digital photographs, obtained using RetCam. It provides improved quality of monitoring and treatment of the patients.
Diana Cormos
OCUSAN Eye Clinic Brasov
Romania
Title: Particularities of the anti VEGF treatment in children
Biography:
Diana Cormos has completed her PhD in 2008 at the University of Medicine and Pharmacy “Iuliu Hatieganu” in Cluj Napoca, Romania with the thesis entitled “Screening and Early Treatment in Retinopathy of Prematurity”. During 1998 to 2009 she taught at the Transilvania University School of Medicine in Brasov. She is the Co-Founder of OCUSAN Eye Clinic in Brasov. Her areas of interest are pediatric ophthalmology and strabismus, cataract surgery, medical retina and glaucoma.
Abstract:
This presentation emphasizes the particularities of the anti-VEGF treatment in children, highlights the latest results of the studies using the anti-VEGF treatment in the therapy of retinopathy of prematurity and presents the personal experience with the pediatric use of those therapeutic agents.
Biography:
Talal Althomali is an Associate Professor of Ophthalmology and the Vice Dean of Hospital Affairs at Taif University and a Consultant Physician of Pediatric Ophthalmology at King Khaled Eye Specialist Hospital, Riyadh and King Abdul-Aziz Specialist Hospital, Tertiary and Referral Center in the Western Region, Saudi Arabia. With outstanding educational and research activities, he has excellent experience in surgeries. He is active member of numerous ophthalmology organizations. Actively participated in many ophthalmology meetings including American academy meeting 2014, American Society of Cataract and Refractive Surgeons 2014, European Society of Cataract and Refractive Surgeon 2008-2015, World Congress of Pediatric Ophthalmology and Strabismus 2012 & 2015 and International Ophthalmology Congress 2014, where some of his research was selected to be amongst the top studies.
Abstract:
Amblyopia is one of the leading causes of acquired monocular visual impairment, with an estimated prevalence in the pediatric population ranging from 2.9-7.5%. Younger children, especially those younger than 6 years, with myopic anisometropia greater than 2diopters (D), hyperopic anisometropia greater than 1 D and astigmatic anisometropia greater than 1.5 D are at increased risk to develop persistent and intractable amblyopia without adequate therapy. Previous research has demonstrated that optical correction of astigmatism (i.e., restoration of normal visual input) can be an effective means of treatment for anisometropic amblyopia with astigmatism during early childhood. Unless amblyopia is successfully treated in early childhood, it usually persists into adulthood, significantly increasing the risk of permanent visual impairment. In children with high refractive errors, spectacle correction may not be the most desirable medical therapeutic option due to induction of anisoikonia and potential loss of binocular fusion. Therefore, contact lens wear is the optimal method of medical treatment for high ametropic amblyopia. However, some children resist contact lens wear and both parents and children find the placement of contact lenses to be difficult and distressing .With the availability of toric PIOLs to correct preexisting astigmatism, it is now possible to target emmetropia and achieve a much higher level of spectacle independence in astigmatic patients. Patients with high anisometropic amblyopia with astigmatism could certainly benefit from toric PIOL implantation. To our knowledge, this is the first study that reports the outcomes of the implantation of toric PIOLs in children with anisometropic amblyopia with astigmatism. Eleven eyes of 10 amblyopic patients aged 5 to 15 years underwent toric PIOL (Visian Toric ICL; STAAR Surgical Company, Monrovia, CA) implantation for refractory anisometropic amblyopia. Preoperative and postoperative clinical evaluation included slit-lamp microscopy, visual acuity, anterior/posterior segment examination and cycloplegic refraction. Toric PIOL implantation may be a viable therapeutic modality in children with clinically significant anisometropic ametropia and astigmatism with secondary amblyopia that have been refractory to medical treatment including spectacles or contact lenses. Longer follow-up visits with larger sample populations will evaluate more effectively the long-term efficacy and late-onset of complication.
Biography:
Najeeb Ghalib Haykal is trained in Cairo University and UK hospitals and is currently working as a Consultant Ophthalmic Surgeon at Gwynedd Hospital, North Wales and had previously been a Consultant Ophthalmologist in UK and overseas hospitals. He was also an Assistant Professor in Ophthalmology at the Jordan University of Science & Technology and a Coordinator and Member of the Assessment Committee, International Council of Ophthalmology, UK.
Abstract:
Reduced tolerance to light stimuli, a frequent symptom in ophthalmology and other specialties, has different causes. The commonest and more severe are anterior ocular segment conditions, but other ocular and extra-ocular ophthalmic conditions can be behind the symptom. Furthermore various neurological and psychiatric conditions are known to be associated with photophobia. More interesting is the different mechanisms behind this symptom. Unclear mechanism in many conditions is getting slowly clearer while more clear mechanisms can be more easily understood in other conditions. Treatment is essentially treating the underlying cause as well as avoiding the direct trigger of the symptom. Other treatments are only applicable in certain conditions or still experimental.
Pepin Williams Atipo Tsiba
Marien Ngouabi University
Republic of Congo
Title: Inbreeding and morbi-mortality: A short literature review from an exceptional association of Usher syndrome and Von Recklinghausen’s neurofibromatosis
Biography:
Pepin Williams Atipo Tsiba has completed his PhD from Marien Ngouabi University of Brazzaville and Post-doctoral study in Switzerland. He has obtained the Federal Ophthalmology title from the Swiss Medical Federation (FMH) and the FEBO (Fellow European Board of Ophthalmology) title in 2005. He is an Assistant Professor in Ophthalmology at Marien Ngouabi University of Brazzaville. He is the Head of Ophthalmology Department at the University Hospital of Brazzaville. He has published over 20 articles in reputed journals.
Abstract:
Usher's syndrome is defined by the association of congenital sensorineural hearing loss of variable severity scalable or not and retinitis pigmentosa gradually blinding. There are three clinical types according to vestibular dysfunction and degree of hearing loss. Type II we are interested in this presentation is controlled by a gene locus D1S81 the long arm of chromosome 1. In this form, unlike the other two, the acquisition of language is possible and retinitis pigmentosa appears later. This retinitis is progressive and becomes very disabling around the age of 30 years. Neurofibromatosis is an autosomal dominant disease. There are two types. Von Recklinghausen's neurofibromatosis described in this work is the type I. It represents about 90% of clinical forms and is due to an abnormality on chromosome 17. It’s most common ocular disorders are represented by iris nodules of Lisch, plexiform neuroma of the upper eyelid, the optic glioma. The coexistence of both diseases in the same person is exceptional; we found no cases in the literature. This observation brings a unique combination of Usher's syndrome and Von Recklinghausen's neurofibromatosis in a man, aged 40 native of Mauritania born of consanguineous union.
Eriko Sugano
Iwate University
Japan
Title: Analysis of adverse effect caused by AAV-2 encoded modified Volvox channelrhdopsin-1 gene therapy
Biography:
Eriko Sugano has worked as a Researcher in Tohoku University School of Medicine in Japan and received PhD from Tohoku University in Life science. She has worked as an Instructor in Biomedical Engineering Research Organization and International Advanced Interdisciplinary Research, Tohoku University. She is the Associate Professor of Chemistry and Biological Sciences, Iwate University. She has published more than 30 papers in reputed journals.
Abstract:
We designed a modified channelrhodopsin-1 (mVChR1) protein chimera, which has a broader, red-shifted action spectrum than that of Chlamydomonas channelrhodopsin-2. We previously reported that its transduction into retinal ganglion cells could restore visual function in genetically blind rats with photostimuli ranging from 486 to 640 nm. However, it has the possibility that mVChR1-mediated gene therapy causes some adverse effects such as immune response because of the use of the non-human gene. To investigate the safety and influence of mVChR1 transgene expression, adeno-associated virus type-2 encoding mVChR1 was administered by intra-vitreous injection into genetically blind rats. Reverse-transcription PCR was used to monitor transgene dissemination to non-targeted organs and the results demonstrated that their expression was restricted specifically within the eye tissues. Moreover, no excess immunoreactivity was present in standard clinical hematological parameters of plasma and serum. Serum antibodies targeting the recombinant adeno associated virus (rAAV) capsid increased after the injection; however, no increase in mVChR1 antibody was detected during for 10 months after the injection. In addition, retinal histological examination showed no signs of inflammation in rAAV-injected rats. In conclusion, our results demonstrate that mVChR1 can be exogenously expressed without harmful immunological reactions in vivo. These findings will help the optogenetic approach for restoration of vision in late-stage retinitis pigmentosa.
Aman Khanna
Khanna Eye Centre
India
Title: Pterygium excision with conjunctival autograft using various techniques
Biography:
Aman Khanna has completed his MBBS from Maharashtra University of Health Sciences in 2011 and then completed his MS Ophthalmology from D.Y. Patil Medical College, India, Pune in 2015. He has published 3 articles and oral papers and poster in All India Ophthalmology Society Conference and various state level conferences.
Abstract:
Purpose: To study the efficacy and compare the outcome of various techniques used for surgical management of pterygium with conjunctival autograft.
Methods: Retrospective, comparative study of 300 patients undergoing primary pterygium excision with conjunctival autograft using 3 techniques. Patients randomly divided into 3 groups of 100 patients each. Patients were evaluated on 1, 7 and 30 day for inflammation, edema and graft stability, whereas, evaluation was made at 3, 6 and 9 month for recurrence. In group A 8-0 vicryl suture, group B fibrin glue and group C no suture no glue technique was used.
Result: In Group A, 84 out of 100 patients had inflammation, 16 had edema and graft was stable in all cases on post-op day 1. In Group B, 2 out of 100 had inflammation, 1 had edema on post- op day 1. In Group C, 1 out of 100 had inflammation and none had edema on day one. Evaluation made for same on day 7 and 30. At 6 months, 14 patients in group A showed recurrence, whereas, 6 in group B and 4 in group C, similar results observed at 9 month.
Conclusion: Study revealed significant reduction in inflammation and edema in group B and C, as compared to group A and similar results when compared on day 7 and 30. Recurrence also was higher in Group A at 6 and 9 month.
Ravi Kumar Chukka
LV Prasad Eye Institute
India
Title: Visual impairment in patients with leprosy in Adilabad district in South India
Biography:
Ravi Kumar Chukka has completed his Diploma in Ophthalmic Assistant at Kakatiya Medical College, Community Eye Health (ICARE-LVPEI) and COSMEC (LAICO- MADURAI). He has obtained his Master’s in Community Eye Health (ICARE-UNSW- Australia) and MA in Public Administration. He also did PGDCA and LLB. He has been working as an Ophthalmology Officer since last 20 years in Government Medical & Health Department. He has received a State Award in 2008 and Best Research Study Award in International Symposium on Community Ophthalmology at Kolkata in the year 2010. He has also received two national level awards. He serves as a Member of Indian Association of Community Ophthalmology, Lions Club of Bellampally, Coordinator of Lions Eye Hospital Bellampally and Regional Secretary State Ophthalmic Officer’s Association.
Abstract:
Introduction: Leprosy is a chronic infectious disease that impairs the affected individuals in many ways.
Methodology: 184 leprosy patients were recruited for this study from the leprosy treatment cell and 82% of them were examined.
Results: Out of 184 leprosy patients 150 cases (82%) had complete examination, out of which 72 (48%) were females. 72 (48%) persons had multi-bacillus leprosy and the rest had Pausi bacillus leprosy. 19(14%) of the subjects had organ deformities. 76(51%) subjects had eye problems requiring intervention and among this 12(16%) subjects had ocular problems caused by leprosy. Only 26(17%) of the subjects had previously accessed eye care services. Moderate visual impairment was observed in 39(26%) cases without correction and the vision level improved with correction in 20(51%) cases. Blindness related to leprosy was seen 5(3.3%) patients.
Conclusion: Ocular involvement was seen in 8% of leprosy patients. Early referral of leprosy patients with eye problems will reduce the prevalence of blindness in leprosy patients.
Vineet Ratra
Sankara Nethralaya
India
Title: Post-operative endophthalmitis: Prevention and protocols
Biography:
Vineet Ratra specializes in Cataract and Glaucoma sub-specialties. He did his Post graduation in Ophthalmology from Sankara Nethralaya and obtained Fellowship from the Royal College of Surgeons, Edinburgh in 2000. He is currently a Senior Consultant at Sankara Nethralaya. He is an acclaimed Academician and has mentored many postdoctoral fellows. He has nearly 20 publications in peer reviewed journals. He has served on the Editorial Board of the Asia Pacific Journal of Ophthalmology and is a Reviewer of the Indian Journal of Ophthalmology, the Asia Pacific Journal of Ophthalmology and the Eye journal.
Abstract:
Post-operative endophthalmitis is a dreaded and feared complication. It can result in profound loss of vision and can have medicolegal implications. Proper attention towards elimination of the risk factors for post-operative endophthalmitis makes the surgery safer to the patient and rewarding to the surgeon. The common organisms causing endophthalmitis are mainly the commensals. However, variation has been noted by different studies from different geographic regions. A detailed discussion on prevention of endophthalmitis will be presented. Critical analysis of the ESCRS study, preferred practice patterns among surgeons, the world over will be discussed. How beneficial is the current practice of intracameral injection of cefuroxime or moxifloxacin at the end of cataract surgery? Pros and cons of intracameral prophylaxis will be discussed.
Lujain Alkhalifa
Al Faisal University
KSA
Title: Awareness assessment of diabetic eye health in a tertiary hospital in Saudi Arabia
Biography:
Abstract:
Introduction: Saudi Arabia is considered as the seventh highest rate in the world in terms of diabetes incidence with about 3.4 million people having been diagnosed with diabetes in 2015. The recent estimate of the disease showed that 24.4% of the adult population is suffering from DM.
Aim: The objective of this study was to investigate among diabetic population of Riyadh region of KSA their awareness, attitude and practices towards this disease and to provide the participants more knowledge for its complications.
Materials & Methods: Observational cross sectional survey conducted among Saudi population aged 12 years and over who attended diabetic clinic in King Faisal Specialist Hospital in Riyadh (KFSH&RC), Saudi Arabia during October 2016. 59 patients were interviewed to answer a questionnaire which included the demographic profile of the patients, details of their diabetes and awareness of its complications on eye health.
Results: Age of the patients ranged from 13- 88 years with an average duration of diabetes is 8 years. Out of 59 patients, 44% of the patients were from rural areas, 50% were males, 39% had secondary education, 33% were graduates and above and only 18% of the patients had their eyes never been checked in the last 12 months. The awareness of complications of diabetes on eye health among the Saudi population recruited in our study was detected in 83% of the patients. In addition to 82% of the patient have a regular eye exam.
Conclusion: In our study, although 44% of the patients were from rural areas and 33% were graduates, 82% of the participants were aware that diabetes can affect the eyes indicating that the Kingdom of Saudi Arabia had achieved a notable economic growth and improvement in life quality.
- Ocular Microbiology & Immunology | Novel Approaches to Ophthalmology Therapeutics
Session Introduction
Pepin Williams Atipo Tsiba
Marien Ngouabi University
Republic of Congo
Title: Ocular disorders in onchocerciasis
Biography:
Pepin Williams Atipo Tsiba has completed his PhD from Marien Ngouabi University of Brazzaville and Post-doctoral study in Switzerland. He has obtained the Federal Ophthalmology title from the Swiss Medical Federation (FMH) and the FEBO (Fellow European Board of Ophthalmology) title in 2005. He is an Assistant Professor in Ophthalmology at Marien Ngouabi University of Brazzaville. He is the Head of Ophthalmology Department at the University Hospital of Brazzaville. He has published over 20 articles in reputed journals.
Abstract:
Onchocerciasis is a dermal oculocutaneous filariasis caused by Onchocerca volvulus. It is transmitted to humans by the bite of a black fly called Simulium. Transmission is by the blood-sucking female insect. This female insect becomes infected by biting a sick man and then infects a healthy person by another bite. Geographic distribution of onchocerciasis includes tropical Africa, the corresponding region of South America and Central America and Yemen. The adult worm is hosted in subcutaneous nodules where it can live about 10 years, during which the female releases millions of embryos. Those will give life to free microfilariae (Onchocerca volvulus) attracted by the light, which migrating from the dermis to the eye and induce damages responsible of the “river blindness”. The general signs begin around 1 year after the infecting bite and are all the more affirmed that contamination is repetitive; river blindness is a cumulative parasitosis. The general syndrome includes headache, asthenia; weight loss and kidney damage. The cutaneous syndrome is characteristic and dominated by the following signs: pruritus (filarial scabies), lymphoedema, skin pigmentation and subcutaneous nodules (onchocerciasis nodule) harboring the adult heartworms. Ocular disorders are observed in about 70% of people living in endemic areas. They are severe in case of immunosuppression. These ocular manifestations are proportional to rate of microfilariae in the body, and are mainly represented by keratitis and chorioretinitis.
Talal Althomali
Taif University
KSA
Title: Reproducibility of flap thickness in sub-Bowman keratomileusis using a mechanical micro-keratome
Biography:
Talal Althomali is an Associate Professor of Ophthalmology and the Vice Dean of Hospital Affairs at Taif University and a Consultant Physician of Pediatric Ophthalmology at King Khaled Eye Specialist Hospital, Riyadh and King Abdul-Aziz Specialist Hospital, Tertiary and Referral Center in the Western Region, Saudi Arabia. With outstanding educational and research activities, he has excellent experience in surgeries. He is active member of numerous ophthalmology organizations. Actively participated in many ophthalmology meetings including American academy meeting 2014, American Society of Cataract and Refractive Surgeons 2014, European Society of Cataract and Refractive Surgeon 2008-2015, World Congress of Pediatric Ophthalmology and Strabismus 2012 & 2015 and International Ophthalmology Congress 2014, where some of his research was selected to be amongst the top studies.
Abstract:
At present, laser in situ keratomileusis (LASIK) is the most commonly performed refractive surgery worldwide. Creation of a hinged flap of a desirable size, thickness and smoothness using a micro-keratome or femto-second laser is a crucial step in LASIK that can affect not only the predictability but also the safety of the procedure. However, flap dimensions can vary considerably, not only between the various micro-keratomes but also with the same micro-keratome as a result of differing patient characteristics. It is, therefore, important to study the consistency and predictability of corneal flap thickness with the available micro-keratomes. Flap thickness, along with ablation depth and preoperative corneal thickness, determines the thickness of the residual stromal bed (RSB), which has been implicated in the development of iatrogenic keratectasia after LASIK. For example, a corneal flap that is thicker than intended may result in reduced RSB thickness, weakening the biomechanical strength of the cornea. In addition, flap thickness has been linked to a variety of postoperative complications, such as epithelial in growth, flap dislocation, striae, irregular astigmatism and corneal opacities, potentially reducing the success rate of LASIK. It is therefore important to accurately predict the achievable flap thickness for a given intended flap thickness. Several studies have assessed the correlations between preoperative variables and corneal flap thickness in LASIK; subsequently, micro-keratome design and technique modifications have helped minimize the variability in the flap and therefore the incidence of flap complications. In recent years, there has been a growing trend toward the use of sub-Bowman keratomileusis (SBK); that is, thin-flap LASIK with an intended flap thickness of less than 100 µm. Sub-Bowman keratomileusis is a hybrid approach that combines the advantages of surface ablation with those of lamellar approaches. Compared with a conventional (thicker) flap, an intended regular thin flap of less than 100 µm leaves a thicker RSB, thereby preserving biomechanical strength and potentially decreasing the risk for corneal ectasia. In addition, refractive and visual outcomes of SBK have been found to be comparable to or better than those of standard LASIK in terms of faster visual recovery, better predictability, better contrast sensitivity, and a lower rate of enhancements. Even though some studies have documented the refractive and visual outcomes of femto-second laser–assisted and micro-keratome-assisted SBK (thin-flap LASIK with intended flap thickness ≤110 µm), to our knowledge there is a paucity of literature on the safety and predictability of SBK micro-keratomes. Furthermore, despite the emergence of femtosecond laser–assisted flap creation, mechanical micro-keratomes remain the preferred choice or the only available option in the majority of developing countries. Therefore, the current study was designed to examine the predictability of flap thickness using an SBK mechanical micro-keratome and to identify factors that may be related to variations in flap thickness in SBK procedures. Patients with a stable refraction for 1 year, corrected distance visual acuity (CDVA) of at least 20/20 in each eye and minimum central corneal thickness of 480 µm in each eye had microkeratome-assisted SBK. Parameters included manifest refraction, uncorrected distance visual acuity (UDVA), CDVA, pachymetry and higher-order aberrations (HOAs). The micro-keratome was reliable with reasonable predictability for SBK flap creation. Extra caution in handling the flaps to avoid flap striae or tears is advised. Flap thickness correlated positively with preoperative pachymetry; however, the variation in flap thickness did not affect visual outcomes.
Ashraf Armia Balamoun
Al Watany Eye Hospital
Egypt
Title: Challenging decision in traumatic anterior segment cases
Biography:
Ashraf Armia Balamoun has completed his MD from Cairo University of Egypt. He has completed his Master degree in Ophthalmology from Cairo University of Egypt and his FRCS in Ophthalmology from Glasgow, UK. He is a Consultant Eye Surgeon at Al Watany Eye Hospital in Egypt, a Shareholder and a Member of the Board of training program at the same hospital. He has participated in various international conferences.
Abstract:
Case one:
- Male patient 15 years old.
- History of RT. eye blunt trauma since 7 years.
- He developed severe ocular inflammation following the trauma ending by formation of white patchy membrane on the iris and the anterior surface of the lens with 2 points of PAS.
- Complicated white cataract developed.
- Vision is HM GP GMF.
- IOP was 16 mmHg.
- Retina was in place by Ultrasound.
- Post surgey vision improved till 6/60.
Case two:
- Male patient 22 years old.
- History of blunt trauma and with traumatic cataract since 2 years.
- He did cataract and implantation of a three pieces posterior chamber IOL and YAG laser posterior capsoulotomy was done.
- He came after two years asking for better vision and we found that he had a wrong calculated IOL.
- Surprisingly,we found that he need a piggy bag IOL with – 16 D.
- We did not found this power and we thought to use an ICL as a piggy bag solution.
- Post surgery vision improved till 6/24.
Khushnooda Ramzan
King Faisal Specialist Hospital and Research Centre
KSA
Title: Characterization of the genes underlying Usher Syndrome in Saudi Arabian Population
Biography:
Khushnooda Ramzan, PhD in molecular biology works as Scientist in the Department of Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. She got her PhD from Punjab University, Pakistan. During her PhD she mapped new loci for hearing loss by whole genome wide scan, which was a first step towards the later identification of a novel gene in the mapped families. Later, she joined department of genetics, KFSH&RC, Riyadh as postdoc and continued working on the genetics of hearing loss in Saudi families. This led her to an unusual finding that the most common gene GJB2 responsible of hearing loss worldwide does not play a significant role in their population. Her research focus was then focused to investigate the role of other genes and to identify the novel loci/genes within the Saudi Population. She has characterized and documented genetic basis of autosomal recessive deafness in more than 150 families of Saudi Arabian origin; their incidence and distribution were also documented.
Abstract:
Hearing loss is one of the most common sensory disorders in humans with both genetic and environmental etiologies. Genetic causes of hearing loss are extremely heterogeneous and the autosomal recessive inheritance accounts for a substantial part of this disorder. The Usher (USH) syndrome is characterized by congenital sensorineural hearing loss and retinitis pigmentosa (RP). It is the most common form of inherited deaf-blindness with a prevalence of ~ 1/6,000. Three clinical subtypes (USH1-USH3) are defined according to the severity of the hearing impairment, the presence or absence of vestibular dysfunction and the age of onset of RP. So far, ten causative genes have been identified underlying different subtypes of the USH syndrome. Consanguineous families are a powerful resource for genetic linkage studies/homozygosity mapping for recessively inherited disorders. Our study aims to comprehensively delineate the genetic basis and occurrence of USH gene mutations in clinically diagnosed Saudi patients. Whole Genome SNP genotyping coupled with targeted sequencing of the candidate gene was utilized. Our results indicate that in the Saudi Arabian population, MYO7A is the most common gene for USH syndrome. Mutant alleles in other genes (PCDH15, CDH23, USH1C, USH1G, and USH2A) were also identified that provided insight in the molecular basis of USH syndrome in this population. The benefit of this study will hopefully provide the foundation for knowledge and awareness through screening of carrier status, genetic counseling; premarital screening, prenatal and PDG opportunities for multiple family members thereby have a major impact upon early intervention and prevention of hereditary hearing loss.
- Young Researchers Forum
Session Introduction
Daniya Alturkistani
Umm Al Qura University
KSA
Title: Prediction of post phacoemulsification visual acuity in patients with different degree of lens opacity using Heine retinometer
Biography:
Daniya Alturkistani is an ambitious and a hard working student. During her collage years, she participated in many research activities. She was the Head of The Scientific Committee of Medical Students Research Club. She is keen on public presentations and gave many lectures and presentations to junior students.
Abstract:
Objective: The objective was to find the usefulness in predicting the visual outcome in patients who are undergoing cataract surgery by using a convenient and standard instrument.
Patients & Methods: This retrospective cohort study was done using Heine lambda 100 retinometer to find the usefulness in predicting the visual outcome at the Eye Center in King Abdulla Medical City, Makkah, KSA.
Results: It is highly specific in the prediction of postoperative visual acuity (VA) (93.5%). It has higher accuracy 87.5%, sensitivity 86% and specificity 100% in mild cataract than denser one.
Conclusion: The Heine lambda 100 retinometer appears to be a clinically useful device to use in patients with comorbid eye condition such as Amblyopia, macular degeneration and a corneal disease in predicting the visual outcome.
Hadeel Seraj
King Abdulaziz University
KSA
Title: Prevalence, habits and outcomes of wearing contact lenses among medical students at King Abdulaziz University, Jeddah, Saudi Arabia
Biography:
Hadeel Seraj is currently a Medical student at King Abdulaziz University (KAU), Jeddah, Saudi Arabia. She has obtained an Academic Excellence Certificate from the dean of the Faculty of Medicine at KAU for two years. She was honored with the Superior Certificate from the deanship of student affairs at KAU. She is a Class Scientific Committee Leader and an organizer of many medical events. She is a volunteer in mobile clinic project in historical Jeddah and a volunteer with Red Crescent Authority in Almasjed Alharam, Makkah. She has participated in the Saudi Diabetic Awareness Campaign and is a volunteer in ER triage Assistance shifts and Patients’ Visits project at KAU Hospital. She is a participant of Health Promotion Unit of The Fifth Youth in Makkah region, Saudi Arabia.
Abstract:
Statement of the Problem: Contact lenses (CLs) have been prescribed since more than a century for correction of refractive errors, cosmetic purposes and for therapeutic modality. However, complications can occur if users fail to take necessary hygienic precautions.
Objectives: To determine prevalence, cause of use, habits, awareness about CL hygiene and its complications among medical students at King Abdulaziz University (KAU).
Method: A cross-sectional study was done and a multi-stage stratified random sampling was used to select 538 medical students. They completed a self-administered, validated, and confidential questionnaire contained questions about CL use, hygienic practices, and their complications. Both descriptive and analytic statistics were done.
Results: The prevalence of CL use among participants was 40.3% (13.3% and 56.2% among males and females, respectively). Second year students had the highest prevalence of CL usage. Cosmetic purpose was the commonest reason of use. It was found that 30.4% of students renew their lenses annually and only 16.6% of students clean their CL daily. A high prevalence of both conjunctivitis (18.9%) and acute red eye (19.8%) were documented and other complications occur but less frequently.
Conclusion & Significance: A high prevalence (40.3%) of CL use was prevailed among medical students. Female had significantly much higher prevalence of wearing contact lenses compared to males. The commonest cause of wearing CL was for cosmetic purpose. The second year medical students were the most interested group in CL wear. The predominance used types of CL are daily and monthly lenses. The respondents reported good knowledge but weak regarding CL related hygiene (cleaning hands prior application and changing case solution overnight). Acute red eye was the common complication (19.4%).
Recommendations: Providing sound, detailed educational messages for all CL consumers by ophthalmologist and at the dispensing shops about CL hygienic practices is required. Early treatment of complications is recommended.
Suliman Al Teriqi
Imam Muhammad ibn Saud Islamic University
KSA
Title: Prevalence of visual impairment and predictors of poor vision among older adults in Saudi Arabia, national survey
Biography:
Suliman Al Teriqi has completed his MBBS from Imam Muhammad ibn Saud Islamic University, School of Medicine. He is currently working as a Medical Intern.
Abstract:
Introduction and Objectives: Visual impairment is one of the most significant health concerns facing both the developed and developing countries as part of age related disabilities. Globally, number of affected people is growing from total of 161 million in 2004 to 285 million are suffering from visual impairment in 2010. Among these, total blindness constitute up to 39 million while the remainder are affected by different levels of Visual impairment. In Saudi Arabia a recent study showed 3.3% of the elderly are totally blind. Yet no study conducted in Saudi Arabia concerned with the prevalence of visual impairment in geriatric population. Our aim was to quantify the prevalence and to assess socio-demographic and medical factors associated with the risk of VI.
Methods: Data is part of Saudi National Survey for Elderly Health (SNSEH) which is a nationwide, representative, population-based cross-sectional survey of Saudi older adults 60 years of age or older. Using complex sampling methods 2946 individuals were recruited from 88 clusters in the study. The sampling weight was used in adjusting the prevalence calculations. During household visit visual acuity was measured for each participant with recording the information about socioeconomic and medical characteristics for each one. We defined visual impairment into normal or visually impaired, which include mild, moderate and sever. Logistic regression model was developed to assess the risk factors for VI.
Results: Of 2946 participants in the study 1190 (40.4%) were visually impaired. Females represent 632 (43.3) and males 558 (37.6) of the visually impaired individuals. According to the ICD-10 visual impairment definition, moderate VI was the predominant level with 36.5%, sever VI with 2.7%, legal blindness with 1.2 and the reminder 59.6% classified as mild or no visual impairment. Of those who reported normal vision 21% were found to be visually impaired. After adjusting for possible confounders significant risk factors of VI were age, gender, monthly income, educational level, depression, diabetes mellitus, history of stork and use of glasses.
Conclusion: The prevalence of visual impairment is high and affecting large number of older Saudi population. Several socioeconomic and medical factors have shown to increase the risk of VI significantly. National programs should be developed to promote vision health and prevent VI. Visual assessment should be part of older adult assessment for early detection of VI and enhancement of the quality of life.
Gloria George
Manipal University
India
Title: Central corneal thickness: A cross-sectional study over a normal Indian population
Biography:
Gloria George has completed her MBBS from Calicut University, Kerala, India and is presently pursuing her Post-graduation in Ophthalmology at Kasturba Medical College, Manipal University.
Abstract:
To aim of the study was to assess the central corneal thickness and its implications over a cross section of a normal population in India based on the race, age, sex and intraocular pressure. The CCT of 300 eyes of 150 normal patients of different age groups, attending the OPD were measured with anterior segment OCT. IOP was measured using Goldmann Applanation Tonometry. The CCT was then compared with the patient's age, sex and IOP and its significance calculated. The central corneal thickness was seen to vary with various epidemiological parameters in a normal Indian population. The mean CCT was found to be 532.62 microns (±21.71). Males were found to have significantly thicker corneas (540.3±22.7) than females (524.6±17.3) and the average CCT decreased significantly with increasing age. The 16-30 age group had the highest mean CCT of 543.2 and the 61-75 age group had the lowest mean CCT of 515.6, the difference of which was significant (p<0.05). It was also found that in normal subjects who had thicker corneas, IOP was found to be higher with 0.4 mm of Hg increase in IOP for every 10 micron increase in CCT. The implications of these differences are tremendous in the increasing era of refractive surgeries as well as in the diagnosis of glaucoma. The variations in CCT based on various epidemiological parameters have been scarcely studied over an Indian population which could provide valuable information regarding the natural progression of physiological changes in the cornea.
Almaha Saleh Almutlaq
King Faisal University
KSA
Title: Depression, anxiety and early presbyopia in Saudi females
Biography:
Almaha Saleh Almutlaq is currently doing Internship at ​ King Abdulaziz Hospital, Al Ahsa. She has graduated from King Faisal University College of Medicine.
Abstract:
Purpose: Presbyopia among middle age adults especially females can result in potential loss of productivity if not corrected. Owing to the physical and social problems related to eye disease, the purpose of this research is to establish the link between poor eye health and mental health and determine the contributory factors associated with the early onset of presbyopia.
Methods: The research involves 28 female participants with 14 control and 14 with early presbyopia. Participants will be given distance refraction with monocular and binocular visual acuities. One percent of cyclopentolate will be administered to participants between the ages of 30 to 42 years. Participants with any systematic ocular pathology's or anisometropia will be excluded from the study. Important variables of the study to be measured include age, education, income or career, vision variables like vision loss, time of onset. Other important variables include adaptation to vision loss, symptoms of depression and anxiety.
Results: The study findings are expected to generate evidence stating that 50% of females develop presbyopia at an early age and contributory factors like anemia, HTM, Hypothyroidism, and DM. The study results are expected to highlight the severity of depression and anxiety among the different control groups. The study is expected to determine the onset of presbyopia errors among females and the role of increased visual tasks. The data collected from the study needs to prove why females with optometric require their first reading treatment at an early age compared to males.
Conclusion: Study findings prove that vision loss is not only linked to depression but can increase anxiety among female patients diagnosed with presbyopia.
Zain Irfan Khatib
Karnataka Institute of Medical Sciences
India
Title: Smartphone indirect ophthalmoscopy: Evolution and progress
Biography:
Zain Irfan Khatib is a currently a Postgraduate student in Ophthalmology working at Karnataka Institute of Medical Sciences. He has presented papers, posters and videos in various state and national level conferences in ophthalmology.
Abstract:
Smartphones, with their ever increasing popularity and the rapid advances in technology have made their way into ophthalmology as imaging devices for both anterior and posterior segment. Smartphone photography, by using various slit lamp adapters has already become quite popular in capturing anterior segment eye photographs. This presentation highlights the methods of using a smartphone for posterior segment photography. This is based on the principle of smartphone indirect ophthalmoscopy, where the flashlight of the phone is used as a coaxial light source to illuminate the patient's retina through a condensing lens (20 D), which can be visualized digitally and captured by the phone camera. This technique has been gaining popularity due to its rapidity and cost effectiveness in contrast to commercially available fundus cameras. However, the images obtained by the above method are not of a very good quality, and it is a difficult technique to master with a long learning curve. In order to overcome these drawbacks, a simple and cost effective adapter can be made, which can maximize the potential of smartphones to obtain better quality images. This presentation describes the evolution of smartphone ophthalmoscopy, right from its inception and shows how small modifications and newer technologies have helped in improving the outcome of this technique.
Kumar Sambhav
Sharp Sight Hospital
India
Title: Incision on incision technique of wound closure in phacoemulsification
Biography:
Kumar Sambhav underwent his basic medical education (MBBS) from J.N. Medical College, Aligarh and Diploma in Ophthalmology from Institute of Ophthalmology, JNMCH, Aligarh. He pursued his higher education, Diplomate in National Board (Ophthalmology) from Sri Kanchi Kamakoti Medical Trust, Coimbatore. He has spent a year in Sankara Eye Care Hospital, Coimbatore undergoing training in Medical Retina. He has many publications in various peer reviewed national and international journals.
Abstract:
The primary phaco incision is one of the most critical steps of cataract surgery because it not only significantly influences the fluidic balance during surgery but is also important at the end of surgery where corneal stromal hydration ensures watertight closure of the incision. A poorly sealed incision can allow infectious agents from the ocular surface to enter into the eye, leading to increase the risk of complications such as endophthalmitis. Here, we will demonstrate a new method of constructing the primary Phaco-incision which ensures an easy way of good wound closure at the end of surgery. In this technique, firstly an incision in made in superficial corneal layer without entering into the AC at the planned site of primary Phaco-incision. The length of incision should be kept at around 0.75 cm. Thereafter, primary phaco wound is constructed at a deeper plane to the initial incision and the phacoemulsification is done. At the end of surgery, the superficial would is hydrated without touching the main deeper wound. A layer of uniform whiteness due to corneal hydration will be seen which ensures good wound closure. The corneal phaco incision is more than an access point for completing the cataract surgery. A good surgical technique is important to avoid stressing the incision. The surgeon should avoid heating the incision and defer from grabbing the roof of the incision with a toothed forceps. The good wound opposition acts as a barrier for entry of infectious agents. This technique is very impressive in the sense of good stromal hydration and watertight wound closure.