ESCRS Congress, London, September 2014

Dr Clare O’Donnell, Head of Eye Sciences, Optegra

The XXXII European Society of Cataract and Refractive Surgeons (ESCRS) Congress took place at the ExCeL, London on 13-17th September 2014. This year more than 8,000 delegates attended, making it the highest ever attendance in the Society’s history. The programme consisted of an inspiring array of lectures, a new interactive ‘Poster Village’, video sessions, instructional courses, ‘wet labs’, expert symposia, satellite meetings, practice management and development sessions and a new ‘Best of the Best’ review.

Welcome to the ESCRS Congress
At the Opening Ceremony, the president of the ESCRS, Dr Roberto Bellucci, welcomed delegates and emphasised that a focus during his term would be on offering high quality education in ophthalmology. He reminded delegates of current educational activities including an accredited iLearn online programme.   Another useful benefit of joining the society is that members can access the web-based presentation library via ESCRS on Demand. This offers the opportunity to view the scientific content of Congresses, past and present.  Dr Bellucci alluded to the Society’s plans to introduce further educational resources, as well as offering continuing support for its research activities and its charity work. Dr Bellucci thanked the delegates from the 125 different countries who were in attendance at the meeting.

The Ridley Medal Lecture 2014 entitled ‘Four decades of cataract surgery – Personal visions for the future’ was given by Professor Gunther Grabner who presented an overview of how cataract surgery has evolved to where it is today, with his view on the outlook for the future. His presentation reviewed the changes in surgical approaches, complication rates, visual and refractive outcomes as well as developments in IOL technology (including toric and presbyopia lenses as well as methods for assessing IOL performance).

Hiroyuki Matsushima received first prize in the Video Competition for a presentation entitled ‘Opacification of Intraocular Lenses’. Dr Zuzana Hlinomazova won a prize in the Education section for a presentation ‘Bubbles Game: Tips and tricks of triple procedure – DMEK and cataract surgery’.First prize in the Cataract Category poster competition was awarded to Shogo Tsuruoka for a presentation entitled ‘Monovision using plus and minus spherical aberration values’. Jorge Alio and colleagues won first prize in the Refractive Category for their poster on the outcomes of a phakic intraocular lens with a five year follow-up. Young ophthalmologist Lampros Lamprogiannis won the 2014 John Henahan Prize for an essay entitled ‘How do I see cataract surgery in 30 years?’

Topical themes
As expected the ESCRS Congress included a range of ‘hot topics’.  Sessions on femtosecond laser-assisted cataract surgery (FLACS) provided delegates with useful updates on the relevant research. With FLACS, the laser can be used to create the incisions, the capsulotomy and to fragment the crystalline lens during cataract and refractive lens surgery. A report of the ongoing international study funded by the ESCRS, supported by EUREQUO, is being used to collate the relative outcomes of FLACS and conventional surgery.

Naturally, sessions on intraocular lenses (monofocal, toric, accommodating, multifocal designs of various types and phakic IOLs) were an essential component of the programme. Themes included the visual and refractive outcomes, as well as advice on the importance of patient selection and counselling. Several authors presented data on trifocal IOLs which may provide improved intermediate and near vision ability compared to some other options.

Sessions on laser vision correction, including femtosecond laser small incision lenticule extraction surgery (SMILE) were a prominent feature on this year’s programme. The procedure involves the creation of a lenticule of corneal tissue with a femtosecond laser that is then removed through a small incision.  Advocates of this relatively new approach claim that it induces a change in refractive power whilst minimising disruption to the superficial corneal layers, corneal nerves and biomechanical properties.

Exhibition and instrumentation
In the exhibition the latest technologies for laser vision correction and intraocular lens surgery were predictably on show, along with the newest devices for ophthalmic imaging, biometry and evaluating and treating dry eye.

Dedicated workshops and sessions on presbyopia, biometry, toric IOL power calculation, interpreting corneal topography and higher order aberration data proved popular and presented delegates with a diverse range of themes to choose from. Recent innovations include intraoperative imaging tools with real-time tracking overlays designed to provide more precise alignment of toric intraocular lenses.

Overlapping meetings
London also welcomed clinicians and researchers interested in retina and macular disease to the 14th EURETINA Congress. Dr Francesco Bandello addressed delegates at the opening ceremony pointing out that the increasing numbers attending demonstrates how EURETINA is going from ‘strength to strength’. This was attributed to the calibre of presenters and also to the Congress overlapping with the ESCRS and EuCornea meetings. This approach has advantages in allowing busy delegates to maximise their time away with increased opportunity for learning, sharing knowledge and networking. Professor Robert McLaren from the University of Oxford and Oxford Eye Hospital presented this year’s EURETINA Lecture 2014 on gene therapy for retinal diseases. He gave an overview of advances in the field including the ongoing work of Oxford team, sharing preliminary results from a clinical trial in choroideremia. Their results highlight the potential for using gene therapy as an early intervention in other retinal degenerations. Over 120 runners competed in the third annual EURETINA charity race around London’s Docklands.

The United Kingdom and Ireland Society of Cataract and Refractive Surgeons (UKISCRS) held its Annual Meeting on Friday September 12th at the ExCeL. The Rayner Medal lecture was delivered by Professor Harminder Dua. A combined ESCRS/UKISCRS interactive video symposium on complex cases offered an invaluable opportunity to see rare procedures such as implantation of an artificial iris. Professor John Marshall received the UKISCRS Lifetime Achievement Award for his outstanding contributions to the advancement of cataract and refractive surgery. Dr Andreas Hartwig and co-authors gave a talk entitled ‘Evaluation of an intraoperative guidance system to align monofocal toric intraocular lenses’ and presented a poster on the ‘Agreement between two optical biometry devices’. Dr Jose Guell president of EuCornea welcomed delegates and again emphasised the benefits for members of the alliance with the ESCRS and EURETINA meetings.

The European Society of Ophthalmic Nurses and Technicians (ESONT) and the United Kingdom & Ireland Society of Ophthalmic Professions (UKISOP) also had a programme of papers, posters, instructional courses and wetlabs. For the fourth consecutive year as part of proceedings, a Glaucoma Day was organised by the European Glaucoma Society. The Glaucoma Day forms part of a wider strategy by the Society to bring together research that can be applied in clinical practice.

In summary, this was a ‘not to be missed’ event for those interested in cataract and refractive surgery and ophthalmology more widely. The 2015 ESCRS Congress will be held in Barcelona.