Top ophthalmologists anticipate ESCRS sessions

The European Society for Cataract and Refractive Surgery (ESCRS) plans to welcome delegates to the Milano Convention Centre in Milan, Italy, for the fortieth time this year, and, judging by the preliminary online programme overview, there is a great variety of ophthalmology sessions on offer.

A range of symposia, programmes, video sessions and workshops will be on offer and are discussed in this brief preview article. There will also be a daily exhibition, enabling delegates to learn about the latest technological advancements in ophthalmology and providing networking opportunities.

I spoke a few members of Ophthalmology Times Europe’s® editorial advisory board members about their anticipations for the Congress:

• Prof. Dr Martin Dirisamer, FEBO, cornea consultant at University Munich, University Graz and Wels-Grieskirchen
• Dr Frank Goes, consultant at the Goes Eye Center, Antwerp, Belgium
• Dr Anastasios G. Konstas, Professor of Ophthalmology at Aristotle University of Thessaloniki, Thessaloniki, Greece
• H. Burkhard Dick, Chair of Ophthalmology, University of Bochum, Germany

Friday 16 September

New this year are the “Cornea Day” and “Glaucoma Day” streams that are due to take place throughout the day. Cornea Day topics will include cataract surgery in patients with ocular comorbidities; ocular surface and anterior segment surgery; and developments in posterior lamellar keratoplasty, keratoconus and cross-linking, whilst Glaucoma Day will cover profiling glaucoma patients, hints for cataract surgeons who are considering MIGS, surgical complications and surgical controversies.

Prof Konstas remarks: “The Glaucoma Day format provides an enticing and practical platform aiming at both young as well as more senior ophthalmologists who have been many years in clinical practice. Attendees will gain greater insight into recent developments in glaucoma diagnosis and management. In particular, the surgical management of glaucoma has been revolutionized by the introduction of MIGS, which aim to meaningfully lower IOP with a better safety profile than traditional glaucoma surgery. Cumulative data suggest that MIGS offer tangible clinical benefits to selected glaucoma patients. The Glaucoma Day will cover the role and emerging potential of several novel antiglaucoma options enabling a better understanding of their future value in clinical practice.”

The Main Symposium to be held at the end of the afternoon will be on the topic of “Emerging Treatment Options for Corneal Endothelial Disease”. There will also be an IME Symposium with the title “Phaco complex cases.”

“A very promising symposium, a bunch of new treatment options for endothelial diseases are on the way, probably also with a paradigm shift (treatment options without need for transplants, cell injection, etc.) Mid-term and long-term data expected of DSO (Descemetorhexis only),” said Prof Dirisamer.

"A highlight for me will be the session on Cataract Surgery in the patient with ocular comorbidity", says Dr. Dick, and adds: "We're seeing patients with a variety of corneal afflictions which just a couple of years ago would have been called 'challenging', if not outright 'desolate'. Today, cataract surgery can in many cases benefit these patients - who value even moderate visual improvement - to an often astonishing degree."

Three instructional courses to be held at the end of the day will cover the topics of “Different Ways of Secondary IOL Implantation without Capsular Support”; “DALK: From Basic to Advanced”; and “Endophthalmitis after Cataract Surgery”. Finally, the Exhibition Hall will open at 13:00 on Friday and remain open until 18:00.

“It’s an exciting topic with several new approaches on the market (IOL, Yamane technique, etc.). I’m excited to hear more about the femto-second laser technology supporting this highly challenging procedure,” Prof. Dirisamer said.

“Assisting my colleagues in medical legal matters I am regularly confronted with endophthalmitis cases, so the topic ‘Endophthalmitis after cataract surgery’ and specifically the analysis of eventual differences between inpatient and outpatient surgery may be of practical use,” said Dr Goes.

Saturday 17 September

Saturday sees the Opening Ceremony of the Congress take place at 10:00, which should provide attendees with a feel of what to expect during the yearly event. This is due to be followed at 11:00 by the Main Symposium on “Demystifying IOLS optics”.

“There is a strong need for a new and clear classification of different IOL’s and technologies on the market,” said Prof. Dirisamer.

Elsewhere, the “Young Ophthalmologists Programme” is running “Starting Phaco” which includes video cases submitted by young ophthalmologists. This programme also offers junior ophthalmologists the chance to network and pick up useful information.

"This is one of the most encouraging events of the meeting," according to Dr Dick, "since we all once again are going to recognize what a huge potential and bright future ophthalmology has - and needs to have given the demographic development in our countries - in these fine young colleagues!"

Prof. Konstas points out: “This session will offer a first-class introduction to all young ophthalmologists to the key steps and pitfalls of the surgical procedure that dominates daily clinical practice in our profession. Understanding the rules of engagement with this procedure is crucial to all junior ophthalmologists.”

Throughout the day, Clinical Research Symposia will be held on: “Digital Medicine – 6 Steps for a Better Future”; “Ocular Tissue Engineering”; “Advancement of IOL Optic – How Far Can We Go?” and last-but-not-least, on the very hot topic in ophthalmology at the moment: gene therapy.

“Gene therapy is certainly a hot topic, with huge chances of big changes in the treatment of genetic caused diseases,” explained Prof. Dirisamer.

"I'm so excited, especially in my function as the Chairman of the ESCRS Research Committee", exclaims Dr Dick, "since we hopefully will learn a lot in these sessions, that finally - finally! - we will be able to cure or at least influence to a hitherto unknown degree the course of terrible diseases, including Morbus Stargardt and Fuchs."

Prof. Konstas underlines: “the topic of gene therapy truly represents a hot topic! With recent advancements in the discovery of specific disease mechanisms, it is even conceivable that future therapies for ocular conditions like open-angle glaucoma will protect ganglion cells and the optic nerve and may even reverse long standing glaucomatous damage. This exciting prospect promotes gene therapy and genome editing into the forefront of ophthalmic research in the hope that it may in due course provide a real therapy instead of the current indirect therapeutic approach of IOP-lowering.”

A total of 28 instructional courses will be running throughout the day on Saturday. The majority of these are 90 minutes long and start at 08:30, 10:30, 14:00 and 16:00. Shorter one-hour courses begin at 14:30. Free Paper Sessions and Presented Poster sessions will also be taking place and the Exhibition Hall will be open from 09:00 to 18:00.

Sunday 18 September

The Main Symposium, on “High Volume Cataract Surgery”, will take place at 11.00 on the Sunday. The JCRS Symposium will be held at 14:00 and a Video Symposium at 16:15 entitled “Surgical Complications: You Make the Call” is sure to draw curious ophthalmologists.Early evening sees the IIIC Symposium at 18:15 on “The Perfect Save: Challenging Cases Managed by International Experts”.

"I recommend this session for very personal reasons," Dr. Dick adds with a smile: "I had the great privilege to act as an editor of a fine new book at Springer, together with Jorge Alio and Bobby Osher, on how to overcome the challenges of complex and complicated cases in cataract surgery. It's so brand new, I even haven't received a copy of it myself! Hopefully I'll see it in 'Publishers Row' in the Exhibition Centre. This session deals with some of the situations that can be successfully treated with the techniques we describe in our book."

“The Main Symposium on ‘High volume cataract surgery’ may help us with how to cope with waiting lists, which have grown to more than a million eyes in some areas,” Dr Goes suggests.

Workshops on Visual Optics will be being held throughout the day, starting with “Visual Function – Visual Behaviour” at 08:30; “Ocular Biometrics/IOL Optics and Calculation” at 10:50 and finally “Imaging of the Human Eye” at 14:00.

Also at 14.00, a “Case Report” Session aims to delve into “Preoperatory Complications and Difficult Manoeuvres”. Meanwhile, there will be a Young Ophthalmologists Session at 16:30 on “Cataract and Corneal Issues”. A Practice Management Masterclass, on how ophthalmologists can optimise the patient experience, will also take place on the Sunday; the exact timings for this are yet to be confirmed.

A further 27 Instructional Courses will be held, starting at 08:30, 10:30, 14:00, 14:30 and 16:30. These cover a broad range of topics including “Corneal Regeneration Therapy and Surgery”, “Enhanced Monofocals and EDOF IOLs” and several aspects of cataract surgery.

Monday 19 September

Instructional Courses also continue with 33 taking place, again starting at 08:30, 10:30, 14:00 and 16:00. Topics covered include “The Art and Science of Personalizing Refractive Outcomes in Cataract Surgery and Beyond”; “When Cataract Meets Glaucoma”; “All You Need To Know About Contact Lenses as a Refractive Surgeon”; and “Phaco Nightmares and Worst Case Scenarios”.

Prof Konstas observes: “Of particular value in current practice would be the Course “When Cataract Meets Glaucoma”. While the chance of improving vision in glaucoma patients manifesting co-existent cataract has never been better, significant controversies still exist requiring further clarification. Emerging evidence however suggests that earlier cataract surgery in patients with glaucoma, especially those with exfoliative glaucoma, will benefit long-term outcomes.

Tuesday 20 September

The final day of the Congress starts at 08:00 with an Orbis Symposium on “Innovative Ophthalmology in Conflict Zones” and a concurrent Presbyopia Workshop titled “Is there a change in the paradigm of presbyopia correction?” The final Main Symposium of the ESCRS at 10:30 is on the eye-catching subject of “How Not to Be Surprised by Refractive Surprise”.

“Since refractive market is growing and cataract surgery is more and more turning into a refractive procedure, dealing with refractive surprises is becoming increasingly important. Further, patients demands are getting higher,” explained Prof. Dirisamer.

“Surprises following refractive surgery do happen and thus the best way to prepare for them, how to optimize their outcome and, of equal importance, how to deal with our patients when they occur is critical,” Prof. Konstas comments. “Unfortunately, many refractive patients have overly high expectations, which will not be met when a refractive surprise occurs. The Main Symposium will help us to optimize the outcome of these surprises.”

The Free Paper Sessions continue, as do a series of Wet Labs starting at 08:00 and 10:30.There will be a final twelve Instructional Courses starting at 08:30 and 10:30, including courses on “Tips and Tricks for Challenging Cataract Surgery” and “Ocular Trauma Assessment and Management”.

The Congress finishes with the ever-popular “Best of the Best” session starting at 12:45 which highlights the best parts of the meeting.