2^nd International Conference and Expo on Advanced Eye Care and Cataract June 14-15, 2018 Rome, Italy

Biography:

Ingrid Kreissig is currently a Professor at Department of Ophthalmology Univ. Mannheim-Heidelberg, Mannheim, Germany. She is also serving as Adjunct Professor at New York Hospital-Cornell Medical Center, New York. Her specialization includes, Posterior Segment of the Eye: St. Gall/Switzerland, Bonn/Germany, and New York Hospital-Cornell Medical Center/USA. During 1979-2000, she has been the Chairman of Univ. Tuebingen/Germany. She has published more than 404 papers, those are been published in national and international journals of ophthalmology, basically on topics such as surgery of retinal detachment with long-term follow-up of anatomic and functional results, cryopexy histology, tumors, AMD, diabetic retinopathy, and intravitreal pharmacotherapy. She has also published many books.

Abstract:

The evolution of present surgical techniques for reattaching a primary retinal detachment will be analysed from 1929 up to present and this in respect to their morbidity, rate of reoperation and long-term visual function.

Publications about retinal detachment surgery is reviewed during the past 85 years. There had been a change from a surgery of the entire retinal detachment to a surgery limited to the area of the break and a change from extraocular to intraocular surgery. 

The 4 major surgical techniques for repair of a primary retinal detachment that are applied in the beginning of the 21^st century, have still one nominator in common: To find and close the retinal break which caused the detachment and which would cause a redetachment, if not sealed off sufficiently. 

Conclusion:  To find and close sufficiently the break(s)  in a primary retinal detachment has been the aim and accompanied the efforts of retinal detachment surgeons during the past 85 years.  However, today 4 postulates have to be fulfilled for an adequate and optimal retinal detachment surgery:  (1) The retinal reattachment should be obtained with the 1^st operation, (2) the procedure should have a minimum of morbidity, (3) not harbour secondary complications jeopardizing regained visual acuity and (4) be performed on a small budget in local anaesthesia.

Biography:

Graduated in Medicine in 1973, specialized in Ophtalmology in 1977, University Researcher and Teacher at Rome and Chieti University(1974-1980).

Pioneer of Refractive Surgery specialized in Moscow in the Fyodorov Eye Institute in 1982, ideated a personal technique of high Miopia correction with Radial Keratotomy and could correct miopics Eyes up to 21 diopters 1982, ideated a special operative needle of 1 mm diameter to perform the first cataract extraction with 1 mm incision and no stitches 1982, ideated ARK (Asymmetric Radial Keratotomy) for KERATOCONUS Correction 1987, ideated LASIK (Pig-Eyes experimentation) 1990, director of “First International Congress on Excimer Laser Micro-Surgery”

Sponsorized by American Visex 20/20in Rome1992, Presentation ,at I.S.R.S. Atlanta Congress, (also as Course Director of R.K.), of  Mini-Ark microsurgery for KERATOCONUS  Correction 1995,  Homotoxicology Specialization in 2007, has performed the first Autologous Stem Cells Implant in human Eyes in Colonia Germany, on behalf of X-Cells Center, in the 15/02/2008, has ideated and performed the first Regenerative Retrobulbar injections in human Eyes with Homotoxicology natural blend chemistries Regenerating Retinal Stem Cells in Maculopaty 2010.Has presented and published : Retinal Stem Cells Reprogramming at European Ophtalmology

Abstract:

Biography:

Graduated in Medicine in 1973, specialized in Ophtalmology in 1977, University Researcher and Teacher at Rome and Chieti University(1974-1980).

Pioneer of Refractive Surgery specialized in Moscow in the Fyodorov Eye Institute in 1982, ideated a personal technique of high Miopia correction with Radial Keratotomy and could correct miopics Eyes up to 21 diopters 1982, ideated a special operative needle of 1 mm diameter to perform the first cataract extraction with 1 mm incision and no stitches 1982, ideated ARK (Asymmetric Radial Keratotomy) for KERATOCONUS Correction 1987, ideated LASIK (Pig-Eyes experimentation) 1990, director of “First International Congress on Excimer Laser Micro-Surgery”

Sponsorized by American Visex 20/20in Rome1992, Presentation ,at I.S.R.S. Atlanta Congress, (also as Course Director of R.K.), of  Mini-Ark microsurgery for KERATOCONUS  Correction 1995,  Homotoxicology Specialization in 2007, has performed the first Autologous Stem Cells Implant in human Eyes in Colonia Germany, on behalf of X-Cells Center, in the 15/02/2008, has ideated and performed the first Regenerative Retrobulbar injections in human Eyes with Homotoxicology natural blend chemistries Regenerating Retinal Stem Cells in Maculopaty 2010.Has presented and published : Retinal Stem Cells Reprogramming at European Ophtalmology

Abstract:

Biography:

Margarita Rozhdestvenskaya has her expertise in regulatory strategies, medical device registration standards, quality management system compliance and in-country regulatory representation. From 2013 she is a director of the Tonom GmbH that is the European Authorized Representative for transpalpebral transscleral tonometer diaton. Tonom GmbH fulfills the obligations of the Medical Device Directive MDD 93/42/EEC and acts as legal entity towards the European authorities as well as providing additional services regarding the technical information of the medical devices within the European Community. Her expertise and proficiency as well as interest to science, innovation and a culture of operational excellence contribute to offer technology, services and support that improve the quality of people's lives.

Abstract:

Great success of the modern keratorefractive surgery and its wide spread require high attention to the biometric parameters of the eye in pre- and post-operation period. The most important parameters are those characterizing the cornea, such as central corneal thickness and its changes, regenerative response of corneal tissue and its regulation, as well as the intraocular pressure (IOP) and its correlation with corneal parameters. Morphological structure of the cornea is altered, during various, and first of all laser surgeries with refractive, reconstructive, optical and other purposes. For the patients after corneal surgery an accurate IOP measurement without corneal contact would be desirable. The transpalpebral transscleral tonometer Diaton is small and mobile. It is a non-corneal device, which allows for IOP-measurement in sitting and supine position. recording of stationary and expansive equipment like slit lamp and air puff machines, in seated or in lying position of the patient, and it is independent from mains supply.

A resent clinical study revealed that the results of IOP measurement using transpalpebral transscleral tonometry in patients with refraction anomaly before and after keratophotorefractive surgery do not depend on central corneal thickness and are similar to CCT-corrected IOP-values measured by Goldmann Applanation Tonometry. A reproducibility study with Diaton showed recently that when performed by experienced or well-trained individuals, IOP-measurements with Diaton possess high reproducibility and low inter-grader variability. Moreover the measuring method has been shown to be easy to learn over a short time.

Clinical application of transpalpebral transscleral tonometry with Diaton makes IOP-measurement efficient and economical. No additional instrumental examination, like measurement of CCT is required.  This allows for the application of Diaton as a screening tonometry device both in clinical and non-clinical environment, as  well as in rural areas

A particular advantage of Diaton is its ability to measure IOP in situations of contraindication to the corneal tonometry,  e.g., ulcer or IOP-monitoring after keratorefractive surgery.

Biography:

Hind Alkatan has completed her Ophthalmology from King Saud University, Riyadh, Saudi Arabia and her Postdoctoral studies from Departments of Ophthalmology/Pathology, University of Manitoba and University of British Columbia, Canada. She is an Assistant Professor (College of Medicine), Consultant (Departments of Ophthalmology and Pathology), Chief of Ophthalmic Pathology Division, and Director of the KSU Post-Graduate Residency & Fellowship Training Programs in Ophthalmology, King Saud University Medical City (KSUMC), Riyadh, SA. She is a member in many international organizations in her field: Eastern Ophthalmic Pathology, Canadian Ophthalmology Society, International Society of Ocular Oncology, and Saudi Ophthalmology Society. She has been contributing as an invited speaker in many international symposia such as the World Congress of Ophthalmology and the European Society of Pathology Annual meetings. She has published more than 120 papers in reputed journals and has been serving as an Editorial Board Member for several journals

Abstract:

Orbital lesions vary in their classification, incidence and presentation depending on the age and the geographic distribution. Such lesions in the pediatric age group has been extensively studied because of the possibility of faster progression of orbital involvement and the higher risk of morbidity in this age group of patients where vision is still developing. In Saudi Arabia, this has been studied over a six-year period in the late 80’s when retinoblastoma cases used to present late with orbital involvement. In this current study, we revisited the same topic 20 years later aiming at finding out the most recent prevalence of orbital lesions in a similar population of patients over a longer period (14 years) in the same eye center and at comparing the current results to other reports worldwide. A total of 107 lesions from 106 patients were identified by tissue diagnosis, out of which more than half of the lesions were benign cystic (being the commonest), vasculogenic and inflammatory in 63% [95% CI (53.3-72.0)] of all biopsied lesions. Neoplasms accounted for 37% [95% CI (28.0 – 45.8)] with rhabdomyosarcoma being the commonest accounting for about one third of neoplasms and no orbital cases of retinoblastoma were found. Our results demonstrated different distribution of orbital lesions in recent years reflecting the indirect effect of the improved health awareness and medical care in Saudi Arabia. This base-line demographic study is expected to be helpful for further clinical and prognostic studies with emphasis on pediatric orbital malignant lesions, their clinical presentation, management and prognosis.

Biography:

Ana Vega Freitas is an ophthalmology resident at São Paulo/Quarteirão da Saúde, graduated from Federal University of Espirito Santo and highly interested in medical education.  Winner of 2017 AAO EyeWiki international contest, she has received an award from the Academy. In 2013, she worked at the visual eletrophisiology lab at Glasgow Caledonian University. At that time, she received financial support from the Scottish Institute for Enterprise for the development of an educative eyemodel. She is  an ad hoc reviewer for the Journal Revista Brasileira de Pesquisa em Saúde and has published in reputed journals such as Br J Surg.

Abstract:

Although cataract removal is the most common elective surgery in some parts of the world¹, it demands uncommon motor control and concentration to be performed. According to the Accreditation Council for Graduate Medical Education - USA residents must perform a minimum of 86 cataract surgeries during the three years of residency². However, studies have indicated the complications rate of resident-performed cataract surgery only becomes acceptable after approximately 100 cases^3,4  and the International Council of Ophthalmology does outline that specific skills, even advanced ones on cataract surgery, should be mastered during residency².

Growing legal and ethical concerns surrounding the use of human patients as teaching cases, along with reported increased costs in terms of experienced surgeon time and complication rates with resident-performed procedures,⁵  set alternative surgical training models and teaching methods as priorities in many residence programmes around the world.

Currently, virtual-reality surgical simulators have begun assuming an important role in phacoemulsification skills training, alongside traditional wet-lab work and master-apprentice training in the Operating Room. Other types of cataracts surgery, such as extracapsular facectomy and  manual Small Incision Cataract Surgery can still be done in artificial models such as Kitaro kit.

Simulation of cataracts surgeries in conjunction with a standardized surgical teaching methodology that can be reproduced and compared, such as the "backward" methodology used at University of São Paulo and in other international institutions^2,6 or the OASIS -Objective Assessment of Skills in Intraocular Surgery⁷ and similars usually lead to lower rates of complications.

Biography:

Italo Giuffre' is a Consultant at the Department of Ophthalmology, Catholic University of Rome (Italy) since 2009 and Lecturer at the Orthoptics School in Bozen (Italy. He graduated as Medical Doctor cum laude from the University of Rome Tor Vergata in 1988. In 1992, he postgraduated cum laude in Ophthalmology from Sapienza University. He completed a Vitreo-retinal Fellowship at Antwerp Ophthalmology Department.from 1995–1996, he was Lecturer of Genetic Eye Diseases at the Postgraduate Course of Ophthalmology at the University of Rome Tor Vergata. In 2001, he received his PhD in Neuropaediatrics and Malformative Diseases from Sapienza University. His publications include one book about genetics of eye diseases, five chapters in international books about ibopamine, apoptosis and tumorigenesis and genetics of glaucoma and over 90 articles in peer-reviewed journals. He served as Medical Officer in the Italian Army (1990–1991) and he is a Captain since 2000. He worked at the Ophthalmological Department at L’Aquila University from 1992 to 2009. Since then he has been serving as Consultant at the Glaucoma Service and Hereditary Eye Diseases Service at the Catholic University of Rome 

Abstract:

Cataract surgery is one of the most intriguing subjects in ophthalmology. Time and time ago, people started to face a reduction of visual function associated to opacification of the lens, mostly in elderly people. In the past, but even in the last century in Eastern Europe, people tried to solve this surgical problem by “reclinatio” that is pushing traumatically the opacified lens into the vitreous chamber. Of course there was a moderate improvement of the visual function but at the risk of endophthalmitis and/or vitreitis. More recently, in the past century, the “intracapsular” cataract extraction was developed, associated with the use of contact lens and/or scleral-fixed intraocular lens (IOL) to improve the visual function of the patient. In the last 30 years, there was a fast evolution of the cataract surgery, including the “extracapsular” extraction, preserving the posterior capsule of the lens and positioning the IOL into the bag till the femto-laser assisted cataract surgery (FLACS). This technique uses the femtolaser to create the side-port, the arcuate incisions to reduce the astigmatism and, mainly, to make softer, the hardest nucleus of the cataract. The most modern cataract surgery techniques include: SMILE (small incision lenticule extraction) about lens extraction and microincision cataract surgery (MICS) with very small side-ports and micro-instruments. The evolution of the cataract extraction technique focuses mostly on some main topics as follows: to help cataract surgeons reduce the risk of intraoperative and postoperative side-effects, such as posterior capsule rupture and/or endophthalmitis, to reduce postop astigmatism, to improve and make faster visual recovery after the surgical procedure.

Biography:

Frenky Ramiro de Jesus has completed his Post-graduate Program in Ophthalmology for from the Medical Faculty and Health Science of University of Timor-Leste in 2017. He is now working at the Ophthalmology Department of the Hospital Nacional Guido Valadares (HNGV).

Abstract:

Timor-Leste is a newly formed country which got independence in 2002. Since then, cataract still remains the main cause of reversible blindness in Timor-Leste. Due to taboo and lack of education, majority of the patients do not opt for eye consultation. Because of which, surgical outreaches have been used as one of the tools by the Ophthalmology Department of Hospital Nacional Guido Valadares (HNGV) to reduce the number of blindness due to cataract.

The purpose of this study was to determine the final visual outcome of patients who undergo cataract surgery through outreach services in Timor-Leste.

 The study began with a week at the cataract surgical outreach in remote areas of six different locations of Timor-Leste. Data were collected from all patients who had cataract surgery during the program from July–December 2017. Patients were identified by the surgery sheets.

 A total of 215 (M: 56%, F: 44%) cataract surgeries were performed in outreach for a week, in six months period of time. Of these, 60% were right eye and 40% left eye. Of the total, 204 had uncomplicated cataract surgery, while 11 required anterior vitrectomy and ACIOL (anterior chamber intraocular lens) insertion. For accurate interpretation of the visual outcome, patients were divided into three groups depending on first day of post-operation. Vision of 6/18 or better was used to define acceptable post-operative vision. This group consisted of 86 (40%) patients; 6/18=12 (14%), 6/15=13 (15%), 6/12=26 (30%), 6/9=8 (9%), 6/7.5=10 (12%) and 6/6=17 (20%). Regular (6/24–6/60) and poor visual outcome (<1/60) were 78 (36%) and 51 (24%), respectively. From 78 patients with regular outcome, 68 (87%) were due to corneal edema, 2 (3%) hyphema and the rest air bubble and lens material retained with 3 (4%) and 5 (6%), respectively. The reasons for poor visual outcome secondary to comorbidities associated were 25 (50%) with macular degeneration, 8 (16%) with previous trauma + lens dislocation, 10 (20%) with glaucoma and 7 (14%) were uneducated.

Biography:

Hind Alkatan has completed her Ophthalmology from King Saud University, Riyadh, Saudi Arabia and her Postdoctoral studies from Departments of Ophthalmology/Pathology, University of Manitoba and University of British Columbia, Canada. She is an Assistant Professor (College of Medicine), Consultant (Departments of Ophthalmology and Pathology), Chief of Ophthalmic Pathology Division, and Director of the KSU Post-Graduate Residency & Fellowship Training Programs in Ophthalmology, King Saud University Medical City (KSUMC), Riyadh, SA. She is a member in many international organizations in her field: Eastern Ophthalmic Pathology, Canadian Ophthalmology Society, International Society of Ocular Oncology, and Saudi Ophthalmology Society. She has been contributing as an invited speaker in many international symposia such as the World Congress of Ophthalmology and the European Society of Pathology Annual meetings. She has published more than 120 papers in reputed journals and has been serving as an Editorial Board Member for several journals

Abstract:

Epibulbar choristoma is a congenital lesion that arises from ectopic pluripotent cells capable of differentiating into several elements: skin, adipose tissue, bone, lacrimal gland, cartilage, and rarely myxomatous tissue. The incidence is 1 in 10,000 and it affects the cornea, limbal conjunctiva and subconjunctival space. In our study, we aimed at presenting our experience with these lesions in a Tertiary Eye Hospital focusing on the complex and/or osseous type of choristomas and their ophthalmic and/or systemic associations. We collected all cases with the tissue diagnosis of epibulbar choristoma during the period: January 2000 to end of December 2016 for review. Out of a total 120 patients with epibulbar choristoma, complex choristoma constituted 13/15 patients (10.8%) while 2 patients only had osseous choristoma (1.7%). All cases were from Saudi Arabia. 11/15 (73.3%) had other ophthalmic manifestations with the commonest being upper lid coloboma in 1/3 followed by optic nerve anomaly, while half had associated syndromes. Goldenhar's syndrome was the most common in 5/13. Other associations included linear nevus sebaceous syndrome (LNSS) and encephalo-cranio-cutaneous lipomatosis (ECCL). One patient with osseous choristoma had an associated Coat’s disease in the same eye. All cases were managed surgically with a mean duration of 44.6 months between the presentations to surgical intervention. The most common indication for surgery was cosmetic. Histopathologically, the choristoma in our series were not different than what has been reported. Interestingly the presence of smooth muscle was significantly associated with a larger size choristoma. In conclusion, in our series 73.3% of complex choristoma had associated ophthalmic abnormality (mostly lid coloboma). We had the first reported case of combined Goldenhar’s and ECCL. Therefore, we recommend further studies on the pathogenesis of these lesions with consideration of molecular genetic etiology.

Biography:

Michael Cho has received his BS degree from George Washington University and PhD from Drexel University. After completing Postdoctoral training at Harvard Medical School, he became a faculty member in the Bioengineering Department at the University of Illinois, Chicago in 2000. He recently joined the University of Texas at Arlington in 2015 as Chair of its Bioengineering Department. He is currently the Alfred R. and Janet H. Potvin Endowed Professor and Fellow in the American Institute for Medical and Biological Engineering (AIMBE). His research is focused on stem cell tissue engineering, development of ophthalmic devices, and mechanism studies of blunt force brain tissue injuries. His research endeavors have been supported by the Office of Naval Research, NIH, and DOE, and led to publishing more than 200 journal papers, book chapters, conference proceedings and abstracts.

Abstract:

Tissue engineering provides strategies and technologies to develop biomimetic solutions to repair and regenerate damaged or lost tissue. The engineered tissue may be either cell-based or scaffold-based without seeded cells; the latter offers advantages by minimizing challenges such as donor shortage, graft rejection and inflammatory response. While tissue engineering approaches have led to some successes in the development of artificial ocular tissues, clinically relevant tissue substitutes are still lacking. To this end, a significant effort has been dedicated to engineer scaffold-based artificial cornea and iris. These two ophthalmic devices have been designed based on engineering principles and utilize readily available materials that are shown to be biocompatible. The artificial cornea provides an alternate option for cornea replacement that minimizes post-implantation tissue melting, and thereby achieving long-term stability in the ocular environment. Moreover, an engineered artificial iris lens is shown to mimic the functionality of the natural iris by dynamically modulating light intensity entering the eye and demonstrates a promising potential for improved treatment option for patients with iris damage.

Biography:

Abeer H A Mohamed Ahmed has her expertise in pharmaceutical formulations development. Her main interest is in the translation of pharmaceutical laboratory research into the clinic. Her research passion is focused on addressing unmet clinical needs. She has been working as Research Fellow and main Formulation Scientist in several projects funded by Medical Research Council and Welcome trust at UCL School of Pharmacy. Her passion is developing novel ophthalmic formulations to treat scarring following ocular surgeries. She is also interested in tropical eye diseases. She has been working in close collaborations with clinicians, academia and pharmaceutical companies to develop anti-scarring ocular formulations.

Abstract:

Glaucoma is the greatest cause of irreversible blindness in the world. This condition can be treated by glaucoma filtration surgery (GFS) which is conducted in the subconjunctiva. GFS is currently a complex surgical procedure that requires considerable post-surgical treatment to stop fibrosis and to promote healing. Fibrosis can be inhibited in 30% of patients using cytotoxic antiscarring agents (e.g. mitomycin-c, 5- fluorouracil), which are the only clinically used medicines to control fibrosis after GFS. There is no licensed treatment to treat ocular fibrosis. Ilomastat is a matrix metalloproteinase inhibitor that has been shown to inhibit fibrosis after GFS in a rabbit model of ocular fibrosis. To reduce scarring and fibrosis following GFS, an effective formulation of ilomastat is required that allows a prolonged local concentration of ilomastat to be maintained within the subconjunctival space. In this study, we describe the development of ophthalmic formulations of ilomastat in form of topical eye drop and self-gelling implants. 

Biography:

Muhammad Ahmad Khan, is a working in the Department of Ophthalmology, Changsha Aier Eye Hospital, Changsha, China. He is pursuing PhD, at the Central South University, China. His activities are in the field of Ophthalmological & clinical practice.

Abstract:

Drug delivery to the targeted ocular tissues remains a challenge. Subtenon transfusion allows prolonged controllable release of drugs directly into the eye according to the need. In this study, we investigate the efficacy of subtenon transfusion of dexamethasone in the rabbit model of experimental autoimmune uveitis (EAU).

Experimental autoimmune uveitis (EAU) in rabbit was induced first by injection the emulsion of bovine serum albumin (BSA) and complete Freund's adjuvant (CFA); and one week later intravitreal injection of BSA. A total of 48 rabbits were randomly allocated to the four groups as follows: (1) received subtenon transfusion dexamethasone; (2) received intravenous and subconjunctive dexamethasone used as a standard therapy control; (3) model EAU control group; and (4) normal control group. Treatment was administered 24 hour post-immunization in the first two groups. We evaluated the anterior segment inflammation state by slit lamp biomicroscopy (standardization of uveitis nomenclature grading) for 14 days and histopathology on 14 days post-immunization.

Uveitis developed in all rabbits of the first three groups, and the clinical uveitis scores and histological scores were all higher than the normal control group. The uveitis anterior segment clinical scores reached peak in the treated group 1 (2.17±0.94) and group 2 (2.42±0.79) on day four, post-immunization, and in model EAU control group (3.25±0.62) on day five. Treatment significantly reduced the anterior segment inflammation score from day five to day 14 and histological score on day 14 post-immunization compared to the model EAU group (P<0.05). In all the observed timepoints, the uveitis clinical score and histological score were insignificantly difference in the two treated groups.