THE SEO CONGRESS WILL BE HELD SEPTEMBER 26 – 29 IN BARCELONA
The advances in the specialty will be presented in this professional gathering of four full days and the technological innovations may be seen in the commercial exposition.
Professor Luis Fernández-Vega, as president of the SEO, informs that the institution has developed an intense scientific program that brings ophthalmologists up to date with the latest advances. It specifically updates issues such as cataract surgery or presbytia, the new options of neuroprotection to manage glaucoma and of the results of the antiangiogenic procedures for the macula. Ophthalmologists in training also have room in this convention through monographic courses on very specific issues such as the updating in keratoconus or the treatment of retinal detachments. Ophthalmologists may outline an itinerary according to their preferences and acquire a good continuous training to apply in their daily practice.
The ophthalmologists of the Institute take part in the congress with different papers such as:
- “Femtosecond current status. Applications and results” (Prof Luis Fernández-Vega Sanz).
- “Femtosecond phaco. A reality with a great future” (Prof Luis Fernández-Vega Sanz and Dr José F. Alfonso Sánchez).
- “A small atlas of infrequent pathologies of the retina”, “Surgery of the VRP, use of trypan blue and LPFC in its management” and “Macular complications of vitreoretinal surgery” (Dr Álvaro Fernández-Vega).
- “What’s new in the treatment of keratoconus?”, “Up to date of intracorneal segments”, “New ICL: indications, management and results”, “Last developments in topography software for the treatment of keratoconus”, “Highlights in corneal surgery” and “Presbiforum 2012” (Dr José F. Alfonso Sánchez).
- “Comprehensive approach to keratoconus” (Drs José F. Alfonso Sánchez and Jesús Merayo Lloves).
- “New ideas in multifocal IOLs” (Drs José F. Alfonso Sánchez and José I. Blázquez García).
- “What’s new in the treatment of dry eye?” and “Neovascularisation patterns following the implantation of intrastromal segments in an animal experimental model” (Dr Jesús Merayo Lloves).
- “Myopic ICL (ICMV4) of -20 dioptres: functional results and vault after 2 years follow-up” (Dr Carlos Lisa Fernández).
- “Results of a new collamer phakic intraocular lens, with perforated orifice” (Drs José F. Alfonso Sánchez and Miguel Naveiras Torres Quiroga).
”Study of the initial endothelial cells following DSAEK with Endosaver” and “Draining device in glaucoma: Baerveldt valve, technique and complications” (Dr Luis Fernández-Vega Cueto-Felgueroso). On top of this, Prof Luis Fernández-Vega presides the official paper of the SEO and the conference “New advances in crystalline extraction and intraocular lens implantation”, Dr Álvaro Fernández-Vega chairs the Day of the Subspecialty “Retina” and Dr Jesús Merayo Lloves is a member of the scientific committee of the “VI contest of clinical cases in ocular surface”.
We will now review the innovations in some of the most common ophthalmological diseases:
In the anterior segment of the eye one must highlight the innovations that affect the transplant of corneal layers. Until recently the complete corneal thickness was transplanted, currently only the affected layer of the cornea is transplanted; therefore the superficial part, mid-face or endothelium can be transplanted, achieving “less rejection as we are transplanting less amount of corneal tissue” explains Dr Luis Fernández-Vega, president of the Spanish Society of Ophthalmology (SEO in Spanish) and Medical Director of the Instituto Oftalmológico Fernández-Vega. “Progress is also more satisfactory as recovery is quicker”. It also has an important advantage, that the same cornea can be used for more than one recipient.
As for cataract surgery, “the eye is approached through a smaller space achieving a faster recovery, also there are new intraocular lenses that enable the patient to see at any distance improving those currently existent. The trend now is trifocal lenses”, assures the president of the SEO.
Glaucoma is “a frequent and devastating disease” says Dr Fernández-Vega, as if it is not treated in time it can cause an atrophy in the optical nerve as well as complete blindness. To avoid this, “we have the option of using more sophisticated diagnosis methods that enable an earlier diagnose, there are as well new eye drops to lower pressure and new surgical techniques that aim for a smaller incision”.
Age-related Macular Degeneration (ARMD) is one of the diseases with more impact in our society as more than one third of the population over 65 years of age has some degree of macular affectation. “This condition, that until a few years ago had barely no treatment, has today a set of substances, anti-angiogenic drugs, that have a positive effect both stabilising the lesion and improving some cases” says Dr José Luis Encinas, secretary of the Spanish Society of Ophthalmology. The function of anti-angiogenic drugs is to inhibit the factor that leads to the growth and development in the macula of capillaries that form a sort of ball “called neovascular membranes that can bleed and destroy the macula. The patient sees a spot in the centre and his/her vision is distorted, the final stage of this distortion is metamorphopsia”, explains Dr Encinas.
On the other hand, one must highlight the improvement in optical coherence tomography that “gives us a high level of capacity for resolution, practically equivalent to a lab or surgery microscopic cut and indications of high magnitude in the myopic patient”, continues Dr Encinas.
Likewise, for refractive defects, which are very common, “there are techniques to be able to treat them both with laser – up to a certain amount of dioptres – and with intraocular lenses in young people with other indications; this improves every year, with more sophisticated techniques that provide better results”, assures the president of the SEO. Even the treatment of presbyopia, in some cases with the appropriate indications it can be solved.
Femtosecond laser helps to perform some steps of cataract surgery in a more precise way, like capsulorhexis, the approach to the anterior capsule of the crystalline to break it in a continuous and circular way “so that it’s easier for the ophthalmologist and safer for the patient” states Dr Fernandez-Vega.
Likewise, the laser “helps to perform incisions that up until now were done manually, it also helps the nucleus of the crystalline to become softer, what we call nucleolysis, and afterwards by means of ultrasounds we can emulsify it, destroy it more easily”, continues the specialist.
Femtosecond laser is also being used for surgery of the cornea, “it helps in the transplant of the cornea because it can perfectly calibrate to what depth of the cornea we want to arrive, which was before done manually”, specifies the President of the SEO.
Likewise, this laser helps in the treatment of keratoconus, a condition in which the cornea has a tendency to being more conic instead of completely spherical, “currently there is treatment with the inclusion of segments, of implants that we do with laser to normalise the corneal surface”, he explains.
Advances in transplant surgery
Transplant surgery has progressed significantly because the cornea isn’t considered a single whole, as there are three layers there are different conditions that affect one layer or the other, before when there was a problem the whole cornea was removed (deep keratoplasty) and, instead, currently we perform a selective transplant of the affected layer. Like this, “the patient recovers much faster, visual quality is better and the risks of intraoperative or postoperative complications are smaller, asserts Dr José F. Alfonso Sánchez, head of the Cornea, Crystalline and Refractive Surgery Unit at Instituto Oftalmológico Fernández-Vega.
Regeneration of the ocular surface
One of the research lines to regenerate eye tissues is applying growth factors that enable the patient’s cells to regenerate the damaged tissue. To this respect, there are several on-going trials with eye drops of sacaridic nature that have been successful in the treatment of trophic alterations in the skin of diabetic patients, and the use of growth factors (PRGF) such as the nerve growth factor. “During the next few months will begin the trials for both products in several centres in Spain”, explains Dr Jesús Merayo, Ophthalmology professor at Universidad de Oviedo and Research Director and Main Researcher at Fundación de Investigación Oftalmológica.
“Estudio de la pérdida celular endotelial inicial tras DSAEK realizada con inyector Endosaver” (Study of the initial endothelial cell loss following DSAEK performed with Endosaver injector) and “Dispositivo de drenaje en glaucoma: Válvula de Baerveldt, técnica y complicaciones” (Drain device in glaucoma: Baerveldt valve, technique and complications) [Dr Luis Fernández-Vega Cueto-Felgueroso]. ?Also, Prof Luis Fernández-Vega presides the official presentation of SEO and the conference “Nuevos avances en extracción de cristalino e implante de lentes intraoculares” (New advances in crystalline extraction and intraocular lens implantation), and Dr Álvaro Fernández-Vega will chair the Day of the Subspecialty “Retina” and Dr Jesús Merayo Lloves is a member of the Scientific Committee of the “VI contest of case reports in ocular surface”.