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Saturday 13 September
08:30-09:30
- IC 1
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Basic microsurgical suturing techniques for beginners
Pre Requisite Course | EBO Accredited
Leader: B. Frueh | Course Level: Basic
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Faculty: K. Mikek A. Geerards B. Bachmann
This is a pre-requisite course for the wetlab(s): BASIC SUTURING TECHNIQUES
Course Description:
This course emphasises basic microsurgical suturing techniques in open globe injuries, extracapsular cataract extraction and trabeculectomies.
Course Objectives:
To teach beginners the basic principles of suturing and preparing them for their wetlab training / their very first case of suturing.
Course Schedule:
K. Mikek: Importance of good suturing and good wound apposition; materials/needles; use of microscope, posture (10 mins)
B. Frueh: Basics of suturing, skin (8 mins)
A. Geerards: Conjunctiva, cornea (15 mins)
B. Bachmann: Trauma, trabeculectomy, sclera (15 mins)
B. Frueh: Glue (5 mins)
Single Product Course: No
Financial Disclosure: None
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Saturday 13 September
10:30-12:30
- IC 2
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The management of complications encountered during cataract surgery
Leader: R. Osher | Course Level: Intermediate
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Faculty: G. Barrett
Course Description:
This perennial course dates back to the earliest days of this Society and is the oldest course offered at the ESCRS. Dr. Osher and Dr. Barrett team up to review a broad spectrum of intraoperative complications that occur during cataract surgery. Edited videos are presented and the speakers analyze warning signs, errors, and detail the surgical maneuvers necessary to achieve a successful outcome. The topics vary from year to year but the attendee should expect lots of excitement and spirited discussion from two highly experienced cataract surgeons.
To teach early recognition of complications and to review those surgical maneuvers necessary to attain a successful outcome.
Course Objectives:
To teach early recognition of complications and to review those surgical maneuvers necessary to attain a successful outcome.
Course Schedule:
- Dr. Barrett will present 20 minutes
- Dr. Osher will present videos for the remainder of the course
Single Product Course: No
Financial Disclosure: None
- IC 3
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Basic phacoemulsification (Part 1)
Pre Requisite Course | EBO Accredited
Leader: K. Tjia | Course Level: Basic
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Faculty: A. Chakrabarti N. Reus
This is a pre-requisite course for the wetlab(s): BASIC PHACOEMULSIFICATION
Course Description:
This is a wetlab pre-requisite course. These courses are designed for the beginning phaco surgeon. The faculty have a wealth of experience of both phaco and teaching principles. An insight will be offered into what phaco machines do and how, as well as technical details of how to set about the safe removal of cataractous lens.
Course Objectives:
The beginning phaco surgeon should finish this course with an insight into the fundamentals of phacoemulsification, and be in a position to perform the surgery in a more structured and safe fashion.
Course Schedule:
Panel: Introduction (5 mins)
K. Tjia: Basic ultrasound and fluidics (40 mins)
N. Reus: Anaesthesia and potential for posterior vitreous pressure (15 mins)
A. Chakrabarti: Capsulorhexis and risk for tear out and management (15 mins)
K. Tjia: Hydrodissection (10 mins)
N. Reus: Soft nucleus management (5 mins) and K. Tjia (15 mins)
Presentations should include enough time to answer questions.
Single Product Course: No
Financial Disclosure: None
- IC 4
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Glaucoma surgery: modern perspectives
Leader: K. Barton | Course Level: Advanced
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Faculty: N. Anand S. Lim T. Shaarawy
Course Description:
This course will deal with trabeculectomy, non-penetrating filtration surgery and aqueous shunt implantation, with an introduction to newer forms of minimally invasive surgery that are on the horizon.
Course Objectives:
The purpose of this course is to describe best practice in trabeculectomy, non-penetrating filtration surgery and aqueous shunt implantation with emphasis on the steps that are essential for success.
Course Schedule:
Surgical technique – key steps and pitfall avoidance:
Keith Barton: Trabeculectomy
Nitin Anand: Trabeculectomy post-op care
Nitin Anand: Non-penetrating surgery
Sheng Lim: Aqueous shunt implantation
New techniques:
Keith Barton: Minimally invasive surgery – a foretaste
Tarek Shaarawy: Suprachorodial shunts
Single Product Course: No
Financial Disclosure: None
- IC 5
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Corneal cross-linking therapy
Pre Requisite Course | EBO Accredited
Leader: K. Mikek | Course Level: Intermediate
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Faculty: C. Koppen Z. Nagy D. O Brart T. Seiler
This is a pre-requisite course for the wetlab(s): CORNEAL CROSS-LINKING THERAPY
Course Description:
This course will provide principles of corneal cross-linking treatment. The course will cover the history and concept behind cross-linking, laboratory studies, pharmaceutical properties of riboflavin and the role of ultraviolet irradiation. Epidemiological data, aetiology, pathogenesis and diagnosis of keratoconus and other corneal ectasias will be discussed. The indications and contraindications for cross-linking therapy including details of different treatment protocols, dosage of riboflavin, and postoperative care will be covered. The result from different centers of corneal cross-linking treatment on its own and when combined with other corneal procedures will be presented. The complications of treatment, theories of corneal wound healing, indications for transepithelial cross-linking, and finally new trends in the use of this technology will be discussed. An overview of the different technologies will be given.
Course Objectives:
This course will allow participants to become familiar with cross-linking treatment. During the course the detailed information about the treatment procedure will be covered: how to make de-epithelization in different ways, installation of the riboflavin eye drops - particularly dosage, handling and testing of different UV radiation systems.
Course Schedule:
1. Kristina Mikek, Slovenia: Introduction: aim of the instructional course together with the wetlab and introduction of the presented speakers (5 mins)
2. Carina Koppen, Belgium: Corneal ectasias and corneal biomechanics: corneal ectasias - epidemiology, genetics, pathophysiology, clinical features, and overview of management options. Corneal biomechanics - corneal structure, possible measurement techniques in-vitro and in-vivo, limitations of current knowledge (25 mins)
3. Zoltan Nagy, Hungary: Principles of corneal collagen cross-linkage: principles of corneal collagen cross-linkage with the review of initial laboratory studies in relation to efficacy and safety (20 mins)?
4. David O Brart, UK: Review of published clinical studies: Update on RCT in London, efficacy, safety, complications, and limitations of current knowledge (30 mins)
5. Kristina Mikek, Slovenia: Operative techniques: Pre-operative assessment, patient counseling, the role of epithelial removal, transepithelial cross-linking, riboflavin dosage regimens, UVA exposure regimens, UV lamps and calibration, post-operative care and follow-up, complications (20 mins)?
6. Theo Seiler, Switzerland: Corneal cross-linking and refractive surgery (20 mins)
Single Product Course: No
Financial Disclosure: None
- IC 6
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Surgical management of malpositioned lenses
Pre Requisite Course
Leader: B. Malyugin | Course Level: Advanced
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Faculty: E. Assia K. Rosenthal V. Pfeifer M.J. Tassignon A. Crandall
This is a pre-requisite course for the wetlab(s): INTRAOCULAR & TRANSCLERAL SUTURING TECHNIQUES
Course Description:
This course is focused on the advanced surgical techniques in the management of cataract cases complicated by the zonular weakness and zonular dialysis with the various types of capsular supporting devices. Participants will benefit from learning different IOL explantation and exchange techniques as well as the microendoscopy assisted vs conventional scleral fixation techniques.
Course Objectives:
Moderate to severe subluxation of the natural crystalline lens can be effectively treated using the conventional and modified CTRs, capsular tension segment and capsular anchor sutured to the scleral wall. Video presentation of a series of cases will provide tips for safe and efficient surgery. Capsular peeling as a part of the technique to restore the integrity of the capsular bag will be shown in different cases of postoperative capsular contraction. The implications of torqued IOL in inducing reduction in visual quality and lenticular astigmatism will be discussed. Participants will benefit from learning the techniques of suturing various types of malpositioned IOLs to the sclera and/or to the iris in order to provide stable long-term fixation. The use of an endoscope to position the suture directly into the ciliary sulcus will be described in detail.
Course Schedule:
Boris Malyugin: Overview of the course topics. Discussion of the main reasons of IOL explantation and exchange. Microendoscopy assisted vs conventional scleral fixation techniques of different IOL models. Management of cataract cases complicated by the large zonular dialysis with the new CTR model (15 mins)
Discussion (5 mins)
Ehud I. Assia: Moderate to severe subluxation of the crystalline lens using the capsular anchor. Different malpositioned IOL suturing techniques. Combined iris-scleral IOL suturing, 4-point iris fixation techniques (15 mins)
Discussion (5 mins)
Vladimir Pfeifer: Iris and ciliary sulcus fixation of three-piece IOL using straight needle. Surgical tactics in natural lens subluxation (15 mins)
Discussion (5 mins)
Kenneth J. Rosenthal: Implications of torqued IOL in inducing reduction in visual quality and lenticular astigmatism. Original technique to suture the lens with tutoplast scleral patches to cover. The viability of secondary IOL sutured to the anterior iris surface, and the use of multifocal IOL’s in exchange (15 mins)
Discussion (5 mins)
Marie-José Tassignon: Dislocated IOL exchange with bag-in-the lens implantation techniques. New CTRs (15 mins)
Discussion (5 mins)
Alan Crandall: Gore-Tex sutures and Cionni modified CT rings and Ahmed CT segments (15 mins)
Discussion & final remarks (5 mins)
Single Product Course: No
Financial Disclosure: Gains financially from competing product or procedure, receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented
- IC 7
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LASIK: basic steps for safety and great results
Pre Requisite Course
Leader: G. Pamel | Course Level: Basic
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Faculty: A. Kanellopoulos J. Vryghem A. Stojanovic
This is a pre-requisite course for the wetlab(s): LASIK
Course Description:
Didactic approach to basic principles in LASIK. Excimer technology will be analysed, as well as microkeratome function and use. Indications, methodology and technique will be approached in a basic didactic function including post-operative care and management of the most common complications. Patient selection and treatment criteria will be discussed as well. This course will focus on the novice clinician, but will reiterate the basic principles for the experienced as well.
Course Objectives:
The participants will share our experience and pearls of indications, patient selection, surgical technique and complication management for safe and effective results.
Course Schedule:
1. Common indications for LASIK surgery are:
- Anisometropia
- Significant ametropia
- Intolerance of contact lens use
- Intolerance of spectacle use
2. Common procedures that have preceded LASIK are:
- RK and AK
- PRK
- INTACS
- Clear lens extraction
3. LASIK for myopia, astigmatism and hyperopia
- Indications
- Surgical technique adaptations for specific refractive errors
- Adjuvant medications
- Post-operative management
- Possible complications and their management
4. LASIK patient selection
- Indications
- Medical contraindications
- Personality dangers
- Pre-operative evaluation and refractive error
5. LASIK instrumentation-microkeratomes
- Basic principles
- Pre-operative evaluation parameters
- Surgical technique
- Possible complications and their management
- Maintenance issues
6. LASIK instrumentation-excimer lasers
- Basic principles
- Pre-operative evaluation parametres
- Surgical technique
- Possible complications and their management
- Maintenance issues
7. LASIK in action
Step-by-step action on several procedures on tape, question-answer session and coverage of basic problem shooting with the panelists
Single Product Course: No
Financial Disclosure: Travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented
- IC 8
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The Joseph Colin ESCRS course on diagnosis and management of microbial keratitis
| EBO Accredited
Leader: T. O'Brien | Course Level: Intermediate
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Faculty: J. Alio J. Güell
Course Description:
This course is a comprehensive introductory course covering all aspects of clinical and laboratory diagnosis, principles of antimicrobial therapy and adjunctive care, including surgical management of microbial keratitis.
The course will include the following topics:
Overview: Rapid, specific diagnosis and rational therapy for proper management
Microbiological and molecular biology techniques for the diagnosis of infectious keratitis
Diagnosis and management of fungal keratitis
Acanthamoeba keratitis: surgical approach
Management of herpes simplex keratitis: new approach
Update on rational antimicrobial therapy, including newer agents for bacterial, fungal and amoebic keratitis.
Course Objectives:
The participants will be able to diagnose different types of infectious keratitis and will be able to treat them specifically.
Course Schedule:
Advances in diagnosis and therapy of:
T. O’ Brien: Bacterial keratitis
J. Alio: Fungal keratitis
J. Güell: Acanthamoeba keratitis
T. O’Brien and J. Alio: Herpes virus keratitis
J. Güell: Surgical management
Single Product Course: No
Financial Disclosure: None
- IC 9
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Phototherapeutic keratectomy: the past, the present and the future
Leader: P. Vinciguerra | Course Level: Advanced
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Faculty: D. Reinstein J. Alio R. Vinciguerra
Course Description:
The course will be divided into four sections. The first part, the authors will present the main indications for phototherapeutic keratectomy, considering the preoperative examinations, the importance of keratoscopy and topography, the most important exclusion criteria and confounding factors. In the second part of the course, presentations will focus on how to prepare a shot file taking into account the importance of the epithelium in irregular corneas, the smoothing with masking fluid and when to decide to stop the treatment. In the third section a new, multi-step technique for the management of difficult cases will be presented (SCTK). In the last section long-term results will be presented.
Prof. Epstein will moderate and facilitate questions and stimulate discussions with the audience.
Course Objectives:
Attendees will learn the main indications of phototherapeutic keratectomy, ranging from traumas, to corneal dystrophies. At the end of the course they will be able to decide when to advise a patient for corneal transplant rather than phototherapeutic keratectomy. Moreover they will learn the role of the epithelium and they will be able to understand the most important steps to prepare a shot file for a phototherapeutic keratectomy.
Course Schedule:
1) J. Aliò: Main indications and limits for PTK (15 min)
2) P. Vinciguerra: Preoperative examination: from slitlamp to OCT (10 min)
3) J. Aliò: How to plan a therapeutic treatment: ablation diameter size, amount of tissue, transepithelial vs non transepithelial (10 min)
4) D. Reinstein: The epithelium (20 min)
5) D. Reinstein: What to look for during the treatment (10 min)
6) Sequential customized therapeutic keratectomy (SCTK) (20 min)
7) The smoothing with masking fluid: what it is, how to do it and why we need it (5 min)
8) R. Vinciguerra: The achievement of a safe and effective improvement of BCVA: quality or quantity of visual acuity (10 min)
9) J. Aliò: Long-term result (10 min)
10 min discussion and questions (divided after every talk)
R. Vinciguerra: Question facilitator
Single Product Course: Yes
Financial Disclosure: Has significant investment interest in a company producing, developing or supplying product or procedure presented, travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented
- IC 10
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Posterior capsule rupture: mastering vitrectomy and IOL implantation – a video based course
Leader: Ath. Agarwal | Course Level: Intermediate
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Faculty: D. Chang A. Agarwal R. Steinert B Little K. Mehta
Course Description:
Posterior capsule rupture can be daunting. One has to know how to perform anterior vitrectomy, manage drop nucleus and also learn to implant an IOL in such cases. All this will be taught through videos.
Course Objectives:
The objective of the course is to see that the delegate can handle any posterior capsule rupture and still implant an IOL comfortably.
Course Schedule:
Introduction and PC Ruptures: Athiya Agarwal (20 mins)
Vitrectomy techniques for the anterior segment surgeon: Amar Agarwal (20 mins)
Managaing the nucleus after a PC Rupture: David Chang (20 mins)
Implanting the IOL after PC ruptures: Keiki Mehta (20 mins)
Challenges of handling PC ruptures: Brian Little (20 mins)
Disaster management: Roger Steinert (20 mins)
Single Product Course: No
Financial Disclosure: None
- IC 11
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Multifocal and accommodative IOLs: face the challenge
Leader: M. Piovella | Course Level: Advanced
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Faculty: C. Carbonara D. Chang J. Pepose
Course Description:
We will review the state-of-the-art knowledge on presently available multifocal/multifocal toric and accommodative IOLs (MAI). Their features, indications and contraindications, matching possibilities, and clinical results, pursuing highly satisfactory uncorrected distance, intermediate, and near vision, will be examined and discussed.
Course Objectives:
Attendees will receive information on how to use MAI. A structured approach on patient and IOL selection based on accurate matching of IOL features with patient needs will be provided. IOL performance in terms of contrast sensitivity, light distribution and loss, management of complications and visual complaints with available solutions will be discussed.
Course Schedule:
Multifocal and accommodative IOLs
1. Optivis
2. Acrilisa – a) Acrilisa toric, b) Trifocal IOLs, c) Trifocal Toric
3. ReSTOR SN60D3 – ReSTOR Toric
4. Tecnis ZM900 (AMO)
5. Synchrony
6. Review Soleko
7. Chrystalens
8. AcriLisa – AcriLisa Toric
9. Multifocal Toric
10. New generation multifocal IOLs
Multifocal and accommodative IOL management
1. Contrast sensitivity
2. Light distribution at different distances
3. Light loss
4. Mix-and-match – a) Tecnis/ReZoom, b) ReSTOR/ReZoom
5. Visual neuroadaptation
6. Intermediate and near vision evaluation
7. Ten pearls – a) Patient selection, b) Management of complications, c) Visual habits, d) Dominant eye, e) Biometry, f) Pupil size – i) Mesopic, ii) Photopic, iii) Near and distance vision as related to pupil size, iv) Pupil diameter and IOL efficacy
8. Astigmatism – a) Amount of astigmatism
9. Which IOL implant first?
10. Time to second eye surgery
11. Residual defect correction (enhancement)
12. The role of pupil diameter
13. Monofocal aspherical providing near vision? – a) AcrySof SN60WF (Alcon), b) Zeiss
Complications management
1. Adequate, flexible postop time schedule
2. How to get refractive plano results
3. Why 0.75 diopters SE refraction causes loss of one line of VA
4. How long to wait before laser refractive treatment
5. Explantation techniques: when and why
Single Product Course: No
Financial Disclosure: Receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented
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Saturday 13 September
14:30-16:30
- IC 12
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LASIK: update with surgical tips in primary and secondary cases – basic comparison with surface ablation technique
Pre Requisite Course
Leader: D. Elies Amat | Course Level: Basic
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Faculty: M. Remy F. Malecaze J. Gaytan-Melicoff C. Von Mohrenfels A. Marinho
This is a pre-requisite course for the wetlab(s): LASIK
Course Description:
LASIK for correcting refractive errors is the most common and widely accepted refractive surgery. This course will provide basic and fundamental information about the special characteristics of LASIK, compared with PRK, as well as the new femtosecond-assisted refractive correction (FLEX and Smile procedures) the use or non-use of ethanol in surface ablation techniques and the role of wavefront-guided strategies with respect to excimer-induced higher-order aberrations will be explained. A range of complications will be identified, and compared with adverse events associated with PRK. Videos of the surgical techniques and some complications will be shown. The background information will be provided in handouts for each participant of the course.
Course Objectives:
The purpose of this course is to describe best practice in LASIK corneal refractive surgery, compared with PRK and femtosecond lenticule extraction techniques, emphasizing on the steps that are essential for success. The course will cover the indications and patient selection criteria for these three procedures, and discuss in detail the modern surface ablation compared to LASIK.
Course Schedule:
Daniel Elies - Introduction: Outline and main goals of the course
1. Matthias Remy - Preoperative evaluation: “What are the critical evaluations and considerations before the surgery?”
2. Francois Malecaze - LASIK surgical technique: basics “step by step” tricks
3. Javier Gaytan - Main surgical tips with the different approaches for LASIK reoperations)
4. C.W. von Mohrenfels - Basic comparison (advantages-disadvantages) between LASIK and surface ablation techniques
5. Daniel Elies - How to handle the main and most common peroperative complications including his own tips for basic LASIK surgery
6. Antonio Marinho - The limits on corneal ablation techniques: main concepts in anatomical and refractive data
All: Guided discussion. Question and answers from the audience.
Single Product Course: No
Financial Disclosure: None
- IC 13
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Basic phacoemulsification (part 2)
Pre Requisite Course | EBO Accredited
Leader: N. Reus | Course Level: Basic
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Faculty: K. Tjia A. Chakrabarti
This is a pre-requisite course for the wetlab(s): BASIC PHACOEMULSIFICATION
Course Description:
These courses are designed for the beginning phaco surgeon. The faculty have a wealth of experience of both phaco and teaching principles. An insight will be offered into what phaco machines do and how, as well as technical details of how to set about the safe removal of cataractous lens.
Course Objectives:
The beginning phaco surgeon should finish this course with an insight into the fundamentals of phacoemulsification, and be in a position to perform the surgery in a more structured and safe fashion.
Course Schedule:
N. Reus: Nucleus management, medium cataract, crack techniques (20 mins)
N. Reus: Nucleus management, hard cataracts, introduction to chop techniques (10 mins)
A. Chakrabarti: Nucleus management, hard cataracts, personal chop techniques (20 mins)
A. Chakrabarti: Mature cataracts (10 mins)
K. Tjia: Nucleus management, hard cataracts, manual chop techniques (10 mins)
A. Chakrabarti: Small pupil management (20 mins)
K. Tjia: Posterior capsule rupture management (20 mins)
Panel: Questions and answers (10 mins)
Single Product Course: No
Financial Disclosure: None
- IC 14
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Management of astigmatism in conjunction with contemporary lens-based surgery
Leader: L. Nichamin | Course Level: Advanced
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Faculty: J. Rubenstein
Course Description:
Course will cover management techniques for pre-existing astigmatism, specifically at the time of implant surgery, with focus upon intralimbal relaxing incisions, toric IOLs and laser (femto/excimer) treatment modalities.
Course Objectives:
Attendees will gain insight as to how to surgically manage astigmatism, with an emphasis on treating astigmatism in combination with phaco and IOL surgery.
Course Schedule:
Dr. L. Nichamin: Fundamentals of astigmatism and options for surgical correction (15 min)
Dr. L. Nichamin: LRI’s—detailed description of surgical technique and video (30 min)
Dr. L. Nichamin: Laser correction of astigmatism (15 min)
Dr. J. Rubenstein: LRI’s—alternative and personal technique (20 min)
Dr. J. Rubenstein: Toric IOL’s (20 min)
Questions and answers: (20 min)
Single Product Course: No
Financial Disclosure: Receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented
- IC 15
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Big bubble, no trouble: a step by step approach to successful deep anterior lamellar keratoplasty with the big bubble technique
Leader: A. El danasoury | Course Level: Intermediate
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Faculty: S. Hannush R. Fogla
Course Description:
Deep anterior lamellar keratoplasty (DALK) has many advantages over penetrating keratoplasty for corneal pathologies sparing the endothelium, the most important is preserving the recipient healthy endothelium. The big bubble (BB) technique enables the DALK surgeon to expose Descemet’s membrane in most cases, however the surgical technique is challenging and it may need a long time to be mastered by a beginner surgeon. This video based course will address the DALK surgical technique in a step by step approach, highlighting the principle, surgical pearls and possible complications at each step from trephination to suturing going through bubble injection, puncture and stromal dissection. Also indications, clinical outcome and management of postoperative complication will be discussed in details.
Course Objectives:
At the completion of the course, attendees should be able to understand the basic surgical principles of BB-DALK, learn different techniques for safe Descemet exposure, avoid surgical pitfalls that may lead to intraoperative difficulties and prevent and manage postoperative complications should they occur. The course will be conducted by an expert panel, with video based presentations that will create an interactive debate both among the speakers and audience.
Course Schedule:
Introduction to the course and the panel (2 min)
Alaa ElDanasoury: Basic big bubble DALK technique (8 min)
Alaa ElDanasoury: My best 5 tips for trephination (8 min)
Comments from panelists and discussion (5 min)
Sadeer Hannush: My best 5 tips for bubble injection (10 min)
Comments from panelists and discussion (5 min)
Rajesh Fogla: My best 5 tips for bubble puncture (10 min)
Comments from panelists and discussion (5 min)
Alaa ElDanasoury: My best 5 tips for stromal dissection (10 min)
Comments from panelists and discussion (5 min)
Sadeer Hannush: My best 5 tips for donor preparation (10 min)
Comments from panelists and discussion (5 min)
Rajesh Fogla: My best 5 tips for suturing (10 min)
Comments from panelists and discussion (5 min)
Alaa ElDanasoury: Complications - avoidance and management (10 min)
Comments from panelists and discussion (5 min)
Sadeer Hannush: Clinical outcome (10 min)
Comments from panelists and discussion (5 min)
Single Product Course: No
Financial Disclosure: None
- IC 16
-
Collagen cross-linking: indications, applications, results, complications and evolving technology
Leader: A. Kanellopoulos | Course Level: Advanced
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Faculty: D. Stulting G. Pamel E. Donnenfeld J. Marshall C. Karabatsas
Course Description:
Didactic approach to the management of progressive cornea ectasia associated with keratoconus and refractive surgery. Several surgical treatment modalities utilized internationally will be presented, including: collagen cross-linking with ultraviolet radiation A in order to halt ectasia, combined in some cases with a customised excimer laser ablation to facilitate visual rehabilitation (as presented in previous ESCRS meetings by the author), these alternatives to intracorneal ring segment implantation, lamellar grafts as well as penetrating graft techniques will be analyzed. Surgical and medical treatment technique, indications, potential complications and their management as well as clinical experience pearls will be presented.
Course Objectives:
The participants will share our vast experience in managing progressive keratoconus and post-LASIK ectasia in order to visually rehabilitate these patients.
Pearls on indications, patient selection, surgical technique and complication management for safe and effective results will be presented and discussed with the participants.
Course Schedule:
1. Keratoconus surgical management, Literature review:
- Thermokeratoplasty
- Lamellar grafts
- INTACS
- Penetrating keratoplasty
- Cornea collagen cross-linking
2. Post-LASIK ectasia-surgical management, literature review:
- How to avoid-risk factors
- Thermokeratoplasty
- Lamellar grafts
- INTACS
- Penetrating keratoplasty
- Cornea collagen cross-linking
3. Patient selection:
- Indications
- Medical contraindications
- Pre-operative evaluation and refractive error
4. Stabilization of ectasia:
- INTACS
- Collagen cross-linking
- Lamellar tissue support
5. Collagen cross-linking:
- Energy source, luminance and duration
- Protective riboflavin A
- Cornea pachymetry issues
- Topographic and elevation changes
- Stabilization of ectasia
- When is it best to intervene?
- FDA issues
6. Customised enhancement techniques:
- Wavefront-guided
- Topography-guided
- Asphericity adjustment
7. Microkeratome-assisted lamellar keratoplasty technique:
- Basic principles
- Pre-operative evaluation parametres
- Surgical technique
- Possible complications and their management
- Clinical data and review of the literature
8. Penetrating keratoplasty considerations:
- Basic principles
- Pre-operative evaluation parametres
- Surgical technique
- Possible complications and their management
- Clinical data and review of the literature
9. Refractive surgery enhancements following these procedures
10. Surgery in action:
Step-by-step action on several procedures on tape, question-answer session and coverage of basic problem-shooting with the panelists
Single Product Course: No
Financial Disclosure: Travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented
- IC 17
-
PRK, LASEK and Epi-LASIK
Pre Requisite Course
Leader: D. Epstein | Course Level: Basic
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Faculty: I. Pallikaris
This is a pre-requisite course for the wetlab(s): PRK, LASEK & EPI-LASIK
Course Description:
The special characteristics of PRK, LASEK and Epi-LASIK as well as the use or non-use of ethanol will be elucidated. The role of wavefront-guided strategies with respect to excimer-induced higher-order aberrations will be demonstrated. Outcomes achievable with cutting-edge technology will also be presented. A range of complications will be identified, and compared with adverse events associated with LASIK. Brief videos of the surgical techniques will be shown.
Course Objectives:
The course will cover the indications and patient selection criteria for these three procedures, and discuss in detail the advantages of modern surface ablation as compared to LASIK.
Course Schedule:
D. Epstein: Basic principles (15 mins)
D. Epstein: PRK (15 mins)
I. Pallikaris: Advanced surface ablation (15 mins)
I. Pallikaris: Epi-LASIK (15 mins)
D. Epstein: Complications (15 mins)
I. Pallikaris / D. Epstein: Wavefront guided ablations and other advanced techniques (15 mins)
Discussion (30 mins)
Single Product Course: No
Financial Disclosure: None
- IC 18
-
How to incorporate diagnosis and management of dry eye into a refractive surgery practice
| EBO Accredited
Leader: M. McDonald | Course Level: Basic
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Faculty: A. Cummings A. Epitropoulos J. Pepose
Course Description:
Undiagnosed dry eye can have a negative impact on visual outcomes following laser refractive surgery. This course will explain the benefits of proactively screening for dry eye, as well as how to treat prior to surgery.
Course Objectives:
Following this course, attendees will have a better understanding about why dry screening is critical in refractive surgery patients, as well as how to treat patients prior to performing laser surgery.
Course Schedule:
- How to incorporate dry eye testing into the practice workflow
- Tear osmolarity testing vs other dry eye diagnostic tests
- Clinical results of tear osmolarity testing
- The benefits of incorporating dry eye screening into the refractive surgery work-up
Single Product Course: No
Financial Disclosure: None
- IC 19
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Best of the best: an update in cataract surgery
Leader: M. Piovella | Course Level: Advanced
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Faculty: L. Mastropasqua S. Schallhorn R. Steinert B. Dick
Course Description:
This course discusses how advances in technology, Femtolaser cataract surgery biometry, IOLs, phaco machines, and indications are making cataract surgery extremely similar to refractive surgery.
Course Objectives:
To provide the attendees key information in applying a refractive surgery approach to exploiting recent technological, surgical, organizational, and patient management advance.
Course Schedule:
1) Introduction. Cataract surgery is becoming refractive surgery?
2) Patient needs
i) Far, near, intermediate vision
ii) Age of surgery and life expectancy
iii) Lifestyles
iv) Identifying and understanding needs
v) Demanding patients
3) Patient evaluation
i) Topography
ii) Aberrometry
iii) Scheimpflug
iv) Pupillometry
v) Angle evaluation: AS OCT
vi) Macular evaluation: OCT
vii) Cataract surgery in refractive surgery patients
viii) IOLMaster
4) Phaco machines vs. Femtosecond laser
i) New phaco settings
ii) Phaco efficiency
iii) Femtosecond laser: present and future
5) IOLs
i) Accommodative
ii) Multifocal
iii) Monofocal
iv) Aspheric
6) Postoperative vision quality
i) The importance of the pupil
ii) Plano target: result management
7) Complication and Complicated cases
i) Management of complications with premium IOLs
ii) Premium IOLs and posterior capsule break
iii) IOL decentration
iv) IOL damage
v) PC opacity
8) Management of the process
i) How to identify patients that will be advantaged by premium IOLs
Single Product Course: No
Financial Disclosure: Receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented
- IC 20
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Management of cataract in challenging cases
Leader: A. Vasavada | Course Level: Advanced
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Faculty: S. Arshinoff Z. Biro A. Crandall R. Osher D. Spalton
Course Description:
This course will review surgical options for successfully managing difficult cataracts and challenging situations. The course will also encompass challenging situations, like shallow chamber, small pupil, pseudoexfoliation and zonular compromise.
Course Objectives:
At the conclusion of this course, the attendee will understand the clinical pearls and tips for enhancing surgical skills and optimizing outcomes in difficult cataract scenarios.
Course Schedule:
Dr. Abhay R. Vasavada - Phacoemulsification in posterior polar cataract ( 20 mins)
Dr. Alan Crandall - Capsule support devices in loose zonules ( 20 mins)
Dr. Steve Arshinoff - Optimising viscoelastic devices ( 20 mins)
Dr. David Spalton - Difficult cataract in a monocular patient ( 20 mins)
Dr. Zsolt Biro - Managing white mature cataract ( 20 mins)
Dr. Robert Osher - Managing floppy iris ( 20 mins)
Single Product Course: No
Financial Disclosure: None
- IC 21
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Multifocal IOLs: pearls and pitfalls
Leader: K. Gekeler | Course Level: Intermediate
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Faculty: K. Boden A. Hunold
Course Description:
The key role for optimal results and a satisified patient is the preoperative selection and a well informed patient. For this, the surgeon has to know the different concepts of MIOLs and the criteria for patient selection. Other critical aspects are patient guidance, preoperative patient information, IOL selection, implantation technique, post-operative care. The participants should finish this course with an insight into the fundamentals of MIOL implantation.
Course Objectives:
The course is designed for experienced phaco surgeons. It comprises the inclusion and exclusion criteria for MIOLs and offers an insight into clinical studies as well as personal experiences of the instructors with MIOLs. The preoperative patient selection, understanding of the concepts multifocal IOLs and postoperative care will be discussed.
Course Schedule:
Introduction (3 minutes)
Karl Boden: Overview of the available models of MIOLs. Refractive and diffractive MIOLs, toric MIOLs (20 min)
Anne Hunold: Patient selection: tips and pearls for your first 20 patients (15 min)
Anne Hunold: Results from the Happy Patient Study, conclusions for the daily practice (15 min)
Katrin Gekeler: Which near addition for which patient? (20 min)
Katrin Gekeler: MIOLs in anisometropic amblyopic eyes and contraindications. How strict should we be? (15 min)
Karl Boden: Multifocal Add-on MIOLs (10 min)
Anne Hunold: Screening for potential sources of complications with presbyopic IOLs (15 min)
Katrin Gekeler; Karl Boden; Anne Hunold: Discussion - How to manage the unsatisfied patient, questions and answers (10 min)
Single Product Course: No
Financial Disclosure: Receives consulting fees, retainer, or contract payments from a competing company
-
Saturday 13 September
17:00-18:00
- IC 22
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Boston type 1 keratoprosthesis: from indications to innovations
Pre Requisite Course | EBO Accredited
Leader: M. Cortina | Course Level: Advanced
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Faculty: S. Hannush J. de la Cruz J. Güell
This is a pre-requisite course for the wetlab(s): BOSTON KERATOPROSTHESIS (B-KPro)
Course Description:
With the emerging success of the Boston KPro type I keratoprosthesis as an alternative to multiple failed corneal transplant, there is a renewed interest in adequate patient selection, implantation techniques, as well as proper postoperative management. Successful keratoprosthesis surgery and retention requires a unique interaction between the corneal prosthesis and its surrounding environment.
Course Objectives:
This video and case vignette based course aims to instruct the surgeon in understanding the basic concepts of Boston KPro type I surgery and management. The course will also present established as well as novel methods on how to successfully approach surgery of the KPro type I in clinical practice.
Course Schedule:
Introduction (1 min)
Preoperative evaluation: S. Cortina (13 min)
Detailed review of most important considerations in patient selection and preoperative assessment when preparing to implant a Boston type 1 Kpro.
Surgical approach: S. Hannush (14 min)
Step by step from assembly to implantation of the Boston type 1 Kpro.
Postoperative management with focus on glaucoma: J. Güell (14 min)
After a review of the International and Institutional experience with the Boston KPro Type I, we will focus on the most important surgical tips especially those related with the management of glaucoma
Innovations and current challenges: J. de la Cruz (14 min)
Recent innovations in device design, preoperative and postoperative management will be discussed as well as future directions in the field of keratoprosthesis.
Questions and answers (4 min)
Single Product Course: Yes
Financial Disclosure: None
- IC 23
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Intracorneal rings for keratoconus and post-LASIK ectasia
Pre Requisite Course
Leader: D. Touboul | Course Level: Intermediate
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Faculty: C. Roberts G. Mello
This is a pre-requisite course for the wetlab(s): FERRARA RINGS, KERARINGS AND INTACS
Course Description:
Several studies have demonstrated that intracorneal rings are able to improve the corneal shape and visual acuity of contact lens intolerant keratoconic patients with central clear cornea.
Different models are currently available.
The rings may be implanted into the stroma with a conventional manual dissection, or with the help of femtosecond laser technology. They are implanted at the periphery of the cornea at two-third depth. The goals of the rings are to improve vision acuity, to prevent or delay corneal grafts and to make contact lens intolerant patients become tolerant.
More than 100,000 Intacs have been implanted worldwide, with an improvement of the vision in about 80% of cases.
The procedure may be used in primary corneal ectasia, keratoconus, or in cases of post-LASIK ectasia.
The procedure is reversible: the rings may be removed if needed.
The course will include the discussion of sequential or simultaneous rings implantation and corneal collagen cross-linking.
Course Objectives:
The attendees will be able to learn the principles, when to indicate the technique and how to diagnose and solve complications in patients with intracorneal rings. At the end of the course, the attendees will be able to participate in a surgical lab and learn how to implant the intracorneal rings.
Course Schedule:
D. Touboul: ICRS for keratoconus and post-LASIK ectasia: basic knowledge (15 + 5 mins)
C. Roberts: Biomechanical concerns hiding behind the rings insertion (15 + 5 mins)
G. Mello: ICRS practice in routine: good and bad illustrated cases (15 + 5 mins)
Single Product Course: No
Financial Disclosure: Receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented
- IC 24
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Learning phaco chop: pearls and pitfalls
| EBO Accredited
Leader: D. Chang | Course Level: Intermediate
-
Faculty: K. Tjia
Course Description:
Phaco chop minimizes ultrasound time and zonular stress. Pearls and strategies for learning this technique will be presented based upon the instructors' experience in teaching residents. Both horizontal (Nagahara) and vertical (quick chop) methods of chopping will be taught with video footage. A stepwise game plan for converting to phaco chop will be presented, along with phacodynamics principles for selecting machine parameters and instrumentation.
Course Objectives:
Attendees will learn both variations of the phaco chop technique, their advantages in complicated cases, the instrumentation, machine parameters, and transition steps involved, and common mistakes.
Course Schedule:
D. Chang: Horizontal versus vertical chop (20 mins)
D. Chang: Transitioning to chop (15 mins)
D. Chang: Chopping brunescent nuclei (5 mins)
K. Tjia: Phacodynamics (20 mins)
Single Product Course: Yes
Financial Disclosure: Receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented
- IC 25
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Management of pterygium: current trends
Leader: T. Chowdhury | Course Level: Intermediate
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Faculty: I. Athanasiadis J. Beltz S. Das
Course Description:
Pterygium surgery should not be taken lightly! Recurrence of pterygium after surgical excision is a frustrating complication for both the surgeon and the patient.
The purpose of this course is to discuss the surgical options available in the management of different types of pterygia (primary, recurrent and double-headed),
the various ways of conjunctival graft fixation for pterygium surgery and how to achieve optimal results.
Course Objectives:
The speakers will demonstrate the various surgical procedures with videos and provide practical tips to achieve the best results. This course is meant for the comprehensive Ophthalmologist who will be able to appreciate the different methods of conjunctival autografting in pterygium surgery. The attendees will have plenty of time for discussion and any queries.
Course Schedule:
Dr. Sayan Das: Introduction and overview of pterygium (10 minutes)
Dr. Jacqueline Beltz: Primary pterygium - different modalities of management (10 minutes)
Dr. Tuhin Chowdhury: Different ways of graft fixation in pterygium surgery, their results, complications and overview (15 minutes)
Dr. Ioannis Athanasiadis: Recurrent pterygium - challanges and the pearls of management (15 minutes)
Panel Discussion (10 minutes)
Single Product Course: No
Financial Disclosure: None
- IC 26
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State-of-the-art corneal tomographic indices in the screening of keratoconus risk for refractive surgery
Leader: R. Krueger | Course Level: Intermediate
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Faculty: D. Smadja M. Nuñez C. Arce
Course Description:
This course will describe and explain the use of the traditional topographic indices for screening keratoconus like the keratoconus prediction index (KPI), keratoconus probability (KProb), Inferior-Superior (I-S or Rabinowitz index), and cone location and magnitude index (CLMI) derived from the anterior surface and other tomographic indices like the squared eccentricity (e2), Kmax, best fit sphere (BFS) and best fit toric aspheric (BFTA) derived from both, the anterior and the posterior corneal surfaces, the thickness progression index (TPI) and their differences and equivalency with indices produced by different devices like the Belin-Ambrosio display (BAD).
This course will also review the new aspheric-asymmetric index (AAI or Kranemann-Arce index) and the CLMIx (that combines anterior and posterior surface and pachymetry) which were recently published as the best statistical discriminators of frustre and initial keratoconus. A correlation of these indices with the total corneal wavefront will also be provided.
Course Objectives:
The objective of this course is to teach any laser refractive surgeons how to separate normal corneas with and without risk factors of postoperative ectasia from frustre or initial corneas with keratoconus based in the corneal topographic, tomographic, pachymetric and wavefront data supplied by a dual Scheimpflug and Placido analysis system of the anterior segment of the eye.
Course Schedule:
Ronald Krueger MD from Cleveland Clinic, USA will explain the basis and principles of topographic and tomographic indices for preoperative screening of keratoconus and the consequences of laser refractive surgery in the cornea.
Maria Ximena Nuñez MD from the Ophthalmology Clinic of Cali, Colombia will explain the base and use of the CLMI and CLMIx indices.
David Smadja MD from the National Centre of Reference in Keratoconus and the University Hospital Centre of Bordeaux, France, will explain the base and use of the AAI index and the intelligent software to diagnose keratoconus.
Carlos G. Arce MD from the Federal University of Sao Paulo, Brazil, will explain the TPI, e2, wavefront data and the comparison with indices shown in other devices.
Single Product Course: No
Financial Disclosure: Receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented
- IC 27
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How to improve your refractive outcomes by skilful interpretation of corneal mapping
Leader: A. Cummings | Course Level: Advanced
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Faculty: E. Ng
Course Description:
This course describes the relationship between features of corneal mapping and outcomes of refractive and cataract surgeries.
Corneal mapping will be discussed in terms of Scheimpflug-based, Placido-based and anterior OCT images.
Course Objectives:
1. To build the skills of the audience in the clinical interpretation of corneal maps.
2. To highlight the relationship between features of corneal maps and outcomes of refractive and cataract surgeries.
3. To improve refractive outcomes and avoid some complications in terms of skillful clinical interpretation of corneal maps.
Course Schedule:
Clinical interpretation of corneal mapping in refractive surgery (Ng, 25 min);
Clinical interpretation of corneal mapping in cataract surgery (Cummings, 20 min);
Discussion (15 min).
Single Product Course: No
Financial Disclosure: None
- IC 28
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IOL fixation with fibrin glue: techniques and results
Leader: M. Sachdev | Course Level: Intermediate
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Faculty: G. Beiko A. Agarwal A. Gupta
Course Description:
In patients with subluxated or dislocated lenses or IOLs, ruptured capsules or zonular dialysis and aphakia with absent capsular support, it is a challenge to put a posterior chamber IOL. Scleral fixated IOLs suffer from disadvantages such as suture erosion/breakage, prolonged surgical time and induced astigmatism. A novel technique of IOL fixation with fibrin glue has gained popularity in the last few years in which the IOL haptics are tucked into scleral pockets created under scleral flaps 180 degrees away from each other. This ensures IOL stability, prevents sidewards and up & down movement and avoids phacodonesis. Reduced surgical time and use of same IOL are the other advantages. Modifications by various surgeons have helped to perfect this technique which is fast gaining popularity.
Course Objectives:
This video based course introduces the attendees to the innovative technique of the glued IOL which allows the surgeon to achieve a stable centered PCIOL in cases with deficient capsular or zonular support. Hence increasing awareness of this innovation and give benefit to many more patients and surgeons.
Course Schedule:
Dr Mahipal S Sachdev: Glued IOL step by step
Dr George Beiko: Glued IOL – our results
Dr Avnindra Gupta: Glued IOL in challenging cases
Dr Amar Agarwal: IOL scaffold with glued IOL
Single Product Course: Yes
Financial Disclosure: None
- IC 29
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Understanding keratoconus: tear biomarkers, biomechanics, newer therapeutics, genetics and beyond!
| EBO Accredited
Leader: R. Shetty | Course Level: Intermediate
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Faculty: V. Arora N. Serbecic R. Nuijts M. Nicholson
"
Course Description:
This course provides the attendees with an overview of the recent advances in keratoconus. The role of tears as biomarkers and possible future efficacy treatment markers will be evaluated. Newer topography devices in addition to newer therapeutics and the use of toric and phakic intraocular lenses in the treatment of astigmatism will be discussed. The role of genetics in keratoconus will provide newer insights into the understanding of the disease and its implication in todays practice.
Course Objectives:
1. The role played by tears as biomarkers and their role as indicators of treatment efficacy
2. To provide an understanding of the role played by topography and biomechanics in management of the disease
3. To discuss newer protocols and treatment modalities
Course Schedule:
Dr. Rohit Shetty: Hidden biomarkers in tears
Dr. Vishal Arora: Comparing newer topography indices
Dr. Nermin Serbecic: Biomechanics and its application
Dr. Rohit Shetty: Overview of newer therapeutics
Dr. Rudy MMA Nuijts: Toric and phakic IOLs for keratoconus
Dr. Maneck Nicholson: Genetics and beyond in keratoconus
Single Product Course: No
Financial Disclosure: None"
- IC 30
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A course honouring Dr Elie Dahan: improving IOP lowering in deep sclerectomy
Leader: P. Sourdille | Course Level: Advanced
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Faculty: T. Shaarawy A. Mermoud J. Acosta
Course Description:
Course will present instructions for improving wound healing modulation by preoperatively treating ocular surface disorders, for treating peri and postoperative complications, for creating suprachoroidal outflow in order to enhance IOP lowering and to decrease subconjunctival filtration with injectable hyaluronate and a new implant.
Course Objectives:
Attendees will learn a comprehensive approach of glaucoma surgery that will allow them to improve IOP lowering and to decrease complications rates.
Course Schedule:
Jorge Acosta: Screening and treating ocular surface disorders preoperatively, influence on wound healing modulation (20 minutes)
Tarek Shaarawy: Technical improvements and complications treatment (30 minutes)
André Mermoud: Creating supra choroidal outflow (SCO), two years follow-up (30 minutes)
Philippe Sourdille: A new implant for SCO, 18 months follow-up (25 minutes)
Q/A from the audience (15 minutes)
Single Product Course: No
Financial Disclosure: None
- IC 31
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Meibomian gland dysfunction and chronic blepharitis
Leader: J. McCulley | Course Level: Intermediate
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Faculty: S. Awwad
Course Description:
The understanding of the role of meibomian gland dysfunction (MGD) in chronic blepharitis and ocular surface disease is rapidly evolving. MGD can be considered one of the chronic blepharitides and is increasingly being recognized as a cause of dry eyes and ocular surface disease. Its place among the blepharitides as well as the sub groups of MGD will be discussed in detail along with the presumed pathophysiological mechanisms involved in each of the sub groups including the role of bacteria and their lipolytic exoenzymes, meibum/lipid biochemical changes, and aqueous tear evaporation. Acute phase therapy to bring the conditions under control will be presented as well as optimal long-term therapy to maintain control. The role of topical therapies as well as systemic therapies will be discussed as they relate to both lid and ocular surface abnormalities.
Course Objectives:
Familiarize ophthalmologists with the place of MGD amongst the chronic blepharitides and pathophysiological mechanisms. Optimal acute phase therapies and chronic therapies to maintain control will be presented.
Course Schedule:
I. Tear film characteristics (5 min)
a) Complex molecular mix
b) Instability options
c) Specifics of lipid layers
II. Blepharitis (5 min)
a) Types
b) Classification system
c) MGD types in McCulley classification system
III. MGD (20 min)
a) Organizational chart classification system
b) Alternate system
c) Definition
d) Approach to diagnosis
e) Major types
f) Clinical signs and symptoms
g) Pathogenesis
h) Clinical significance of MGD
IV. Therapy (20 min)
a) Principles of acute and maintenance therapy
b) Management of MGD
c) Patients needing topical antibiotic
d) Patients needing systemic antibiotics
e) Tear substitutions of choice
f) Nutritional supplements
V Conclusion (5 min)
a) An integrated ocular surface complex in health and disease
b) Blepharitis is better understood and better treated, but it still sucks!
VI Questions and answers (5 min)
Single Product Course: No
Financial Disclosure: None