Day 1 :
Keynote: Long-term results of accelerated trans-epithelial cross-linking for keratoconus with osmotic riboflavin solution (ParacelTM)
Time : 09:10-09:40
Roberto Pinelli graduated in Medicine and Surgery at the State University of Milan, and specialized in Ophthalmology. He trained in refractive surgery with Dr Michael Gordon at the Vision Surgery Laser Center in San Diego, the United States (currently the Gordon-Weiss-Schanzlin Vision Institute). In 2013 he undertook a new project in the Canton of Ticino, SERI Switzerland Eye Research Institute in Lugano, an eye surgery and ophthalmology research institute and care centre for visual defects and all kinds of eye diseases. Until 2014, he was a lecturer in corneal pathology and refractive surgery techniques at the ESASO, European School for Advanced Studies in Ophthalmology in Lugano. An ophthalmology and eye surgery specialist with the FMH (Swiss Medical Association), he has pioneered leading-edge surgery and innovation in ophthalmology, including P-Curve for presbyopia correction, osmotic transepithelial corneal cross-linking for the treatment of keratoconus, and the ParaCel eyewash. He was invited to join the exclusive International Intra-Ocular Implant Club (IIIC) for surgeons founded by Sir Harold Ridley. In 2009-10, in view of his groundbreaking research activity in the field of refractive surgery and the science of vision, he was invited to join the executive committee of the world’s most prominent ophthalmology association, the American Academy of Ophthalmology (ISRS/AAO). Currently a member of the Scientific Advisory Board of Biosyntrx (Colorado Springs, Colorado), a biotech company operating in the field of ophthalmology, and the Medical Advisory Board of Avedro (Waltham, Massachusetts), a leading company in the calibration of instruments and devices for eye pathologies.
Aim: The aim is to present the long-term results of accelerated transepithelial cross-linking (CXL) for keratoconus with osmotic riboflavin solution. Methods: Patient with progressive keratoconus had accelerated transepithelial CXL. Visual and refractive outcomes and the endothelial cell density /ECD) were evaluated preoperatively and postoperatively. Results: Thirty-five patients were examined unilaterally; postoperatively 35 eyes were evaluated at 3 months, 6 months, 1 year and 2 years form the treatment. No intraoperative or postoperative complications occurred. The mean uncorrected distance visual acuity improved significantly form 1.12 ± 0.60 logMAR preoperatively to 0.68 ± 0.49 logMAR at the last follow up and the mean corrected visual acuity form 0.37 ± 0.25 logMAR to 0.09 ± 0.15 logMAR, respectively. The mean steep and the mean flat keratometry readings decreased significantly form 54.71 ± 5.26 diopters (D) and 46.82 ± 3.29, respectively, preoperatively to 46.82 ± 3.69 D and 44.93 ± 3.61 D, respectively, at the last follow-up. The mean corneal astigmatism improved significantly from -6.75 ± 4.38 D preoperatively to -2.50 ± 3.10 D at the last follow-up. No significant ECD alteration occurred. Conclusion: Accelerated trans-epithelial CXL was effective and safe in keratoconic patients over a long-term follow-up.
Hospital Sant Joan de Deu de Barcelona, Spain
Time : 09:40-10:10
Joan Prat has completed studies in Medicine (Autonomous University of Barcelona) and Ophthalmology in 1991. From 1991 to 2002 he worked in orbital diseases in Bellvitge Hospital (Barcelona) and later became the Head of Department of Pediatric Ophthalmology in Hospital Sant Joan de Déu de Barcelona until today. He has innovated in eyetracking both in research and development of medical devices for pediatric use and has been attending conferences in WCPOS and EPOS. He is now the Director
of Master’s degree in Pediatric Ophthalmology in Barcelona University and President of Spanish Society of Ocular and Orbital Plastic Surgery.
Psychiatric disorders are usually evaluated through different specific methods such as interviews, questionnaires or family references. The lack of known biomarkers is an important problem to have an objective diagnosis, that is why researchers have been studying the presence of ocular signs associated to several psychiatric disorders in the last two decades. Ocular motility alterations have been found using eye-tracking devices consisting on infrared video cameras and a computer vision software. Schizophrenia has been the most studied disorder, characterized by some defects in smooth pursuit movements. Patients can not follow a target in a medium velocity and have more frequent compensatory and intrusive saccades. Convergence defects and abnormal patterns of scene scanning have been observed, too. Other physical observations are thick retinal venules and thin retinal nervous fiber layer with OCT. These biomarkers can be used to identify adolescents with risk to present psychotic disorders, due to these alterations can appear earlier. Other disease well documented in children is the attention deficit hyperactivity disorder (ADHD). The characteristic failure of inhibitory systems of ADHD seems to produce abnormalities in saccades, specifically in antisaccades. Likewise, an improvement of saccades has been observed after treatment with amphetamines. One of the most important advances are related with early diagnosis of autism (ASD). In visual preferences test, ASD toddlers show preference to look at geometric images instead of faces and other social images, contrary to well-developed children. Moreover, several studies including 6 to 24-month children show a correlation between the performance of the test and the presence and severity of the disorder. In conclusion, the study of ocular biomarkers by noninvasive eye-tracking techniques in psychiatric disorders can help to obtain an early diagnosis, a better categorization and a better treatment. We encourage pediatric ophthalmologists to collaborate with mental health professionals in eye-tracking diagnosis of psychiatric diseases.