Corneal specialists, basic scientists, Eyebank personnel and optometrists gathered in March for the annual Cornea Society Meeting to share ideas, concepts, the latest research and surgical techniques.
The annual meeting, which was held in Auckland, was hosted by The Department of Ophthalmology, Auckland University.
This year the guest lecturer was Professor Mark Terry from Portland Oregan USA who is a pioneer in endokeratoplasty, the preferred surgical technique for endothelial diseases such as Fuch’s dystrophy and pseudophakic bullous keratopathy. Prof. Terry was an engaging and generous speaker who provided an update on current surgical techniques and clinical outcomes. His key point was that surgical techniques and outcomes are rapidly improving.
The use of an automated machine to prepare the corneal button (DSAEK) was superior to manual preparation of tissue (DSEK) but the newest, and still investigational, technique (DMEK), which involves the thinnest transplantation of tissue, remains superior.
Professor Trevor Sherwin and colleagues presented novel results in the culture of corneal stromal cells
Unfortunately, the complication rate associated with this latest development has prevented wide-spread uptake amongst surgeons around the world, many of whom believe that the failure rate and the loss of corneal tissue is too high at present. I believe that this technique is the future, however, as the rejection rates in these early series is much lower than with traditional transplanting techniques.
Amazing Basic Research
The basic research presented was really quite amazing. Professor Trevor Sherwin and colleagues presented novel results in the culture of corneal stromal cells with a view to inserting them into patients with keratoconus to “strengthen” the cornea. Professor Nick Di Girolamo from the University of New South Wales summarised his pioneering work in limbal epithelial stem cells and Associate Professor Mark Daniel summarised the CERA, Melbourne University’s work on endothelial stem cell culture.
Professor Kerryn Williams provided her annual report on the Australian Corneal Graft Registry based at Flinders University. Despite a move among Australian Corneal surgeons towards lamellar corneal procedures, visual outcomes have yet to surpass those of traditional penetrating keratoplasty (full thickness transplantation).
Lively Ethics Discussions
One session of the conference was devoted to Ethics. I was asked to host a round table discussion looking at ethical situations in eyebanking. Our guests included Associate Professor Martin Wilkinson and Professor Ron Patterson, both experts in ethics and health. It was a vibrant and lively debate on a number of topics including directed organ transplantation and a family’s right to veto the wishes of the deceased. It was Hannah Arendt who said, “Truth comes from arguments amongst friends.”
Overall it was an absorbing two days and I would strongly encourage anyone with an interest in any aspect of corneal disease or research to attend next March when the meeting will be held in Adelaide.