Focus on the future of ophthalmology in ancient Japan

Sean Henahan has just returned from Kyoto where more than 500 cornea specialists from throughout Asia and beyond gathered for the 2nd Asia Cornea Society Biennial Scientific Meeting.

Japan's ancient capital, showing its best autumn colour, served as backdrop for the conference, the theme of which was An Enlightening Focus on the Future.

"For 40 years, not much was happening in cornea, there was PK and that was about it. But now it has become one of the most exciting fields in ophthalmology. We are seeing a major paradigm shift over the past few years. The rationale for creating the society was to provide opportunities for networking among the Asian countries and the international societies, and to allow for networking, education and research,"  Donald Tan MD, president of the Asia Cornea Society, told EuroTimes.

The meeting served as an occasion for the announcement of two major initiatives by the Asia Cornea Society. The first of these is the creation of Association of Eye Banks of Asia (AEBA). The concept of this programme is to create standards for the collection, preparation, storage and delivery of donor corneas throughout Asia. The first phase, now under way, involves revamping the Sri Lanka Eye Bank, historically one of the leading centres in Asia.

"Asia has the highest rate of corneal blindness in the world. So we are taking a problem solving approach to this. That is the rationale for the AEBA. The ultimate goal is to create high quality local eye banks that are able to procure local donors and make corneas available locally, and eventually to be able to export any excess tissue."

The second initiative announced at the conference was Asian Cornea Society Infectious Cornea disease Study (ACSICS). The one-year prospective observational study will involve 11 sites in eight countries. These will document the extent and impact of keratitis in the region. Researchers aim to learn more about risk factors, aetiology, regional characteristics, antibiotic resistance etc. This will ultimately allow for the creation of meaningful practice guidelines, Dr Tan said.

The four-day meeting served up everything from essential basic research to the latest therapeutic strategies for the full spectrum of corneal disease.

Cornea specialists were probably the first to use stem cells therapeutically, by way of cell transplantation for ocular surface reconstruction. There have been considerable advances in that field, with major contributions from Japanese investigators. Attendees heard about current efforts to use cell sheet transplantation. In addition to cultivated limbal epithelial transplantation, researchers are now using cultivated oral mucosal epithelial cells, autologous nasal mucosal cells, and even ear perichondrium cells for ocular surface reconstruction.

Keratoconus continues to be a bread and butter issue for cornea specialists. Joseph Colin MD, Bordeaux, France, presented the latest findings on treating the disease with Intacs, and collagen cross-linking, alone and in combination.

Contact lens related ocular infection also continues to be a problem. Prof John Dart of Moorfields Eye Hospital in London presented a  large-scale epidemiological study of contact lens related keratitis. The largest study of its kind, it details differences in rates of Acanthamoeba keratitis, which is almost unheard of in continental Europe, but is an ongoing problem in England. More than 90 per cent of cases of contact lens related keratitis could be prevented with proper patient education and hygiene, he reported.

Conference delegates also got an update on corneal and lenticular refractive surgery. Hiroko Bissen-Miyajima MD, Tokyo, Japan discussed LASIK enhancement in patients who have received multifocal IOLs. She also presented information on new IOLs available for microincision cataract surgery.

The genetics of corneal dystrophies was another topic of interest, with considerable advances in screening for these disorders. Akira Murakami MD described early work using a hydrogel contact lens as a device for single gene transfer. He reported early success in animal work delivering a gene via a special contact lens a single gene disease. This approach also has broader potential for treatment of various corneal disorders, he noted.

Look for comprehensive coverage from the conference in upcoming issues of EuroTimes.

EuroTimes wins design award

Paddy Dunne, senior designer, EuroTimes, has won the Designer of the Year (Business Magazines) award 2010.

The judges of the award presented by Magazines Ireland said they saw evidence of major design innovation and excellence with a refreshing new look for the magazine following its redesign earlier this year.

"I believe the rebranded issue of EuroTimes vastly improves on the previous template," said Paddy in his submission for the award.

"Reader feedback on our new look has been very positive. With every issue since June 2010, we strive to make further improvements giving our readers a much more satisfying reading experience. This rebrand has given our product a massive reinvigoration and it is for these reasons that I believe EuroTimes eligible for Best Designer in B2B."

After accepting his award Paddy also paid tribute to EuroTimes assistant designer Janice Robb who played a major factor in the 2010 redesign.

Colin Kerr, executive editor, EuroTimes, said that winning the award was a major recognition for the magazine.

"This was very much a team effort and I would also like to thank the editorial and marketing team at EuroTimes and our international Editorial Board headed by Dr Emanuel Rosen, chairman of the ESCRS Publications Committee," he said.

For more information visit http://www.ppa.ie

ESCRS symposium on emerging lenticular options at AAO/ISRS refractive subspecialty day

Light-adjustable lenses that may be used to achieve emmetropia in post-LASIK cataract patients or increase binocular depth of field through selective manipulation of asphericity in mini-monovision were among the growing list of lenticular refractive options presented at the ESCRS symposium at the 2010 AAO annual meeting refractive subspecialty day sponsored by the International Society of Refractive surgery.

As in laser vision correction, a slight negative asphericity in the eye targeted for near in mini-monovision also has been shown to increase depth of field in pseudophakic patients, noted Jose Guell MD, Barcelona, Spain. “It can be a very useful tool for presbypoia improvement,” he said.

However, there are important limitations in applying it for IOLs, Dr Guell said. The tolerance for spherical aberration is limited to about 0.2 microns and achieving this level of precision can be difficult. For one, the degree of asphericity is related to the degree of residual astigmatism, so an accurate spherocylindrical correction is essential. The effects of lens decentration, tilt or rotation also affects asphericity and other higher order aberrations, and small lens movements could increase aberrations beyond the tolerable range.

Light-adjustable lens may be one way to address these issues, Dr Guell suggested. The power and asphericity of the lens can be adjusted after surgery. Laser corneal enhancements are another option and may be possible in conjunction with light-adjustable lenses, he added.

In a study presented by Roberto Bellucci MD, Verona, Italy, 20 eyes implanted with light-adjustable lenses were found to have higher levels of spherical aberration, resulting in their aberration-derived Strehl rations being similar to those seen in spherical monofocal lenses. He believes the increased asphericity, which averaged 0.118 +/- 0.044 microns for the eye, was most likely due to the reshaping of the lens with ultraviolet pulses after surgery. This resulted in a myopic shift of about 0.9 dioptre with an increase in pupil size from 4 mm to 6 mm.

However, and somewhat unexpectedly, the light-adjustable lenses did not result in higher levels of coma or other asymmetrical aberrations, Dr Bellucci noted. “From a clinical point of view all our patients were satisfied and reported good uncorrected vision. It can be postulated that the increased depth of focus involved with the high spherical aberration played an important role in this satisfaction.”

A study of 26 eyes implanted with the Crystalens HD accommodative IOL by Ioannis Pallikaris MD PHD, Crete, Greece, (pictured above with the other ESCRS presenters) found that the lenses produced a good range of vision even when implanted in the sulcus. Mean uncorrected distance vision improved from 0.41 +/- 0.21 to 0.70 +/- 0.19 on a decimal scale, and corrected vision improved from 0.66 to 0.87. At intermediate distances 80 per cent of patients achieved J1 and at near 70 per cent were J3 or better. The three patients with sulcus-implanted lenses also demonstrated accommodation, Prof Pallikaris said.

Joaquim Neto Murta MD, Coimba, Portugal, presented results on a new rotationally nonsymmetrical multifocal lens without Fresnel lines. The pupil independent lens has an aspheric asymmetrical distance zone combined with a sector near zone with a +3.0 add to minimize light loss and light sensations. The lenses provided adequate vision, were stable and provided good contrast sensitivity, he said.

Also presenting were Oliver Findl MD, Vienna, Austria, on add-on lenses to correct residual sphere and cylinder error and Beatrice Cochener MD, Brest, France on refinements in toric implantation. She emphasised the importance of meticulous technique, including removing all viscoelastic from the chamber, to help minimize lens rotation after surgery.

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ESCRS celebrates 20th anniversary of LASIK with new consumer website

Marking the 20th anniversary of LASIK and the European Year of LASIK, the ESCRS has launched “LASIK Safe in Our Hands” (www.LASIKSafeinOurHands.com), a consumer-oriented website dedicated to getting out the facts about LASIK surgery. The website is the centrepiece of a new campaign to address through education lingering concerns about the procedure held by many who have not had LASIK.

European patients who have experienced the benefits of LASIK surgery are nearly unanimous in their enthusiasm for the procedure. A staggering 98 per cent confirmed they would recommend it to someone else, according to an international survey conducted this spring by the well-known Opinion Health poll.

Even so, four out of five respondents who had not had LASIK still had concerns – even though 69 per cent agreed that eye surgery is a safe and well-established procedure. Of those expressing reservations, the greatest number, 30 per cent, said they needed more information. Another 24 per cent didn’t think they could afford it. Potential side effects were the major worry of 17 per cent while 11 per cent said they would not consider the procedure.

“LASIK can be a life-changing procedure, but these survey results show that people do not understand just how safe and effective modern LASIK is in the hands of a well-qualified and experienced laser surgeon. We hope that our new campaign will help bridge the information gap so that more people might benefit from good vision without glasses or contact lenses,” said ESCRS president Jose Guell MD, Barcelona.

Dr Leigh Speilberg wins EuroTimes writing prize for young ophthalmologists

The winner of the 2010 John Henahan Prize is Dr Leigh Spielberg. The writing prize for young ophthalmologists is sponsored by EuroTimes on a specially chosen theme. This year’s theme was “The Outstanding Memory of My Residency.”

Dr Emanuel Rosen, the chairman of the judging panel, presented Dr Spielberg with his prize during the Young Ophthalmologists’ Forum. He said that the standard of entries had been very high, but in the end there could be only one winner.

“A physician colleague once commenting upon the importance of taking a detailed history observed that this aspect of medical management was an equally important principle in ophthalmology as in medicine in general,” said Dr Rosen. “He then went on to comment on an ophthalmologist colleague who achieved this end by asking of a patient ‘which eye?’

“Dr Spielberg’s account of his outstanding memory of his residency confirms that not only does he write very well and maintain the readers’ interest throughout his essay, but that as a budding ophthalmologist he shares empathy with his patient. He was meticulous in his documentation of the particular disorder and managed personal follow-up of his patient, an action not always possible in a busy ophthalmic department where care is shared amongst colleagues.

“Dr Spielberg is correct in recognising that ophthalmology is not only the medicine of the organ of sight but is dependent more than most medical specialties on diagnosis being mainly dependent on visual observations notwithstanding his recognition of the value of historical detail,” he said.

Dr Rosen also thanked the other members of the judging panel: Jose Güell, president of the ESCRS; Oliver Findl, chairman of ESCRS Young Ophthalmologists’ Forum; Sean Henahan, editor of EuroTimes; Paul McGinn, editor of EuroTimes and Robert Henahan, contributing editor of EuroTimes.

Dr Spielberg is an ophthalmology resident at the Rotterdam Eye Hospital in the Netherlands. Originally from Long Island, New York, Dr Spielberg studied medieval and ancient history at Yale University before completing his medical studies in Belgium. After medical school, he conducted two years of vitreo-retinal imaging and therapy research in the departments of ophthalmology in the Leuven University Hospital and New York Eye & Ear Infirmary. His interests include travel, photography, alpine skiing and medical writing.

“Participating in the EuroTimes John Henahan essay competition gave me the opportunity to write about the medical profession and the doctor-patient relationship in a freestyle manner for a select readership of ophthalmologists. I am very honoured to have been selected for this year’s prize,” he said after receiving his award. Dr Spielberg’s prizewinning essay will be printed in the October edition of EuroTimes.

ESCRS president Jose Guell highlights spirit of collaboration at Opening Ceremony

Welcoming delegates to Paris at the official Opening Ceremony of the XXVIII Congress of the European Society of Cataract and Refractive Surgeons (ESCRS), Jose Guell, president of the ESCRS, said that the success of this year’s meeting looks set to mark a new stage in the evolution of the society.

“On behalf of the ESCRS, I would like to say how pleased we are to be holding the first ever joint meeting of our own Congress alongside that of the European Society of Retina Specialists (EURETINA). Although both organisations have their own significant programmes, several joint symposia have been organised, emphasising the spirit of collaboration and cooperation between our two organisations for the benefit of all our members,” he said.

Dr Guell noted that joint meetings such as this year’s ESCRS/EURETINA one offers delegates a compelling proposition in difficult economic times and with an increasingly crowded ophthalmic calendar.

“At a time when we all have to choose carefully which congresses to attend, this model of offering delegates two complementary meetings seems very valuable, with almost 6,000 delegates registered for the ESCRS and around 2,800 for EURETINA this year,” he said.

Building on the success of this year’s joint meeting, Dr Guell informed delegates that next year’s ESCRS Congress in Vienna will take place in conjunction with the second EUCORNEA meeting.

“I hope that this collaboration of two subspeciality organisations that have such close links will also prove beneficial for our members and delegates,” he said.

At the Opening Ceremony Dr Guell presented the Ridley Medal to Dr David Spalton (see picture). Dr Guell also announced that the ESCRS Board had unanimously decided to elect Dr Peter Barry from Ireland as the next President of the Society, taking office at the beginning of 2012.

Japanese doctor wins ESCRS Video competition for ophthalmologists

Dr Junsuke Akura, Japan, was presented with the Overall Prize in the Annual ESCRS Video Competition from Dr Jose Guell. There were 120 entries for the competion and the judges chose Dr Akura’s video on “Advanced KITARO WetLab –Development of High Quality Artificial Lens for Phaco Surgery Training" as the outstanding entry.

Paris welcomes delegates to the 10th EURETINA Congress and XXVIII ESCRS Congress

Thousands of delegates have arrived in Paris, France, for the 10th EURETINA Congress and XXVIII ESCRS Congress.

In a special guest editorial in September's EuroTimes Béatrice Cochener MD, president of the French Society of Ophthalmology (Société Française d’Ophtalmologie – SFO) welcomed delegates to both meetings.

"Outstanding scientific programmes are planned, with numerous lectures, presentations, courses, posters and videos. Leading experts of these two sub-specialities (or “hyper”-specialities), will present the latest scientific knowledge in research and state-of-the-art of ophthalmology,” she said.

“This 'ecumenical' pursuit towards reliable standards of treatment in medical science, the importation of knowledge and skills through modern methods and the rational policy in affording care services, is an important point that ophthalmologists of different expertise are striving for,” said Prof Cochener.

EuroTimes is offering delegates a bumper 6o-page issue of Europe’s leading ophthalmology magazine. Eight thousand copies of the issue will be inserted in delegates' bags at the conferences.

Berlin celebrates WOC ® 2010 in spectacular style

DRAWING inspiration from the past, present and future of ophthalmology, delegates from all over the world gathered yesterday for the spectacular Opening Ceremony of the World Ophthalmology Congress® (WOC®) 2010.

Over the course of five days, Berlin, the celebrated capital of Germany, is set to provide the perfect backdrop for the WOC 2010, sponsored by the International Council of Ophthalmology (ICO) and organised in conjunction with the German Society of Ophthalmology (DOG) and the German Academy of Ophthalmology (AAD).

Welcoming delegates in his role as WOC® 2010 president, Prof Gerhard K Lang said that he was honoured and delighted that the prestigious WOC® 2010 was taking place in Berlin.

“It is wonderful and rewarding to see so many ophthalmologists from all over the world make their way to Berlin for WOC® 2010. May I take this as an expression of your sympathy to share the different challenges we are all facing as ophthalmolgists. For instance, in some countries, one single ophthalmologist covers the eye care of a million or more people with more or less adequate equipment,” he said.

Dr Lang said that whatever the difficulties faced by the ophthalmological profession in the future, those involved in eye care should never forget that a major source of strength and inspiration lies in the common bond that united all ophthalmologists.

“Among the eye doctors present at this meeting and coming from over 140 countries, there are many of us practising with different methods, on different levels with different equipment and with different training. However, although there may be many challenges in the life and work of ophthalmologists around the world, there is one thing that we should always keep in mind and that is the wonderful profession of ophthalmology and its community which always brings us together,” he said.

Bruce E Spivey MD, current president of the ICO, also welcomed delegates to Berlin for what he said should prove to be the most stimulating and rewarding WOC Congress to date.

“It is an honour to be here with you in Berlin, a truly international city of history, sophistication, beauty and charm. Berlin provides all the scientific and social sustenance to this 32nd International Congress of Ophthalmology meeting, the World Ophthalmology Congress® of 2010. This congress promises to be a marvellous experience for us all,” he said.

Dr Spivey paid special tribute to the individuals who had put together a first-class Scientific Program for the WOC® 2010.

“The world is shrinking and ophthalmology is an international family that brings us together closer than ever before. On behalf of the over 150,000 ophthalmologists in the world, I want to congratulate Dr Stephen Ryan and Dr Gabriele E. Lang on the excellent Scientific Program they have developed for this meeting. We owe them both a debt of gratitude for their work,” he said.

Dr Spivey also reminded delegates of the ophthalmologists’ noble goal to reduce the burden of blindness worldwide and called for greater solidarity in delivering eye care to those areas in the world where it was needed most.

During the Opening Ceremony, several prestigious international awards, including the International Duke Elder Medal, Gonin Medal, Jules Francois Golden Medal, Bernardo Streiff Gold Medal and the Naumann Award were presented to Mohammad Daud Khan MD, Alan Bird MD, Gisele Soubrane MD, Gullapalli N Rao MD and Ursula Schlötzer-Schrehardt MD respectively for their services to ophthalmology.

Delegates were also treated to some stunning high-definition video sequences of the eye compiled by Karl Brasse MD and the team at Eyeland Design. A fulsome tribute was also paid to Albrecht von Graefe, pioneer of the ophthalmoscope and perhaps the most celebrated German ophthalmologist of the 19th century.

Award winning film director premieres Going Blind in Berlin

GOING BLIND is a  new documentary by New York based Peabody Award-winning director and vision advocate Joseph Lovett. Joseph Lovett has lost considerable vision from glaucoma. and he has decided to  premiere  his film at WOC®2010 .

Filmmaker Joe Lovett and producer Logan Schmid will be present at the screening, which is being held at 4pm  on Tuesday, June 8 in the Stockholm Room.

GOING BLIND is paving the way for an international national grass roots campaign aimed at preventing blindness by treating eye diseases effectively, educating the general public on how to learn to adapt to various forms of vision loss and illustrating the effectiveness of low vision therapy. The World Ophthalmology Congress is the longest continuous international medical meeting, which consists of the top speakers and experts in the field of eye-care.

The film follows Joe through five years of struggle to save his remaining vision. During that time he seeks out people who have already lost their vision from diseases like art teacher Jessica Jones (Diabetic Retinopathy), architect Peter D’Elia (Age-related Macular Degeneration), Seeing Eye Outreach Coordinator Ray Kornman (Retinitis Pigmentosa), Veterans Administration worker Patricia Williams (Glaucoma and Traumatic Injury), 11 year old Emmet Teran (Strabismus) and Iraq War Veteran Steve Baskis (Road-side bomb attack).

“GOING BLIND is an essential first step in taking action to preserve the gift of sight and address one of the prevailing health issues affecting millions of people worldwide,“ said Lovett. “We are pleased by all of the interest the film has received thus far, particularly by our inclusion in The World Ophthalmology Congress,” he added.

The World Premiere in Berlin will be followed later this month by an exclusive screening at Harvard Medical School and the Massachusetts Eye and Ear Infirmary Vision Rehabilitation Center in Boston, Massachusetts, with leading eye-care professionals. GOING BLIND will then platform into additional local communities across the United States with the support of various vision advocacy leaders and organizations, culminating in the celebration of World Sight Day on October 14.

GOING BLIND draws attention to the importance of sight loss and low vision therapy issues by seeking to raise awareness through several platforms, including the development of an online education tool kit, sponsored panels hosted by prominent vision leaders, and much more.

Major supporters of the film to date include: The National Eye Institute (USA), Readers Digest Partners for Sight Foundation, Pfizer Ophthalmics, The Allergan Foundation, Allene Reuss Memorial Trust, and The Gibney Family Foundation.

For more information or interviews, visit: www.goingblindmovie.com

Art Auction at WOC® 2010

Delegates attending WOC® 2010 have the opportunity to purchase modern works centered on the theme of “Art in the Art of Healing”. In the works of art donated by Georg Thieme Verlag, renowned contemporary artists have dealt with the fascination of the human body, and also its fragility and limitations. This has resulted in the creation of impressive works of art, which are available for purchase as hand-signed, numbered serigraphs (limited edition of 250).

Founded in 2008 by the German Society of Ophthalmology (DOG), Stiftung Auge is dedicated to fighting avoidable blindness and serious visual impairment. Its commitment is to raising awareness, training and the promotion of research to preserve vision. If you would like to support the work of Stiftung Auge, join the bidding and see what delights your eye.

The artists featured in the auction are Peter Halley, New York,Rosemarie Trockel, Cologne (whose picture is featured above), Marc Francis, London,Laurence Weiner, New York and Matt Mullican, New York

Their work will be on exhibition in the main foyer of the ICC next to the Stiftung Auge stand. The value of each work is estimated at at least 1,300 Euro. Delegats can join the auction by making an opening bid of 300 Euro.

Should you wish to bid in the auction, you can have your name entered on a list of bidders at the Stiftung Auge stand.

WOC 2010 offers something for everybody

The World Ophthalmology Congress (WOC) 2010 promises to offer something for every one of the expected 10,000 international delegates coming to Berlin from all corners of the globe.

WOC president Prof Gerhard K Lang, Ulm University Clinic, Ulm Germany, in an interview with ET Today, the official newsletter of the Congress, said the diversity of the meeting makes it so special.

"Every country has its own set of problems and challenges in ophthalmology. What unites us all, however, regardless of where we come from and which challenges face us, is the conviction that we share the most interesting, aesthetic, and elegant specialty, ophthalmology,” Prof Lang said.

Prof Lang believes that eye doctors who travel from far away to attend the WOC have a right to expect a sterling scientific program. Also, colleagues should be able to discuss topics of interest and hear different viewpoints. Exchanging experiences is highly beneficial and makes the world congress a unique setting for learning and meeting new challenges, he said.

“The challenges met by the pioneering German ophthalmologist Albrecht von Gräfe involved separating ophthalmology from surgery, as its own area of specialisation. Those were very exciting times. Today our challenges are new and different. Today, the ophthalmic industry is so vast and progressive that we have to find ways to pay for the high level of refinement we have achieved. We have worked beyond excimer laser surgery and have now reached the frontiers of macular degeneration and presbyopia. There is hardly another specialty that can keep up with the advancements seen in ophthalmology. We too are living in very interesting times,” he noted.

For the full interview get your copy of ET Today which will be distributed free to delegates on Saturday June 5 in the Congress Centre.

Dr Emanuel Rosen is ASCRS honoured guest

Emanuel S Rosen MD, FRCSE, FRCOphth was one of two honoured guests of the American Society of Cataract and Refractive Surgery (ASCRS) annual meeting in Boston.

Dr Rosen, picture receiving his award from R Doyle Stulting Jr MD, incoming ASCRS president, was recognised for his role in advancing anterior segment surgery as founding co-editor of the Journal of Cataract and Refractive Surgery (JCRS).

“In 1995 Emanuel Rosen was editor of the European Journal of Implant and Refractive Surgery,” Dr Doyle told the congress’ opening session. “He and Steve Obstbaum, then editor of the Journal of Cataract and Refractive Surgery agreed to combine their respective journals to produce the definitive peer-reviewed publication of anterior segment surgery. After approval was received from the ASCRS and ESCRS Boards, the new journal was launched in January 1996 with Dr Rosen and Dr Obstbaum as co-editors. Today the journal is edited by Drs Rosen and Mamalis.”

Dr Rosen credited the many colleagues and staff members who have contributed to his own development as a surgeon, and helped build JCRS into the influential publication it is today.

A full report on Dr Rosen's presentation will appear in the June edition of EuroTimes.