A 276-strong gathering of ophthalmologists, paramedical staff and industry representatives attended the RANZCO NSW Branch Annual Scientific Meeting in the Hunter Valley mid March.
The theme of the meeting was broad ranging and simply titled, ‘Ophthalmology: its Ups and Downs’.
Invited speakers included Dr. Rupesh Agrawal, an expert in uveitis from Singapore, Dr. Ken Nischal a paediatric ophthalmologist from Pittsburgh, USA; and internationally renowned Australian retinal specialist Dr. Wilson Heriot.
Dr. Con Moshegov succinctly summarised the two day congress by describing it as covering, “all the coats of the eye and beyond with talks on extraocular muscles and neuro-ophthalmology” He said hearing about dealing with ocular trauma, diagnosing causes of uveitis, rectifying refractive surprises after cataract surgery, preventing endophthalmitis and cystoid macular oedema after cataract surgery, paediatric cataract surgery, dangerous conditions causing diplopia, corneal and macular pathology all consumed audience attention.
I discussed some of the controversies surrounding its use in rapidly growing and developing babies, including concerns over the minimum required dose, difficulties diagnosing disease recurrence, uncertainty over follow-up schedules and also over its systemic safety
“In the session I had the honour of chairing, we determined that most ophthalmologists don’t think there is role for topical antibiotics after cataract surgery yet continue to use them routinely because this is the traditional standard,” he said.
CATARACT AND GLAUCOMA
Dr. David Manning began a presentation on minimally invasive surgery (MIGS), by asking, “should every glaucoma cataract patient receive a MIGS implant?”.
He explained that the intent of MIGS is to give further options for those patients with glaucoma who are not doing so well on drugs and to try and bridge the gap between lower and higher risk interventions.
Currently in Australia, MIGS procedures are only Medicare rebateable when performed in conjunction with cataract surgery. Speaking of MIGS using iStent (Glaukos), Dr. Manning said he has found that patients who undergo cataract and istent procedures together have no further glaucoma interventions, whereas 5 per cent of those who have cataract surgery alone require glaucoma interventions.
Dr. Caroline Catt described a broadranging paediatrics session, chaired by Dr. Nisha Sachdev and Professor Ken Nischal. “Professor Nischal opened the session by presenting his two-incision push-pull technique for creating a paediatric capsulorhexis. He recommends its use for both anterior and posterior capsular openings and says it keeps the vitreous face intact, which avoids the need for routine anterior vitrectomy during paediatric cataract surgery.”
Dr. Catt spoke on the use of intravitreal bevacizumab (Avastin) for treating Retinopathy of Prematurity in premature babies. The evidence for its use, arising from the BEAT-ROP study was presented, as was its effect in cases she and colleagues have treated in their unit at Liverpool Hospital. “I discussed some of the controversies surrounding its use in rapidly growing and developing babies, including concerns over the minimum required dose, difficulties diagnosing disease recurrence, uncertainty over follow-up schedules and also over its systemic safety,” she said.
“Dr. Mike Jones presented a paediatric ophthalmologist’s view on the pearls and pitfalls of managing paediatric strabismus for the general ophthalmologist, including how errors of strabismus measurement and diagnosis can be avoided.
“Dr. Kim Tan then spoke about the challenges of assessing optic disc swelling in children, when to arrange neuro imaging or other forms of imaging, and the benefits of magnetic resonance imaging over computed tomography in children.”
For Dr. Christine Younan, highlights included a keynote by Professor Ken Nischal, who she described as “a world authority on paediatric anterior segment surgery and research”. He delivered three insightful talks at the event. “His talks covered the banded technique for paediatric traumatic cataract, paediatric cataract surgery and integrated intraoperative OCT.
“Professor Rupesh Agrawal, whose areas of interest are ocular inflammatory disorders, ocular trauma, ocular nanotechnology, and choroid imaging, presented on the state of ophthalmic trauma in 2017 and then provided a useful run through of the do’s and don’ts of ocular trauma management.
“Another highlight was hearing from distinguished Australian vitreoretinal surgeon, Associate Professor Wilson Heriot who presented on the topic of retinal surgery, outlining both current developments and those expected in the future.
“The talk by Dr. Peter Kaiser titled Diabetic Macular Oedema: Maximising Outcomes, was particularly useful in educating attendees on how to ensure the best possible outcomes for their patients,” said Dr. Younan.
“Finally, a particular highlight of the meeting was the acknowledgement of Richard Grills, with an award for his contribution to ophthalmology and ophthalmic education over the years.”