ESCRS Homepage

March 2003
IN THIS ISSUE

New ESCRS trial in bid to cut endophthalmitis rate to 0.01%
Lasik corrects refractive errors after PK in selected patients
Africa-Luz mobilises to provide eye care in regions riven by poverty
Multifocal IOL
choice hinges on patterns of daily routine
Anti-histamine drug mitigates risk of developing DLK after Lasik, says study
Untreated eyelid inflammatory disorders pose risk for postoperative complications
Thermotopography shows ‘enormous promise’
for diagnosis and treatment of eye diseases
Lasik offers ‘very effective treatment’ for
refractive errors after PK, says US specialist
Good results with PRK and Lasek rival Lasik for top spot in refractive excimer laser surgery
Orbital lymphomas respond well to local, systemic therapies, says study
Laser technologies still beam but economy and consumer demand will determine future of refractive surgery
Legally blind cardiologist finds new beat in low vision rehabilitation
‘Pivotal’ anti-TGF antibody therapy reduces
filtering bleb wound formation, says report
Neuroprotective agents stem optic nerve damage
by ‘offering a solution’ to open-angle glaucoma
Echothiophate iodide shortage leaves US specialists struggling to find alternative for acute cases
Postoperative complications of PK will have serious consequences unless tackled 'aggressively’
Private refractive clinics claim young specialists as public waiting lists grow in Canadian eye surgery
German doctors’ helpers oil the cogs of the private ophthalmic practice
Study of 900 ICLs reveals good safety and long-term refractive results, says Spanish specialist
New toric IOL corrects high corneal astigmatism after cataract surgery, Austrian study reveals
IVF children run increased risk of developing
retinoblastoma, claim Dutch researchers
Suture-free DLEK preserves corneal surface topography and ensures faster wound healing
The day I said goodbye to cataracts and hello to the world without glasses
Retina specialists and trauma ophthalmologists
prepare to trade notes at joint Hungarian conference
Night blindness casts bogeyman into the shadows
Erbium laser phaco requires longer time but less energy for moderately hard cataracts
FEATURES
From The Editor
Reflections on Refractive Surgery
In Your Good Books
Bio-ophthalmology
In The Driving Seat
Prime Site
The Collector's Eye
Regulatory Matters



From The Editors: By Paul Rosen FRCS, FRCOphth

I AM writing this from the Meribel in the French Alps. As I sit in the UV light, I remember the conflicting advice we gave to patients post-PRK about skiing after undergoing surgery.

There are a number of articles in this month’s issue of EuroTimes focusing on a previously unloved area of anterior segment surgery — external eye disease and its relationship with refractive surgery.

Many of us involved in laser refractive surgery have appreciated for some time that the ocular environment and surface plays a critical role in the success of surgery. The contributions of Boorstein and Maldonado address some of these issues. It is an area often ignored and considered tedious, with little therapeutic potential.
I am also intrigued, if not surprised, to see the upsurge of interest at trade exhibitions of products to manage dry eyes. My colleague in Oxford, UK, Anthony Bron FRCOphth, a world-renowned expert on the tear film, is delighted that this work has come to prominence. Expertise in this area should be part of any refractive surgery training programme.

The issue of Lasek vs Lasik is also given column inches and the more the rival refractive techniques are debated, the more elusive the absolute answer. That proponents of one technique over another become passionate about their conviction only serves to emphasise the need for randomised controlled trials (RCT). Crucially, the ECSRS is sponsoring an RCT for the prophylaxis of endophthalmitis — a comprehensive and very ambitious study, comparing strategies to minimise this devastating complication of intraocular surgery.

I urge all members to support this study and the study partners. The complexity and difficulty of recruiting 35,000 participants cannot be underestimated, as well as following them up within the severe financial constraints imposed on the study.

In Oxford, for example, we are part of a very large general hospital which is STG£20m (€29,812,000) in debt and therefore cannot automatically support studies as large as this.
We have reached the stage where refreshments are no longer provided at departmental meetings!

Finally, I am very pleased to see that a panel of international experts believe refractive surgery has a bright future, but this also has its downside.
The study from Canada showing the predicted ‘brain drain’ from hospital practice into the more lucrative world of private refractive surgery must send out a signal to governments and the consumers of eye health care to, in every sense, support and reward doctors so that they feel inspired to stay in the mainstream health profession.

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