International Conference on Clinical Ophthalmology and Oculoplastic Surgery May 24-25, 2018 Osaka, Japan

Biography:

Dr. Mithra Gonzalez is an Associate Professor in the Department of Ophthalmology at the University of Rochester School of Medicine and Dentistry. He is affiliated with Strong Memorial Hospital and has a secondary appointment in the Eastman Dental Institutes Department of Oral and Maxillofacial Surgery. 
 

Abstract:

Statement of the Problem: Floppy eyelid syndrome (FES) was originally described by Culberston and Ostler and although common to an oculoplastics practice, the biochemical/biomechanical remain unclear. The phenotype includes long eyelashes, lash ptosis, pigmentary changes, lid laxity, dermatochalasis, blepharoptosis, irritation and discharge often lead to surgical correction.  The syndrome is associated with obstructive sleep apena. As a result of this association, possible etiologies include but are not limited to, connective tissue defects, micro-trauma associated with sleeping on the face. Interestingly, the phenotype of floppy eyelid syndrome is similar to that of prostaglandin associated periorbitopathy. Methodology & Theoretical Orientation: We compared biopsied eyelid tissue of unaffected patients (controls) to those with clinically diagnosised floppy eyelid syndrome. We hypothesize that patients with floppy eyelid syndrome have significantly higher levels of prostaglandin F2 and E2 compared to controls. These measures are made using real-time PCR. Findings: Prostaglandin E2 trended upward in FES patients compared to controls. Prostaglandin F2 trended down in FES compared to controls. Conclusion: Floppy eyelid syndrome seems to be a prostaglandin mediate process. Additional studies are needed to elucidate the precise mechanism.

Biography:

Medical graduate of Odessa State Medical University, Ukraine Post graduate specialisation in ophthalmology with subspeciality in vitreo retinal surgery from Kyiv Medical Academy for post graduate education from Kiev, Ukraine.

Abstract:

Aim: Provide a surgical handpiece using femtosecond technology for perforating/cutting ocular tissue for ophthalmic surgery with a flexible, compact, safe and robust self cleaning performance.

Solution : 

- Use of a preferable switchable fs-laser source from an automated ophthalmic surgical laser system to this manual handpiece.

- Use of special Kagome - photonic crystal fiber delivery system.

- Use of a very small sized disposable handpiece adapter with focusing and laser self cleaning exit window with additional fluid flow channels

Possible claims:

1) Switchable automated and manual ophthalmic surgical fs-laser apparatus

2) kagome fiber coupled compact, disposable and self cleaning surgical handpiece

3) Procedure for manual, traction free, perforating/cutting ophthalmic surgery.

The invention is related to a device and a procedure which enables to treat certain eye diseases in human eyes with help of a surgical handpiece, which delivers an ultrashort pulse laser beam for surgery. The hand held device is capable of delivering ultrashort pulsed laser energy in the femtosecond and picosecond range directly to the ocular tissue like retina, lens (cataract) and sclera. 

Biography:

Jianmin Ma is an ophthalmologist from the Eye Center of Beijing Tongren hospital and his specialty is ocular tumors and orbital diseases. And as we all know, the Eye Center of Beijing Tongren hospital is the most famous one in China which has a large amount of patients and strong scientific research strength.

Abstract:

Biography:

Dr. Ayelet Priel is an ophthalmologist at the Chaim Sheba Medical Center at Tel Hashomer. She is a fellow in ophthalmic plastic and reconstructive surgery in the Department of Ophthalmology at the University of California in San Diego, California. She hopes that the large volume of patients and well known specialists under whom she is working will afford her the experience in training for orbital surgery and other diseases of the eye. Dr. Priel is joined by her husband and their three children. She is the recipient of a joint American Physicians Fellowship/Israel Medical Association Fellowship grant.

Abstract:

Punctal stenosis is a common cause for epiphora. The reasons for punctal stenosis vary from mechanical stenosis, iatrogenic stenosis (radiation, chemotherapy), involutional or eyelid position causing stenosis etc. Understanding the mechanism cannot always solve the stenosis that has already evolved. Several surgical punctopalsty techniques are known. Some of them involve slunting of the punctal circular muscle using a blade.

Methods- We would like to present our method in details, using the Kelly punch in two directions after dilation by a punctal dilator. OCT was performed before and after punctoplasty, in a specific method to be described. All histologic specimens were retrieved from the Kelly punch – tested also by Masson Trichome stains

Results – Histologic evaluation revealed only 1 out of 22 specimens to involve muscle, therefor not influencing the pumping mechanism which is extremely important for the normal tear flow. OCT sections of the punctum before and after punctoplasty will be presented to show anatomical enlargement of the puncta and ampullae which is statistically significant.

Conclusions- Kelly Punch Punctoplasty is a safe method for widening the punctum without sacrificing the tear pumping mechanism, with excellent results supported by histologic and imaging testing.

Biography:

Chandni Nigam has Graduated from Imperial College London and is pursuing Ophthalmology as a specialty in the UK. She holds the position of President of the Imperial College Ophthalmology Society, which was set up to enhance undergraduate ophthalmology education and promote the field to undergraduates as a career. She is a published author of peer-reviewed articles.

Abstract:

Infective conjunctivitis is a common self-limiting condition which constitutes around 35% of ocular presentation in general practice. A Cochrane systematic review investigating the effect of antibiotic treatment in the management of bacterial conjunctivitis concluded that the benefits from antibiotic use compared to placebo were marginal. UK national clinical guidelines further state that topical antibiotics should not be prescribed as first line treatment for conjunctivitis. The aim of this audit was to compare the frequency of antibiotic prescription at a busy general practice surgery against the standard set by national guidelines. A retrospective analysis of patients presenting with symptoms and signs of infective conjunctivitis over a period of fifteen months were collated using the SystemOne patient database. 97% of patients included in the study were prescribed topical antibiotics as first line treatment for conjunctivitis. Another 2% of consultations showing evidence of delayed prescribing. Doctor and patient education is important to manage expectations relating to the prescription of antibiotic to reduce unnecessary use. This has implications for reducing antibiotic resistance and improving cost-effectiveness of treatment. Changes implemented at the practice following the audit included updating general practitioners on the latest evidence and national guidelines on infective conjunctivitis management and creating an information leaflet for patients presenting with infective conjunctivitis containing advice on supportive measures to manage their symptoms.

Biography:

Mohammad Idris is an ophthalmologist at Lady Reading hospital, Pakistan. He is also the member of ophthalmological society of Pakistan.

Abstract:

Objective: To determine the effectiveness of wound closure in external dacryocystorhinostomy with use of small skin incision in terms of safety, postoperative skin scar, and patient comfort.

Materials & Method: Study design was prospective, interventional case series. The study was carried out at Department of Ophthalmology, Govt. Lady Reading Hospital, Peshawar from July 2011 to Jan 2013. We have received 100 cases from outdoor department for management and were admitted for external dacryocystorhinostomy. Data was collected on special proforma. Frequencies and percentages were calculated for age, gender and success of external DCR and causes of failure.

Result: The study population comprised of 100 cases. Females were in majority (65%). Old patients more than 40 years were common. Mean age was 60±11years. It is cosmetically better (97%) compared to large skin incision and is satisfactory to patient as well (95%). The success of external dacryocystorhinostomy was (95%).

Conclusion: Closure of external dacryocystorhinostomy skin wound closure using 8-10 mm incision Size is an effective, quick and less traumatic technique. There is less scar formation, bleeding and soft tissue damage. It is cosmetically better compared to large skin incision and is satisfactory to patient as well (95%). There is no effect on failure rate of external dacryocystorhinostomy as well compare to conventional large incision. It is slightly difficult technique as exposure of operating field is small and learning curve of this technique is longer.

Biography:

Director of ophthalmology ,Shanghai children's hospital affiliated to Jiaotong University

Abstract:

Purpose: To describe the clinical features of congenital double elevator palsy (CDEP) and to evaluate different surgical outcomes based on improvements in the primary eye position and ocular motility.

Methods: Sixteen patients with congenital double elevator palsy in Shanghai Children's Hospital were enrolled from July 2014 to January 2017. Forced duction test ( FDT ) was negative in 15 cases. Twelve patients underwent standard Knapp procedure, with or without horizontal squint procedure; one patient underwent Hummelsheim procedure (part of the tendons capsule transposed); two patients underwent augmented Knapp procedure. And one patient had inferior rectus recession in affected eye and superior rectus recession in sound eye, because FDT was positive. Cure standard was defined as final vertical residual deviation ≤10 PD and ≥25% improvement in restriction after operation.

Results: 14 of 16 patients (87.5%) were aligned to with and within 10 prism diopters (PD), all of patients (100%) reached ≥25% improvement in restriction after operation. 5 patients from severe limitation (-3) to only slight limitation (-1) or normal, while improved in the other 11 patients from moderate limitation (-2) to only slight limitation (-1) or normal. One limited case of left “double elevator palsy” was found to have the right “double elevator palsy” as well after the surgery. One case exposed bilateral DVD with esotropia after the surgery. Three patients had binocular vision before and after surgery and none gained it after surgery. No significant surgery complications were observed during the follow-up periods.

TABLE 1. Summary of horizontal rectus muscle transposition procedures (Knapp procedure)

Conclusions: Surgical procedures for CDEP must be individualized according to clinical evaluation and the results of FDT. The results of FDT is of vital importance to choose the appropriate surgical procedure. In addition, CDEP is also needed to early diagnosis and treatment to get the best outcome.

Biography:

Abstract:

Myopic eyes have a higher incidence of sight-threatening retinal complications compared with emmetropic eyes. Three techniques of refractive surgery are primarily used to reduce severe myopia: corneal refractive techniques (laser in situ keratomileusis,LASIK), phakic intraocular lens (IOL) implantation, and refractive lens exchange (RLE). Each technique has its inherent advantages and disadvantages. Thus, there has been a renewal of interest in the removal of the clear crystalline lens and RLE for the correction of severe myopia.

There have been considerable improvements in surgical technique and in the past 20 years of lens surgery.Phacoemulsification in the capsular bag, use of viscoelastic substances, implementation of sutureless corneal tunnel incision, and better equipment have improved the confidence of cataract surgeons and stimulated new interest in clear lens extraction. These considerations allowed some authors to propose that myopia correction with phacoemulsification and low-power IOL implantation can provide results comparable to those of other techniques.

Despite advances in surgical technique, retinal detachment remains a major concern after RLE for high myopia. Uhlmann et al reported that RLE by phacoemulsification in combination with pars plana vitrectomy (PPV) can reduce the risk of retinal detachment without increasing the risk of other complications, but the main limitation of their retrospective series is the small sample size (eight patients), leading to uncertainty in the conclusions. In this study, our aim was to prospectively evaluate the outcomes and complications of RLE by phacoemulsification with simultaneous PPV in the management of severe myopia.

Biography:

Chaokai Chang has graduated from Medical School of Kao-Hsiun University (1990) and has completed his PhD from South Carolina University (2011). His current positions include Chairman and CEO of Taiwan Nobel Medical Institute, President of Taiwan Cataract and Refractive Surgery Society and Taiwan Micro Invasive Aesthetic Society; Board Member of ROC Medical Laser Society, ROC Ophthalmology Society and International Medical Health Care Promotional Society. He is the Assistant Professor of Yuan -Pei University and has over 27 years of experience in cornea, refractive and cataracts surgery.

Abstract:

Purpose: To investigate if presbyopic induce accommodative spasm can be a factor in causing or aggravating dry eye disease. Teaching hospital clinical observational study combines with National Health Insurance database (population data base), 14 years of retrograde data statistical analysis.

Methods: 26193 presbyopic cases and 122959 age-matched control subjects were recruited using the National Health Insurance database. Kaplen-Meier Survival analysis method where use to calculate the hazard rates of these patients becoming dry eye. Using Stratified Cox Proportional Hazard model, confounding factors such as DM, allergic eye, post-surgery status were adjusted and the hazard rate ratio where obtained. 25 patients from dry eye clinic were recruited into the observational study. Dry eye disease was established by traditional methods. Hyperopic/presbyopic corrective glasses were prescribed and patients were follow-up with OSDI (ocular surface disease index) and other dry eye indexes.

Results: The Kaplen-Meier survival curve shows a significant difference between those cases who had presbyopia and those that do not have presbyopia diagnosis. After adjusting for confounding factors with Cox model, the hazard ratio was calculated to be 2.61, showing a significant increase of risk for those that have presbyopia to acquire dry eye disease. In the clinical observational study, full hyperopic corrections and near corrections of glasses were given to the 25 cases, the OSDI shows improvements of symptom signs as soon as 1 week time.

Conclusions: We have statistically proved that the risk of having dry eye disease is much higher if the patient had presbyopic refractive errors. Clinically follow-up of dry eye patients with aggressive treatment of this refractive error such as use of full corrective glasses show an improvement of OSDI. We therefore proposed that presbyopic refractive error can aggravate dry eye disease.