Biography:

Dr. Ahmad Kunbaz has completed his M.D. degree at Cerrahpasa faculty of medicine, Istanbul university. He has published more than 20 scientific papers with more than 200 citations and is currently enrolled in the faculty of medicine, Istanbul Medeniyet University, department of ophthalmology as an ophthalmology resident. 

Abstract:

Objective: This oral presentation aims to present a case of platelet-rich fibrin membrane pterygium surgery.

Introduction: Pterygium is a common disorder worldwide. It’s due to the abnormal growth of fibrovascular tissue of the degenerative bulbar conjunctiva over the limbus onto the cornea. The most common risk factor is long-term exposure to ultraviolet (UV) radiation, especially from the sun.

Nowadays, there have been many different surgical techniques for pterygium excision, starting from leaving bare sclera, which is rarely used in advanced medicine. The current most used technique is the conjunctival autografts, but recurrence risk is remaining a major concern. However, no surgical technique is accepted as the gold standard treatment that prevents recurrence. Platelet-rich fibrin (PRF) was first described by Dohan et al. in 2006, which contains cytokines, platelet-derived growth factors, and many growth factors that facilitate regeneration.

Methods: A special technique was applied for the preparation of the fibrin membrane. Blood samples were taken from the patient's antecubital vein with a 24-gauge needle into two tubes that did not contain anticoagulants.   Blood samples were immediately centrifuged at 3,000 rpm for 10 minutes using a table centrifuge system. After centrifugation, 3 layers are formed: cell-free plasma at the top, platelet-rich fibrin clot in the middle, and red erythrocytes at the bottom (graph 1). Before surgery, the contents of the tube are poured onto sterile gauze (graph 2). The fibrin layer is formed into a thin layer by pressing lightly between sponges. As soon as the PRF membrane was prepared, it was sutured, without any delay. The sclera is closed by suturing the conjunctiva and the fibrin membrane continuously with 10/0 nylon.

Case presentation:

74 old female patient presented to our clinic with symptomatic pterygium in both eyes (graph 3). She was operated on with the Platelet-rich fibrin (PRF) membrane technique for pterygium surgery.

It was observed that the fibrin membrane thinned and its color faded in the first week after surgery.

In the 3rd week, it was observed that the platelet fibrin membrane was not completely dissolved. continuous sutures were removed at 3 weeks. at two-month follow-ups, the patient did not have any complications and no recurrence was detected.

Conclusion:  Pterygium surgery with platelet-rich fibrin membrane is performed in a shorter time compared to autograft surgery. Especially in patients with glaucoma, the conjunctiva is preserved for future surgeries. Large case series and long follow-up periods are needed in terms of recurrence and late complications.

Biography:

Dr Sameena Sheriff is a Cornea, Cataract & Refractive Surgeon. She is a Fellow of the Royal College of Surgeons, Glasgow, UK. She has done her masters in ophthalmology from M.S.Ramaih Medical College, Bangalore and was awarded gold medal as the best outgoing postgraduate student. 
Dr Sheriff has been practicing ophthalmology for more than 12+yrs. She has extensive experience in the field of Cornea, Advanced cataract surgery and Refractive procedures. She also has vast experience managing ocular trauma and has performed many Anterior segment repair surgeries. She is an avid academician and has presented scientific papers and posters at national and international ophthalmic meetings. Her areas of interest are corneal surface disorders, multifocal and toric IOLS, keratoconus, wavefront optics, pterygium, and excimer laser ablation. 

Abstract:

Introduction:

With the increasing demand for recurrence free pterygium surgery globally, Conjunctival autograft with fibrin glue have become the preferred choice of pterygium excision method for surgeons which not only minimizes recurrence rate but also surgical time and postoperative pain. However, the procedure comes with its own set of challenges; Expensive glue, Meticulous graft preparation, Possible transmission of blood borne diseases, Graft dehiscence, Anaphylaxis, Conjunctival granuloma etc. resulting in poor surgical outcome and patient dissatisfaction.

Methods:

We reviewed existing literature to identify the challenges associated with patient selection, preoperative evaluation, Intraoperative care and postoperative management measures to optimize the outcome.

Results:

We present a brief overview of conjunctival autograft technique with fibrin glue, Intraoperative steps to achieve a perfect graft, Newer treatment options for the management of postoperative complications along with comparative results of other popular pterygium surgeries.

Conclusion:

Carefully planned and executed Pterygium e surgery with fibrin glue fixed conjunctival autograft can greatly optimize the surgical outcome and reduce patient dissatisfaction. 

Biography:

Ashkhan Hojati is a 4th year medical student at Carle Illinois College of Medicine at University of Illinois Urbana-Champaign. He graduated in 2016 with a BS in Biomedical Engineering from VCU and received his MS in Physiology & Biophysics at VCU Medical Center in 2019. He has held multiple research positions at VCU Medical center and has published and presented on a variety of topics including molecular psychiatry, medical device design, and pharmaceuticals.

Abstract:

Abstract:

Introduction: Goldmann Applanation Tonometry (GAT), the gold standard technique for intraocular pressure measurement was developed in the 1950s by scientist Hans Goldmann. GAT utilizes the Imbert-Fick Principle where intraocular pressure equals the contact force required to flatten, divided by the area of contact on an infinitely thin-walled sphere. An unskilled practitioner can cause harm to a patient during performance of GAT by potentially causing corneal abrasions, incorrect IOP measurements, or risk of cross infection. Numerous other techniques have been developed, such as Tonopen, Ocular Blood Flow tonograph (OBF), NonContact Tonometer (NCT), and Transpalpebral Tonometer, due to the complicated technical aspects of GAT. However, GAT remains to be the most accurate IOP check technique across ophthalmology practices, as the interobserver reliability is lower for other techniques. While GAT is the gold standard for IOP measurement it also requires a high skill of operation, thus appropriate training is critical. Present day training requires a courageous volunteer to act as a patient. Physical models acting as artificial globes have been developed for training but require materials that may not be easily accessible and have associated costs. To advance training in the modern age, we developed an online application which mimics the steps of GAT and is free to use for trainees at gatsim.com.

Methods: A website was created using HTML and JavaScript ES6, tested on Google Chrome version 103.0, hosted on GitHub. The code is publicly available at https://github.com/ryerrabelli/TonometrySimulation.

Results: We developed an online application which mimics the steps of GAT and is free to use for trainees at gatsim.com. Trainees can now train on our model before seeing patients, which may ultimately improve outcomes. To our knowledge, this is the first time ever an online simulation of Goldmann Applanation Tonometry has been developed. This will allow individuals to train and learn the mechanics of GAT via an easy-to-use online application. We hope such technology will improve the skills

Biography:

Dr. Sibylle Scholtz, Biologist, Chemist, Ph.D. in Ophthalmology, International Science Correspondent, Associated Senior Research Fellow (Institute of Experimental Ophthalmology, Saarland University Faculty of Medicine, Germany), longstanding experience in the ophthalmic medical device industry.

Abstract:

Purpose:

The Internet database IOLCon, founded in 2017, established itself meanwhile as a reliable, worldwide available source for optimized IOL constants and specifications. Based on modern optimization strategies, IOLCon also offers individually optimized IOL constants free of charge for ophthalmic surgeons. Recently, IOLCon supports ophthalmic surgeons e.g. in selecting the individual IOL by its new "Lens Power Calculation Module" (LPCM).

Methods:

Close cooperation with Institute of Experimental Ophthalmology, University Homburg/Saar (Germany).

Results:

The method used by IOLCon to optimize IOL constants is characterized as an "intelligent IOL constant optimization strategy", which uses modern nonlinear optimization methods. Optimizations of the constants for the following published formulae can be found on IOLCon: Haigis, Hoffer-Q, Holladay 1, SRK/T - and now also for the new Castrop formula. The prerequisite is the use of current measurement techniques that precisely measure all distances of the eye. IOLCon´s newly launched online calculator, LPCM, is based on the Castrop formula, and supports ophthalmic surgeons when selecting the individual IOL power. The calculator is intended to be used for scientific purpose only and in combination with comprehensive eye exams, respective diagnostics and measurements required for patients undergoing cataract surgery.

Conclusions:

A modern database for optimized IOL constants and lens specifications that meets the demands of today’s cataract surgery is just as urgently needed today as modern online calculation tools that serve as a decision-making aid when selecting the individual IOL power. IOLCon offers both: with its (individually) optimized IOL constants and the online calculation tool “Lens Power Calculation Module”, it is an essential instrument for modern cataract surgery and will also meet future demands of ongoing developing ophthalmic surgery

Biography:

Christina Bornberg is a scholar of the Joint Erasmus Mundus Degree ”Medical Image Analysis and Applications”. Research experience include work at the Ophthalmology Department (Medical University of Vienna) and WEISS center (University College London). She is currently a research contractor at the Sin- gapore Eye Research Institute (Singapore National Eye Center). She published deep learning work applied to medical image analysis at MICCAI workshops and other small conferences.

Abstract:

Replacing routine diagnosis tasks such as drusen detection in the medical field with deep learning approaches such as convolutional neural networks (CNNs) should lower the workload of medical doctors. To train such a CNN, labels are required that need to be obtained by a medical doctor. This task is time con- suming and therefore research in fields such as semi-supervised, self-supervised and unsupervised learning has been made, where little to no labels are needed. Semi-supervised learning generally uses a dataset where only a small number of images are labelled. In this ongoing work, we want to understand what similar- ity in an image means according to convolutional neural networks to determine which images should be annotated in a dataset and reduce the time needed by a medical expert to label images. The approach that is currently under develop- ment is a combined clustering and knowledge distillation approach to determine memorable examples. First, a feature vector is obtained from a pre-trained classification network for each image. Principal component analysis (PCA) is applied for acquiring more meaningful and reduced features.These features are fed into a mean shift clustering implementation, which produces clusters based on density. Furthermore, we want to perform classification based on the clusters to figure out the memorability of images. To evaluate the approach, we want to perform segmentation with a semi-supervised approach where labels are only used for memorable examples while the remaining images are used without labels. This will be compared to a fully supervised approach.