Scientific Program

Conference Series Ltd invites all the participants across the globe to attend World Eye and Vision Congress Dubai, UAE.

Day 1 :

Keynote Forum

Dr Ajay Tripathi

Russells Hall Hospital, United Kingdom

Keynote: Orbital Inflammation- The myths and the facts

Time : 09:45-10:20

Conference Series Eye 2018 International Conference Keynote Speaker Dr Ajay Tripathi photo
Biography:

Mr A. Tripathi did his masters in Ophthalmology in India and then completed fellowships in Ophthalmology from The Royal College of Physicians and Surgeons of Glasgow, The Royal College of Surgeons Edinburgh and The Royal College of Ophthalmologists, London. He completed his super speciality fellowships in lid, lacrimal and orbital surgery from University of Leicester and Cambridge University UK. He is working as a consultant in UK since 2007 and is also an Honorary Senior Lecturer in University of Birmingham. He is actively involved in teaching and training programmes within UK, Europe and India. He has a number of research publications in international peer reviewed journals. In addition to his professional committments, Mr Tripathi is an accomplished singer, actor and writer and he has written many plays, poetries and has directed many plays. He regularly does musical concerts throughout the world to support various charitable organisations.

Abstract:

Orbital inflammation is an important, yet often misdiagnosed and mismanaged clinical condition. A delayed diagnosis or inappropriate treatment could have a long lasting impact on an individual’s vision. In this keynote address the author dispells various common myths about orbital inflammation and explains simple facts about the condition with the help of a number of clinical case presentations. The role of imaging and some other special onvestigations is also discussed.

 

Conference Series Eye 2018 International Conference Keynote Speaker John S Jarstad photo
Biography:

Dr. Jarstad is an Associate Professor and Director of Cataract & Refractive Surgery at University of Missouri.  He is a graduate of Brigham Young University (B.S.), University of Washington Medical School (Seattle WA) and completed an Internship and Residency at the Mayo Clinic in Rochester MN in ophthalmology.  He was a medical student research fellow at the N.I.H. Bethesda MD.   Dr. Jarstad is past president of the Washington State Academy of Eye Physicians and Surgeons, a member of the American Society of Cataract and Lasik surgeons, and was elected to the Royal Society of Medicine - United Kingdom in 2006.  Dr. Jarstad is the author of one book and more than 90 publications and presentations in the eye surgery literature. He is the inventor of the Jarstad Refractive Cataract Surgery Marker, the first injectable foldable lens inserter (Chiron Passport) and an FDA phase I, II and III clinical investigator for medications and phaco machines used in eye surgery.  Along with family members, he has participated in 41 short term medical missions to Egypt, Zimbabwe, Angola, Madagascar and Nigeria Africa, the Philippines, Vietnam, Cambodia, Indonesia and North Korea.

 

Abstract:

Cornea collagen crosslinking has emerged as a highly successful treatment for keratoconus and post-LASIK ectasia. The use of topical concentrated riboflavin solution, along with a calibrated ultraviolet light source has been shown to successfully cross-link and stiffen the cornea align storm and arrest and in most cases, reduce the effect of corn steepening in  several degenerative cornea conditions including keratoconus and post-refractive surgery ectasia.

  

Cornea cross-linking with the Avedro commercial UV light source and concentrated topical riboflavin solution produced in a standard dose is widely accepted and was FDA approved in the USA in 2016 as a treatment for Keratoconus and post refractive surgery ectasia.  The high financial treatment cost, along with the high cost of the Avedro machine, has limited ophthalmologist’s and patient’s access to this new effective treatment.

 

We report cases at three separate institutions where patients, either on the own or under the suggestion of their ophthalmologist ingested high doses of dietary riboflavin (Vitamin B2)  and were exposed to 15 minutes per day of direct sunlight and noted within 6 months to experience a significant amount of cornea flattening by both topographic and keratometric measurements.  No adverse effects were observed or reported in patients taking up to 1500 mg of dietary riboflavin per day and spending 15 minutes daily outdoors walking briskly facing the sun without sunglasses.    

 

We conclude that high-dose dietary riboflavin may have a place in the treatment of keratoconus and post-refractive surgery kerectasia as an economical alternative or adjunctive form of treatment.  It may be especially useful in paediatric and pregnant patients who are more likely to regress after commercial cross-linking therapy.

 

  • Incidence of diabetes mellitus (DM) is increasing worldwide
Location: Souq

Session Introduction

Ayman Abd Elhamid Shouman

Institute of Ophthalmology, Cairo-Egypt

Title: Incidence of diabetes mellitus (DM) is increasing worldwide

Time : 16:20-16:50

Speaker
Biography:

Ayman Abd Elhamid Shouman is a Professor of Ophthalmology in the Research Institute of Ophthalmology in Cairo-Egypt. He has built his experience over 27 years of practice between Egypt, Germany, Saudi Arabia, Sultanate of Oman and United Arab Emirates. He is an expert cataract and vitreoretinal surgeon with expertise in uveitis and ROP management. He has a lot of published articles over a wide range of ophthalmological subjects with a vast experience in teaching and continuous medical education activities through his career. He is a visiting Consultant in the Spanish centre for eyes in Dubai.

 

Abstract:

The duration of diabetes and glycaemic control is collective risk factors for severity and progression of diabetic retinopathy. Diabetic macular edema (DME) emerges as one of the leading causes of blindness. The incidence of diabetes and its retinal complications is increasing in a rapid pace especially in the gulf region. The treatment of DME has evolved from focal and grid laser photocoagulation as the gold standard of therapy for DME, as stated in the Early Treatment of Diabetic Retinopathy Study (ETDRS), yet, the evolvement of new modalities specially the intravitreal injection changed the paradigm of treatment of DME. New therapies has developed with proven efficacy like vascular endothelial growth factor inhibitors (VEGF) agents like Bevacizumab and Ranibizumab, VEGF and placental growth factor inhibitor like Aflibercept, Corticosteroid materials like Triamcinolone Acetonide, Dexamethasone and Fluocinolone Acetonide. A high volume of studies to support such modalities have been conducted including RISE and RIDE, RESOLVE , DRCR, RRESTORE, RETAIN, RELIGHT, VIVID, VISTA, CHAMPLAIN, ETC…. A review of the different results of these trials with different case reviews with the different modalities of treatment is to be presented and discussed.

 

  • Eye Surgery | Ophthalmology Management | Diagnostic and Imaging Tools in Ophthalmology
Location: Souq
Speaker

Chair

Georges Hatoum

JFK Comprehensive Cancer Institute, USA

Session Introduction

Shlomo Dotan

Hebrew University of Jerusalem, Israel

Title: Neuro-ophthalmic aspects of drug toxicity
Speaker
Biography:

Dr. Shlomo Dotan is working as the director of the Neuro-Ophthalmology Service at the Hebrew University-Hadassah Medical Center in Jerusalem for more than two decades. He is part of the Editorial Board of the esteemed journal - Neuro-Ophthalmology. His major research project in the past was The Optic Neuritis Treatment Trial Study and The International Optic Nerve Trauma Study which were published in The New England Journal of Medicine and several ophthalmological journals. He is currently involved in several scientific projects investigating therapeutic aspects in MS, NMO and NAION. He is member of the Israel Medical Association, Israel Ophthalmological Society, North American Neuro-Ophthalmology Society, and American Academy of Ophthalmology, European Neuro-Ophthalmology Society, and the European Ophthalmological Society. He has been giving lectures worldwide on various ophthalmological and neuro-ophthalmological topics and has published articles in several prestigious medical journals. He has been part of many esteemed conferences held in Europe, including Israel.

 

Abstract:

The toxic optic neuropathies are typically characterized by subacute or chronic, bilateral, symmetrical and painless loss of vision. Treatment is initiated by recognition and drug withdrawal. Historically, methanol (though not a medication), ethambutol and isoniazid were the first to be recognized as neurotoxic. Later, cyclosporine, a widely used immunosuppressant and other chemotherapeutic agents, like; cisplatin, carboplatin and vincristine were recognized as having neurotoxic adverse reactions. Amiodarone-associated optic neuropathy has been widely discussed in the ophthalmic literature less than half a century ago. It is still controversial whether sildenafil and other phosphodiesterase-5 inhibitors prescribed for erectile dysfunction, cause visual loss by triggering ischemic optic neuropathy. Vigabatrin, used around the world as an anti-epileptic drug, was reported to cause irreversible visual field defects in children. Infliximab, an anti-tissue necrosis-alpha monoclonal antibody currently in use for granulomatous diseases, is also known to cause toxic optic neuritis. A long list of reported drugs is associated with increased intracranial pressure, though not confirmed by controlled studies. Vitamin A derivatives, corticosteroids, tetracyclines, fluoroquinolones, gonadal hormones, indomethacin, lithium and tamoxifen are just a small part of this list. Abnormalities of eye movements, including nystagmus and inappropriate vestibulo-ocular reflex are reported at toxic levels of neuroactive drugs like: diazepam, methadone, phenytoin, barbiturates and chloral hydrate. Drug-induced disturbances of neuromuscular transmission, occurring at the pre-or-post synaptic levels, include prominent ptosis and ophthalmoparesis along with variable degrees of extremity muscle weakness resembling true myasthenia gravis.

 

Georges Hatoum

JFK Comprehensive Cancer Institute, USA

Title: The radiation treatment of ocular melanoma: Techniques and advances

Time : 11:40-12:05

Speaker
Biography:

Georges Hatoum obtained his medical degree with honors from the Lebanese University, Faculty of Medical Sciences. His residency was completed at the Syracuse Upstate Medical University. He was then appointed as the Chief of Radiation Oncology at the Stratton VA Medical Center, NY. From 2006-2010, Dr. Hatoum worked at the Sylvester Cancer Center of the University of Miami. He carried different appointments including Associate Professor of Clinical Radiation Oncology, co-leader of the head and neck cancer site disease group as well as Associate Director of Radiation Oncology at Jackson Memorial Hospital Dr. Hatoum serves currently as the Medical Director for the JFK Comprehensive Cancer Institute. He is the principal investigator of the NGR oncology clinical trials, and his work has been published in several prominent medical journals. Dr. Hatoum has won several awards, including America’s top Radiation Oncologists, as well as the Osler Institute award of Excellence in teaching.

 

Abstract:

Statement of the Problem: Ocular melanoma is a rare subset of melanoma, yet comprises the majority of ocular malignancies. Management of ocular melanoma consists of either enucleation or glob-preserving therapies including radiation therapy (RT) and surgical resection. There are generally two categories RT for ocular melanoma, radioactive plaque brachytherapy and external beam radiotherapy (EBRT), including charged particle radiation and photon stereotactic radiosurgery (SRS). In this presentation we give an overview of the technical details and clinical efficacies of different RT techniques for ocular melanoma. In an effort to reduce the invasiveness without compromising accuracy, we developed a novel approach of real-time tracking to ocular tumors that can be applied to high-precision RT either with charged particle or photon beams.

 

Methodology & Theoretical Orientation: A novel “pupil tracking” approach uses a derived 2D/3D transformation to relate the pupil’s 2D coordinate captured by a video camera in the image plane with the tumor’s 3D location in the CT space. A motion phantom was development to test the feasibility of this technology with a robotic radiosurgery system.

 

Findings: The results show that the unique 2D/3D transformation algorithm is not only theoretically possible but also consistently reproducible with sub-millimeter accuracy.

Conclusion & Significance: Charged particle RT or SRS can eliminate invasiveness of brachytherapy. Pupil-based tracking can further assure the physical accuracy and achieve optimal clinical outcomes.

 

Speaker
Biography:

Fellow of the Royal college of physicians and surgeons of Glasgow (FRCP – Glasgow). Hold a Doctorate degree in Public Health and Epidemiology, Master degree in Clinical Epidemiology (MSc), Master degree in Public Health (MPH), all from The Netherlands Universities with broad experience driving Research and Development (R&D) strategies and operations.

 

Abstract:

Background: Neonatal and early screening is aimed at the primary prevention of visually impairing disease (e.g. mainly premature infant require a consistent approach to screen them for Retinopathy of prematurity ROP). ROP is one of the few causes of childhood visual disability, which is largely preventable. The screening can as well detect other congenital blinding eye diseases like cataract or Glaucoma that can be treated to prevent permanent visual loss. In addition other diseases that can pick early may include the autosomal recessive inheritance disorders that are the causes for retinal dystrophies such as Retinitis Pigmentosa (RP) and Leber's congenital amaurosis (LCA). 

Method: A qualitative methodology approach is used. An in-depth interview sessions were conducted concentrating on specific topics related to Retinopathy of prematurity (ROP).

Participants: The in-depth sessions consisted of three ophthalmologists working in Dubai, with extensive knowledge about vision programs and services.

Setting: Three sessions were performed during January- June 2017.

Key findings:

1. Retinopathy of prematurity (ROP) is one of the few causes of childhood visual disability which is largely preventable. Many extremely preterm babies will develop some degree of ROP, which usually resolves spontaneously without treatment. A small proportion, develop potentially severe ROP which can be detected through retinal screening. If untreated, it can result in serious vision impairment. Therefore, all babies at risk of sight-threatening ROP should be screened.

2. Among children, Retinopathy of Prematurity (ROP) is potentially blinding eye disorder that primarily affects premature infants. The estimated prevalence is about 10% among premature infants annually develop ROP and about 1–2% that are severe enough to require medical treatment. There is no follow up studies in Dubai to show how many of these each year become blind from ROP.

3. Currently different hospitals used different international guidelines to tackle ROP. However, A local Guideline for the Screening and Treatment of Retinopathy of Prematurity (ROP) is required to set up the standards and criteria when ROP should be screened.

 

Ayman Abd Elhamid Shouman

Institute of Ophthalmology, Cairo-Egypt

Title: FLACS + 27G vitrectomy, perfect combination
Speaker
Biography:

Ayman Abd Elhamid Shouman is a Professor of Ophthalmology in the Research Institute of Ophthalmology in Cairo-Egypt. He has built his experience over 27 years of practice between Egypt, Germany, Saudi Arabia, Sultanate of Oman and United Arab Emirates. He is an expert cataract and vitreoretinal surgeon with expertise in uveitis and ROP management. He has a lot of published articles over a wide range of ophthalmological subjects with a vast experience in teaching and continuous medical education activities through his career. He is a visiting Consultant in the Spanish centre for eyes in Dubai.

 

Abstract:

The emergence of femto laser in the extraction of cataract has revolutionised our mechanisms with better control of the procedure steps and adding to the verstality like addressing astigmatism better with laser assisted LRI. In addition more wide spread use of small gauge 27 and 29 vitrectomy instruments have decrease the traumatic effect of vitrectomy surgery on the eye. By combining the 2 mechanisms in relevant cases increase the benefits and decreased post-operative traumatic inflammatory effect on the eye with better and faster rehabilitation. This presentation is to highlight the procedure, pros and cons and rationale.

 

Speaker
Biography:

Shuliang Jiao received his Ph.D from the department of Biomedical Engineering of Texas A&M University in 2003. He joined the faculty of Bascom Palmer Eye Institute of University of Miami as an assistant professor after graduation. He is currently a professor in the Department of Biomedical Engineering, Florida International University. His research interest is mainly focused on the development of innovative technologies for imaging and treatment of eye diseases. His current research includes the technological development and application of Optical Photoacoustic Microscopy, Optical Coherence Tomography, and Multimodal Functional Imaging for the early diagnosis of age related macular degeneration, diabetic retinopathy, and glaucoma.

 

Abstract:

Lipofuscin, a byproduct of the vision cycle of photoreceptors, is the major source of the fundus auto-fluorescence (FAF) in the Retinal Pigment Epithelium (RPE). Lipofuscin accumulates with aging and in certain pathological disorders and is thus a biomarker for degenerative retinal diseases. Therefore, quantification of lipofuscin is important in the diagnosis, progression monitoring, and treatment evaluation. Lipofuscin quantification is challenging because light is attenuated by the media anterior to the RPE which is subject to inter-individual and intra-individual differences. Further, various illumination power and detection sensitivity of different imaging systems can also affect the readings of the detected FAF.

 

We developed a technology to provide simultaneous VIS-OCT and AF of the retina and a reference standard target at the intermediate retinal imaging plane with a single broadband visible light source. Since both OCT and AF images are generated from the same group of photons the OCT probe light experiences attenuation by the same ocular layers. The technology is able to eliminate the varying pre-RPE attenuation factor in AF imaging using the simultaneously acquired VIS-OCT image. To quantitatively bridge the OCT and AF detection systems thus eliminate the effects of illumination power and detector sensitivity, a standard reference target with known reflectivity and fluorescence efficiency was implemented into the system. Using the standard reference, similar to the one used by Delori AF and reflectance signals are normalized to a known reference value that are independent from the exposure power and detection gain. The system was calibrated and tested in vivo.

 

  • Workshop
Location: Souq
Speaker
Biography:

Shuliang Jiao received his Ph.D from the department of Biomedical Engineering of Texas A&M University in 2003. He joined the faculty of Bascom Palmer Eye Institute of University of Miami as an assistant professor after graduation. He is currently a professor in the Department of Biomedical Engineering, Florida International University. His research interest is mainly focused on the development of innovative technologies for imaging and treatment of eye diseases. His current research includes the technological development and application of Optical Photoacoustic Microscopy, Optical Coherence Tomography, and Multimodal Functional Imaging for the early diagnosis of age related macular degeneration, diabetic retinopathy, and glaucoma.

 

 

Abstract:

 

 

Lipofuscin, a byproduct of the vision cycle of photoreceptors, is the major source of the fundus auto-fluorescence (FAF) in the Retinal Pigment Epithelium (RPE). Lipofuscin accumulates with aging and in certain pathological disorders and is thus a biomarker for degenerative retinal diseases. Therefore, quantification of lipofuscin is important in the diagnosis, progression monitoring, and treatment evaluation. Lipofuscin quantification is challenging because light is attenuated by the media anterior to the RPE which is subject to inter-individual and intra-individual differences. Further, various illumination power and detection sensitivity of different imaging systems can also affect the readings of the detected FAF.

 

We developed a technology to provide simultaneous VIS-OCT and AF of the retina and a reference standard target at the intermediate retinal imaging plane with a single broadband visible light source. Since both OCT and AF images are generated from the same group of photons the OCT probe light experiences attenuation by the same ocular layers. The technology is able to eliminate the varying pre-RPE attenuation factor in AF imaging using the simultaneously acquired VIS-OCT image. To quantitatively bridge the OCT and AF detection systems thus eliminate the effects of illumination power and detector sensitivity, a standard reference target with known reflectivity and fluorescence efficiency was implemented into the system. Using the standard reference, similar to the one used by Delori AF and reflectance signals are normalized to a known reference value that are independent from the exposure power and detection gain. The system was calibrated and tested in vivo.

 

  • Optometry & Contact Lenses | Eye: Developmental Biology | Ocular Inflammation & Immunology
Location: Souq

Chair

Bilal Rawashdeh

Sharif Eye Centers, UAE

Session Introduction

Bilal Rawashdeh

Sharif Eye Centers, UAE

Title: Speciality contact lenses in practice
Biography:

Abstract:

Contact lenses play an Effective role in the treatment plan for critical cases especially in paediatric and refractive unites. In this presentation, short and direct to the point – case studies will be discussed to show (practically) the Importance of specialty contact lenses in practice.

Case studies will include scleral CL fitting, aniridia and albinisim (made to order) CLs. All cases will be in a simple and direct to the point manner, Q & A are more than welcomed.

 

Biography:

Rahat Husain MBBS FRCOphth MD(Res)Senior Consultant Ophthalmologist, Glaucoma Service, Singapore National Eye Centre.

He is Director, Regional/Community Eyecare (SingHealth), Adjunct Associate Professor, Duke-NUS Graduate Medical School, Adjunct Senior Clinician Investigator, Singapore Eye Research Institute, Associate Program Director, SingHealth Residency (Ophthalmology).

 

Abstract:

Problem: The ministry of health in Singapore has recently announced an initiative to change the landscape of healthcare from hospital to community care and from quality care to value driven care. This necessitates a change in the way ophthalmologists and optometrists manage patients.

Methodology: In this presentation I will elaborate on various initiatives we have embarked upon to fulfil the ministry of health’s directives. This includes training of hospital optometrists, engaging community optometrists, virtual clinics, establishing fit-for-purpose eye centres in the community and rationalising the movement of eye patients around the island such that they are seen by the right level of professional, in the right place and at the right time. Similar models of care that have already been established in UK will be described for comparison.

Findings: Models of care that have already been established will be described and data presented on patient outcomes including patient experience, safety and effect on the hospital eye service. Theoretical approaches to collaborations between optometrists and ophthalmologist will be discussed and an interactive question and answer session is anticipated.

Conclusions: I hope to expound some ideas of collaborations between optometrists and ophthalmologists that draw upon the strengths of each such that patient care remains high quality but with greater value.

 

Biography:

Elatta Kamal has clinical MD in Ophthalmology and has sub speciality in cataract surgery, working in Magrabi eye center in Alahsa. He has good experience in medical researches and special interest in cataract and glaucoma. Elatta has long experience as volunteer in many camps for free cataract surgery and trachoma surveuys and surgeries in Sudan and other african countries. . He has built this model after years of experience in research, evaluation, teaching and administration both in hospital and education institutions.

 

Abstract:

Introduction: Glaucoma and Cataract often coexist in the same eye One of the accepted surgical options in patients with severe glaucoma and coexisting cataract is first to control the IOP with trabeculectomy and then extract the cataract several months later , or by cataract surgery alone when trabeculectomy is not indicated Recently, primary lens extraction alone gained more acceptance.

Purpose: To review the current ophthalmic literature regarding the impact of modern cataract surgery on intraocular pressure (IOP)

Materials and Methods: Study design: Hospital based, retrospective study conducted from November 2014 to March 2015.

Study population: Patients who had phaco surgery for cataract with coexisting POAG.

Sample size: 50 patients were selected according to inclusion criteria.

Study area: MAKKAH EYE COMPLEX; specialized ophthalmology Center, well equipped and serves patients from all over Sudan, with sub specialized ophthalmic services. Sample selection obtained from only one clinic twice a week.

Results: There were 50 patients, 29 Males and 21 females (Fig 1), underwent uneventful phacoemulsification surgery, 26 right eyes and 24 left eyes, 22 % were diabetic. The mean preoperative IOP was 21.3 mmHg 4.8 SD, mean 1 week postoperative IOP 20.4 mmHg 4.3 SD (P – value 0.08), one month 20.1 mmHg 3.7 SD (P – value 0.04), and two months 19.6 mmHg (P – value 0.01) The mean IOP reduction was 0.8 to 1.7 mmHg (P = 0.00). The mean number of preoperative ant glaucoma topical medications 2.1 drugs 0.7 SD, one week postoperative 1.6 drugs 0.9 SD (P-value 0.008), one month 1.58 drugs 0.78 SD (P-value 0.003), two months 1.44 drugs 0.7 SD (P-value 0.000)

Conclusion: In conclusion phaco induces significant intraocular pressure reduction in the short postoperative period in glaucomatous patients. Phaco can be performed with intent of achieving better IOP control. Glaucomatous patients may get benefit from phaco by decreasing the amount of topical anti glaucoma medications.

 

Biography:

Abstract:

  • Special Session
Location: Souq

Session Introduction

Shlomo Dotan

Hadassah-Hebrew University Medical Center, Israel

Title: Neuro-ophthalmic aspects of drug toxicity
Speaker
Biography:

Shlomo Dotan is working as the director of the Neuro-Ophthalmology Service at the Hebrew University-Hadassah Medical Center in Jerusalem for more than two decades. He is part of the Editorial Board of the esteemed journal - Neuro-Ophthalmology. His major research project in the past was The Optic Neuritis Treatment Trial Study and The International Optic Nerve Trauma Study which were published in The New England Journal of Medicine and several ophthalmological journals. He is currently involved in several scientific projects investigating therapeutic aspects in MS, NMO and NAION. He is member of the Israel Medical Association, Israel Ophthalmological Society, North American Neuro-Ophthalmology Society, and American Academy of Ophthalmology, European Neuro-Ophthalmology Society, and the European Ophthalmological Society. He has been giving lectures worldwide on various ophthalmological and neuro-ophthalmological topics and has published articles in several prestigious medical journals. He has been part of many esteemed conferences held in Europe, including Israel.

 

Abstract:

The toxic optic neuropathies are typically characterized by subacute or chronic, bilateral, symmetrical and painless loss of vision. Treatment is initiated by recognition and drug withdrawal. Historically, methanol (though not a medication), ethambutol and isoniazid were the first to be recognized as neurotoxic. Later, cyclosporine, a widely used immunosuppressant and other chemotherapeutic agents, like; cisplatin, carboplatin and vincristine were recognized as having neurotoxic adverse reactions. Amiodarone-associated optic neuropathy has been widely discussed in the ophthalmic literature less than half a century ago. It is still controversial whether sildenafil and other phosphodiesterase-5 inhibitors prescribed for erectile dysfunction, cause visual loss by triggering ischemic optic neuropathy. Vigabatrin, used around the world as an anti-epileptic drug, was reported to cause irreversible visual field defects in children. Infliximab, an anti-tissue necrosis-alpha monoclonal antibody currently in use for granulomatous diseases, is also known to cause toxic optic neuritis. A long list of reported drugs is associated with increased intracranial pressure, though not confirmed by controlled studies. Vitamin A derivatives, corticosteroids, tetracyclines, fluoroquinolones, gonadal hormones, indomethacin, lithium and tamoxifen are just a small part of this list. Abnormalities of eye movements, including nystagmus and inappropriate vestibulo-ocular reflex are reported at toxic levels of neuroactive drugs like: diazepam, methadone, phenytoin, barbiturates and chloral hydrate. Drug-induced disturbances of neuromuscular transmission, occurring at the pre-or-post synaptic levels, include prominent ptosis and ophthalmoparesis along with variable degrees of extremity muscle weakness resembling true myasthenia gravis.

 

Speaker
Biography:

Background: Since LASIK was introduced about three decades ago, an estimated 28 million LASIK surgeries have been performed worldwide, and more than 500,000 of those surgeries were performed in Israel. Many of the patients who had refractive surgery 20 years ago have now reached the age of cataract surgery, and seek to continue their spectacle independence. However, patients who have had refractive surgery frequently experience increased optical aberrations, with the cornea itself often becoming multifocal in nature.  Placing a multifocal intraocular lens (MFIOL) IOL behind a multifocal cornea may run the risk of a reduction in visual quality.

Methods: This is a retrospective compression case series of the cataract surgeries implanted with a MFIOL. Data was abstracted on uncorrected and best corrected visual acuity (UCVA, BCVA). A comparison was made between naïve and post-refractive surgery eyes.

Results: We identified 1200 consecutive cataract surgeries: 800 were naïve eyes (group 1) and 400 had previous refractive surgery (group 2). All cataract surgeries were Femtosecond laser-assisted (Lensx or Victus) and performed by a single surgeon. All MFIOLs were manufactured by Fine Vision (Physiol). The formula used was the “Levinger Formula”, which is a modification of the SRKT formula. At 1 month postoperatively, the UCVA was 0.18 (log MAR) in group 1 and 0.23 in group 2 (p=0.1). At that time, there was a negative effect of age in both groups (r= 0.14 p= 0.04). Near UCVA was 2.01 in group 1 and 3.71 in group 2 (p<0.001). BCVA was 0.09 and 0.12 in group 1 and 2 respectively (p=0.06).

Conclusion: Implantation of a MFIOL in cataract surgery in eyes with previous refractive surgery is a viable option - achieving good distance UCVA, with the understanding that there is a slight limitation of near UCVA.

 

Abstract:

Shmuel Levinger, is a Member in Professional SOCIETIES Academy of Ophthalmology (AAO) American, International Council Representative of Israel-for the American Academy of Ophthalmology, the Eye M.D. Association (ASCRS). American European Congress of ophthalmology (AECOS), Israel Society of Ophthalmology, Israel Society of Laser Surgery. 2000-present- General Manager of Enaim Medical Center, Jerusalem, Israel.