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

Biography:

Beatrice Schuler-Thurner (Head of Experimental Immunotherapy, Head of GMP regulated production and qualified person), is a board examined Dermatologist and has profound experience in “The guidance of a GMP facility”. She has a plethora of experience in “Performing investigator initiated clinical trials with peptide-loaded and RNA transfected dendritic cells”.

Abstract:

Accumulating evidence suggests that T cells recognizing mutated cancer antigens are crucial for successful cancer immunotherapy. They seem to represent the common mechanistic pathway to control tumors and prolong overall survival in active antigen-specific (vaccination) as well as passive antigen-non-specific (checkpoint blockade) therapies. Dendritic cells (DC) besides mutated antigens are the other key to develop better T-based vaccines. Our group has systematically developed the adoptive transfer of these monocyte-derived DC for cancer vaccination loaded with antigens in form of peptides or RNA transfection. In lately secluded trials, high immunogenicity and long-term clinical benefit correlating with certain biomarkers in blood (including simple ones such as eosinophilia) became evident. Using autologous tumor RNA for loading of dendritic cells has the advantage of using not only patient unique mutations as antigens but also the abnormal ligandome generated by abnormal splicing und processing inherent in malignant cells. Following preclinical work and evidence for clinical efficacy in metastatic melanoma, we have started a randomized phase III (NCT01983748) trial in high risk (monosomy 3) uveal melanoma using RNA-transfected DC to vaccinate against the total antigenic repertoire of patient´s individual tumors to retard or prevent metastases after resection of the primary tumor in the eye. A total of 200 patients are randomized into arm A (DC vaccination) or arm B (observation as standard of care). Twenty million mature, monocyte-derived DC loaded with autologous tumor RNA are administered respectively at eight vaccination time points over two years. Objectives are to: Prolong DFS; prolong OS and; induce and measure immune responses. The trial has been started in 2014 and is currently performed in cooperation with Departments of Ophthalmology at eight University Hospitals in Germany (Erlangen, Essen, Hamburg Eppendorf, Homburg/Saar, Köln, Lübeck, Tübingen, and Würzburg).

Biography:

Gustavo Rojas Damiano studied Medicine at Unibersidad Iberoamerican; Ophthalmology at Hospital Elias Santana in Dominican Republic; two year Fellowship in Retina and Vitreous at IPS Boris J. Bajaire in Bogota Colombia

Abstract:

Aim: Aim of this study is to evaluate the effectiveness of the intravitreal implant of dexamethasone 0.7 mg in patients with cystoid macular edema (CME) in a four months period.

Methods: The medical records of three eyes of three patients with CME after cataract surgery who were treated with the implant were made. Baseline and follow-up visits included best corrected visual acuity (BCVA), intraocular pressure (IOP), central macular thickness (CMT) as measured by spectral domain optical coherence tomography was performed at baseline in month one and four.

Results: The mean CMT in the visit prior the implant for the three cases was 473 microns with a mean of 12 mm Hg IOP and a mean BCVA with logMar of 0.53. At first month of the implant of dexamethasone 0.7 mg, the CMT mean was 258 microns, the mean IOP 16 mm Hg and the mean BCVA with logMar 0.3. At 4^th month, mean CMT was 293 microns, the mean IOP 15 mm Hg and mean logMar was 0.23.

Conclusion: The implant of dexamethasone 0.7 mg for patients that have a CME is a real option for treating patients with this disease.

Biography:

Born in March 23 of 1949, medical studies 1967/77, including residency in Cardiology and Artificial Kidney Unit.SFO Member since 1980, SFO Oral Presentation 2005, E Poster and Film 2014/ E poster 2015/16.
EVRS Member since 2006, Best scientific Poster 2006 ASRS/EVRS Meeting Cannes Retina Festival, EVRS Oral presentation Prague2008/Sevilla2012/ and Film Porto2014. All présentations up on the Vortex Vien Occlusion VVO concept.

Abstract:

A dialyzing structure consists of two compartments separated by a semipermeable membrane and animated by opposite flows, which increases the exchange surface. A pressure gradient (a dialyzing bath depression) between both compartments directs fluid and ion exchanges but not necessarily those of gases. Clotting is avoided by heparinization of the hemodialysis blood compartment. According to Poiseuille's law [D=flow rate= ((Πr4)/(8n l))×(P1-P2)], the session’s efficiency depends on the homogeneity and the importance of the blood flow which will condition the exchange surface. All rheological disorder from hyper-viscosity or partial thrombosis will alter this efficiency by reducing flow and condition the presence of deposits called “protein-cakes” on the dialysis membrane, compounded by depression of the bath. The aim of the study was to compare the anatomical and functional unit choriocapillaris/posterior retina [pigmentary epithelium (PE)+outer segments of vision cells (OSVC)] to that of a dialyzing structure. An anatomical structural comparative analysis between an artificial capillary kidney cartridge and the couple choriocapillaris/macular posterior retina is performed. It is confronted with the drusen and pseudo-vitelliform deposit wash-out resorption flows obtained by vortex vein occlusion (VVO) in AMD. That flow will be characterized by the mean of cine angiography ICG and OCT exams before and after VVO procedure. The two compartments are firstly choriocapillaris which may be equated with a dialyzing bath driven by a rather centrifugal flow; secondary the couple PE+OSVC as the dialyzed sector is driven by a centripetal flow. The bruch membrane composed partly of protein glycans (similar to heparin composition) is the semi-permeable membrane. The pressure gradient is consisted by the epithelial pigment physiological one. Drusen and basal linear deposits on bruch's membrane reveals analogy with the “protein-cakes” deposit. The drusen resorption flow observed by OCT follows centrifugal choriocapillaris blood flow direction. That was demonstrated by cine angiography ICG comparison before and after VVO procedure, showing choriocapillaris new recruitment flow restoration and confirming the existence of a dialyzing function. Disruption of the rheological choriocapillaris hemodynamics could limit or alter the function of the dialyzing choriocapillaris upon posterior macular retina and be a starter in some choroidal pathogenic diseases, especially in AMD, where the ischemia is a cofactor recognized. This is for a choriocapillaris supply disease but the dialyzing function impairment could be realized by failure of the venous drainage proximal or distal. In those cases venous staining will provoke consequently local hyper-pressure and create a collection of edema by pigment epithelium pump blockage. Central Serous Chorio-Retinopathy (CSCR) seems to be a concerned disease by this pathogenesis. Anatomical and functional resemblance to that of a dialyzing artificial capillary kidney cartridge, the choriodialysis term is suited to describe the purifying function of the choriocapillaris upon posterior macular retina.

Biography:

Georgii Kliuiev completed his speciality in Medical treatment at Odessa Medical Institute named by N I Pirogov in 1982. In 1982-1988, he has worked as an Ophthalmic Surgeon at Filatov Eye Disease and Tissue Therapy Institute of Odessa. He completed his Doctor of Medicine in 1992. He is the Chief of Ophthalmology department in Health Technology Ltd. In 2015, he got the certificate in Child Ophthalmology. He has published 52 scientific publications and has five patents. He has 35 years of varied experience in Ophthalmic Surgery

Abstract:

The method of micropulse transscleral contact-compression diode laser cyclocoagulation (MTCCLCC) is considered to be safe and rather effective method of treatment for lowering intraocular pressure (IOP) in glaucoma. Especially it is very important for patients that act as resistant to medical and surgical treatment. In recent years, MTCCLCC is becoming a more common procedure as an alternative to surgical interventions for refractory glaucoma, which is difficult to treat. In this context, the aim of our study is to evaluate the effectiveness of our methodology of MTCCLCC in the treatment of patients with refractory glaucoma. To assess the effectiveness of MTCCLCC in 84 patients (88 eyes) with refractory glaucoma, it was researched IOP before and after treatment. The patient’s condition was observed up to three years. MTCCLCC have been repeated if the IOP was not adequate after one month of observation. Data are presented as M±m. For data analysis, paired Wilcoxon test with SPSS 10 was used. Before applying MTCCLCC to patients with refractory glaucoma, IOP was in the range of 18-58 mm Hg on maximum medical therapy. The average value of the group was 33.05 mm Hg. There was a significant reduction already after one day of observation among patients after the one-time treatment of MTCCLCC. These patients had the IOP 24.07±2.06 mm Hg which accounted 72.8% compared with the original data (33.05±1.13 mm Hg). In the average period of observation (7-10 days) was noted a steady decrease of IOP and it was 22.19±1.99 mm Hg 67.1% compared to the original data. After treatment, the IOP of patients was significantly reduced to 20.89±1.78 mm Hg which accounted for 63.2% compared with the original data. The obtained data confirm high efficiency of treatment of patients with refractory glaucoma by using our techniques of micropulse transscleral contact-compression diode laser cyclocoagulation (MTCCLCC). 

Biography:

Ibrahim Kocak has completed his PhD from Istanbul University and Post-doctoral studies from Istanbul Training Hospital and Medipol University School of Medicine. He is an Assistant Professor in Ophthalmology department at Medipol University. He has published almost 40 papers in medical journals

Abstract:

Background: Treatment of pigment epithelial (RPE) detachment (PED) is a controversial issue and there are no recommended guidelines for their management. The treatment options have been laser grid or scattered photocoagulation, photodynamic therapy (PDT), anti-vascular endothelial growth factor (VEGF) therapy with ranibizumab or bevacizumab, nevertheless most of them are reported to be ineffective or with high complication rates.

Method: Large landmark clinical trials like ANCHOR and MARINA did not report the PED response to ranibizumab treatment. A smaller study, pronto, highlighted the resistance of PEDs to ranibizumab therapy compared to sub-retinal fluid and intra-retinal fluid. Similar results were reported for bevacizumab therapy in terms of sub-RPE fluid resistance. However, some promising reports show efficacy of aflibercept in those resistant cases. In our institution’s experience, we have promising results with aflibercept in PED cases.

Results: Aflibercept treatment may have a reasonable rationale by virtue of recalcitrant feature of PED. In previous studies, Major, He, Kanesa, Broadhead all reported reduction in PED dimensions and some of them reported visual acuity improvement. In our institution’s experience, we observed significant decrease in PED dimensions and visual acuity improvement after transitioning aflibercept.

Conclusion & Significance: Aflibercept seems to have promising functional and anatomical outcomes in treatment resistant PED cases. Further investigations are needed to provide a recommended treatment guideline and to define more treatment sensitive subtypes of PED.

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:

Background: Central serous chorioretinopathy is easy to treat when the focus of leakage is obvious; however, in diffuse leakage the treatment is unknown. We use an individualized treatment for CSC based both on traditional procedures and on experimental ones. Laser stimulation therapy can be beneficial even in cases without the typical focus of leakage.

Methods: A group of 88 patients with diagnosed CSC included various, very different findings. We excluded 20 eyes which healed spontaneously within several months and also five eyes where the finding was questionable and it reminded AMD. We treated 30 eyes where the focus was clearly defined with focal laser, even in eyes where the focus was juxtafoveal. Here, we used threshold energy. In nine eyes in which the focus could not be clearly defined, we used threshold or sub-threshold laser into the anticipated focus. In 13 eyes with multiple leakage or diffuse leakage, we used a “stimulation laser” in the areas of leakage, believing in the activation of the RPE leading to the sealing of the area of leakage. In six cases, we first tried topical steroid drops in an intensive mode of application, i.e. every hour within one to two weeks, or Avastin, Triamcinolone, or Eylea injections.

Results: The laser treatment was followed with a complete recovery not only in cases of focal treatment of the leakage point but also in the eyes with very chronic (even lasting seven years) leakage from undefined site. Steroid drops as a mono-therapy also helped with healing of two patients but neither Avastin nor Eylea and Triamcinolone did not bring a convincing effect.

Take home message: CSC can be treated with laser not only in cases with clearly focal leakage but even in cases with poorly defined, only anticipated or diffuse leakage.

Biography:

Zeyad A. Alzaben received his bachelor degree in Optometry (2013) at the Jordan University of Science & Technology (JUST), and the first MSc degree in Science of Vision and Optometry (2014) at the Universitat Politècnica de Catalunya (UPC), and the second MSc degree in Visual Rehabilitation (2014) at Universida de Valladolid (UVa) / Medicine Faculty,  and he is a PhD candidate in Optical Engineering doctoral program (2014-2016)  at Universitat Politècnica de Catalunya (UPC). He is currently employed as full-time optometrist at the Department of Low Vision of Optipunt Eye Clinic (www.optipunt.com). He has conducted two new researches about normal patients and patients affected by pathological myopia using OCT and MAIA microperimeter, waiting the acceptance letters to be published. Student of Corporate Program for Management Development / Advanced Program for Optics Management in ESADE Bussines School in Barcelona (2014-2017). He is looking for helping people, giving the higher care to the elder patients, kids and youths. Using his skills to improve his experiences and keep learning more with respect to the challenges about using his valuable assessments. Making the last aim how could he improve his substantial life. 

Abstract:

Optical coherence tomography (OCT) is a useful non-invasive technique to assess the retina without the need for pupil dilation. In particular, the macular and optic disc areas may be explored in detail and with a high level of spatial resolution. A transversal study was designed in which a spectral-domain 3D-OCT-2000 (Topcon, Inc., Barcelona, Spain) was employed to evaluate several retinal parameters in a sample of 37 young Caucasian adults aged between 12 and 23 years (spherical equivalent from -3.00 to +4.00 D). Normal inter-ocular asymmetry values were determined and 95% inter-ocular difference tolerance values were obtained. Inter-ocular statistically significant differences were uncovered in mean and superior RNFL thickness, as well as in central macular thickness, with larger values in the left eye in all instances, and with tolerance limits of inter-ocular asymmetry (2.5^th and 97.5^th percentiles) of -9.00 µm to 6.00 µm, -28.00 µm to 9 µm and -39.00 µm to 29.00 µm, respectively. In addition, statically significant differences were found between males and females in mean thickness of the retinal nerve fiber layer (RNFL) in the right eye. These findings give support to the exploration of the normal asymmetries of the retina as an effective approach for an early detection of pathologies such as glaucoma. Differences in instrumentation and sample characteristics compromise direct comparison with published research and warrant the need for further studies.

Biography:

Juan Carlos Luna da Costa has completed his formation from Universidade Federal da Paraíba, Resident and fellowship programs from Centro Oftálmico Tarcízio Dias (CENOFT), Brazil. He is the Supervisor of Resident Program at CENOFT. He has published several papers in reputed journals.

Abstract:

Aim: This paper describes a rare case of bilateral symptomatic iris pigment epithelium (IPE) cysts successfully treated with frequency-doubled Nd:YAG laser photocoagulation.

Methods: Frequency-double Nd:YAG laser (532 nm) was the treatment of choice to rupture the wall (cystotomy), drain the cyst content and shrink the remnants of the pigment epithelium, using laser parameters at the lowest effective levels.

Results: Four primary iris cysts at the pupillary margin were treated with laser photocoagulation. Despite the increase of pigment at anterior chamber angle, no complication was observed during six months of follow up.

Conclusions: This is the first paper to describe frequency-doubled Nd:YAG laser (532 nm) photocoagulation as a therapeutic option for patients with symptomatic primary IPE cysts at pupillary margin.

Biography:

Mariyah Selmi is a Junior Doctor at Royal Oldham Hospital, Manchester, United Kingdom. She has completed her MBChB with a 1^st class Honors degree in Imaging Sciences at Kings’ College London. She has multiple publications in the field of Radiology with a special interest in “Radiation awareness and dosimetry”.

Abstract:

CT head examinations may result in irradiation to the lens of the eye, one of the most radiosensitive tissues in the body. Standard CT head examinations expose the lens to approximately 25-103 mGy. The International Commission on Radiological Protection estimates opacity formation with doses as low as 0.5 Gy. In younger age groups, the likelihood of repeat head CT scans is increased and with it the risk of accelerated cataract formation if the lens is not avoided. Common reasons for mal-positioning include confusion, dementia and arthritis limiting mobility; features generally less prominent in the young. Undoubtedly, the diagnostic information gained from CT head scans is vital for management. In emergency cases, the need for rapid scanning may outweigh the risk to the lens; however in non-emergency cases in the young, every effort should be made to avoid this. A preliminary study across Pennine Acute Trust demonstrated >50% inclusion rate of the lens with similar results in other trust. Therefore, it is important for both specialties to integrate knowledge and experience to ensure patient safety. Departmental teaching on positioning of radiographic baseline, setting region of interest and use of head rests to achieve optimum positioning has led to radiographers obtaining anatomically sound images without the need to angulate the gantry incurring a radiation dose penalty; with promising feedback. Using our findings a new protocol is being developed, with the hope to reduce the unnecessary radiation burden to the lens during CT head scans minimizing the risk of visual impairment.

Biography:

I am a final year medical student at University of Liverpool with an interest in academic ophthalmology research. I took time out of training to do a Masters in Research in Eye and Vision Sciences degree at the Institute of Aging and Chronic Diseases in Liverpool. During this time, my research was primarily focused on corneal and ocular surface diseases. This experience broadened my understanding  in corneal and ocular surface stem cell biology using pluripotent stem cells as models. In the next year, I will be taking up a position as an academic junior doctor, which would allow me to further develop my research experience.  

Abstract:

Biography:

Dana Ghazaleh was born and raised in Palestine, and is now a final year medical student at An-Najah National University, Palestine. Her passion for medicine has come to surface ever since high school where she founded a weekly medical show in the school broadcast to promote health and wellness among the community. She has been part of many voluntary projects which fostered her desire more and more in pursuing her career as a physician. During college years, she expressed great interest in providing competent and compassionate care for a wide variety of patients. Moreover, she realized the role of scientific research as a major contributor to medical care development, so she became a research assistant. Dana was the student representative for a whole of 4 years. Her professional interests include internal medicine and ophthalmology. In her spare time, she loves reading novels, she also enjoys outdoor activities such as Tennis and swimming 

Abstract:

Biography:

Mayla Myrina Bianchim Monteiro is a Speech Therapist, Post-doctoral student in Health interdisciplinary and Rehabilitation at State University of Campinas, School of Medical Sciences. She has knowledge in the areas of language and visual impairment.

Abstract:

Introduction: The growth of the elderly population led to interest in studies of aging and the quality of life. Aging well depends on the balance between the limitations and potential of the individual who selects priority areas in this stage of life and have different motivations and abilities. Among the limitations that occur as age advances, those related to vision and importance are regarded as priorities.

Aim: Aim of this study is to evaluate the quality of life of elderly with visual impairment focusing on optical aids and routine activities through the LVQOL and VFQ-25 questionnaires.

Method: Two questionnaires on quality of life, LVQOL and VFQ-25 were applied before and after therapeutic intervention within thrice-monthly meetings.

Results: 52 subjects of both sexes were studied, 41% aged between 60 and 70 years; 38% between 71 and 80 years and 21% over 80 years. The main causes of low vision found were macular degeneration (38%), cataract (38%), glaucoma (20%), diabetic retinopathy (10%), and optic nerve atrophy (5%). Regarding the use of optical aid before the intervention, 37 subjects (61%) were using the aid, and after the intervention these figures rose to 45 subjects (86%).

Conclusions: After participating in the therapeutic intervention, the elderly were prone to improvement in performing not only the daily activities, but also using of optical aids, as well as in reading and writing activities, leading to a better quality of life.

Biography:

Wino Vrieda Vierlia completed her Medical degree at University of Brawijaya, Indonesia in 2007. She has been interested in Neuro-ophthalmology subdivision and has joined some courses to improve the knowledge. She has attended several international ophthalmology conferences.

Abstract:

Traumatic isolated sixth cranial nerve palsy is a rare condition that has been reported to be as low as 1% to 2.7% following traumatic brain injury. The sixth nerve innervates the ipsilateral lateral rectus which abducts the eye. Isolated loss of lateral gaze with no other cranial nerve signs and muscular entrapment is thought to be resulted from an injury to the peripheral nerve along its course from the brain stem to the lateral rectus. We presented a case of traumatic isolated unilateral sixth cranial nerve palsy in a 44-year-old female patient who was referred to our department with diagnosis of head trauma and multiple facial fractures after an alleged motor vehicle accident. She had suffered traumatic brain injury and transient altered level of consciousness. She complained of diplopia and restriction movement in the lateral gaze of left eye with no diminution of vision noted in both eyes. An urgent brain magnetic resonance imaging (MRI) revealed zygomatic comaxillary complex fractures and retrobulbar hemorrhage of the left eye with cerebral edema. Eye examination showed isolated sixth cranial nerve palsy. Vision tests and fundoscopy examination were normal. She was undergone open reduction and internal fixation to treat the facial fractures. Systemic steroid treatment with tapering dose was also given postoperatively. Improvement of the lateral gaze restriction and reduction of diplopia were gained after ten weeks of follow up.

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: