.jpg--.jpg)
Rome, April 28 (beraking latest news Salute) – All the most important innovations in the field of cornea transplantation and cataract treatment will be the focus of two new refresher courses for doctors available soon in the continuing education in medicine (Ecm) offer on the Sky 440 channel, ‘Doctor’s Life’, published by beraking latest news Salute.
“Certainly, during the lockdown period, healthcare resources were redirected for more effective management of the pandemic emergency. As a result, all non-urgent outpatient hospital services slowed down. As for cataract surgery, surgery performed on an outpatient basis, although not in itself a procedure to be performed urgently, cannot be delayed indefinitely, especially in the presence of a progressive loss of vision “. This was stated by beraking latest news Salute Francesco Aiello, specialist in corneal diseases, cataracts and refractive surgery at the Tor Vergata Polyclinic in Rome, who will take care of the two courses: ‘Only endothelium: cornea transplantation is no longer a problem’ and ‘ cataracts: an opportunity to take off your glasses’.
These courses represent a great opportunity for doctors to get to know and better understand the many innovations introduced in recent years in the ophthalmology field. “In Italy, about 2,000 corneal transplants are performed every year. The most frequent indications are represented by different types of degenerative pathologies (keratoconus, Fuchs endothelial corneal dystrophy), as well as by outcomes of infections or previous corneal trauma”, underlines Aiello .
“Ten to fifteen years ago, due to an alteration of the deepest layer of the cornea, called the endothelium (thickness of about 15-20 microns), the entire tissue was replaced and a donor one was implanted, anchored with 16 sutures. It was a highly invasive technique – warns the surgeon – defined perforating keratoplasty, burdened by a number of intraoperative complications and a considerable risk of rejection. Nevertheless, the visual results were often not excellent, due to the development of forms of often elevated or irregular post-operative astigmatism.
“Recently – remembers Aiello – cornea transplantation has undergone profound changes, mostly represented by the introduction of lamellar endothelial transplantation techniques. Among these, we must remember the ‘Dsaek’ technique, which involves the implantation of a tissue, the whose thickness is on average between 120 and 80 microns, being made up of endothelium, Descemet’s membrane and part of the posterior stroma of the donor’s cornea. This is a real revolution in the world of cornea transplants, providing this technique, the use of a limited number of stitches and able to guarantee an already appreciable visual recovery within a few months “.
“To date, the Dsaek ‘technique has benefited from a further evolution, thanks to the introduction of the’ Dmek ‘technique – remarks Aiello – The latter involves the replacement of the removed layers with an extremely thin donor tissue (about 20 microns) , basically consisting of Descemet’s membrane and endothelium. Only the portion of the cornea affected by the disease is removed, so as to keep the overall corneal architecture unaltered. It is a more complex procedure from a technical point of view; however, it is it allows to guarantee a faster and better visual recovery, together with a significant reduction in the risk of rejection, which is less than 1% “.
During the course “, therefore, not only the technical aspects of each of the endothelial keratoplasty procedures will be discussed, but we will try to place them in the context of the daily clinical practice”, underlines the surgeon. “Cataract surgery is the most frequently performed in the world with about 5 million procedures registered in Europe alone every year. The development of this pathology represents, in fact, a normal phenomenon related to aging, which usually occurs after 60-65 years and which is characterized by the progressive opalescence of the ‘lens’ of the eye – warns the ophthalmologist – If up to 10-15 years ago the cataract surgery involved, in addition to the mechanical removal of the lens, the implant of only monofocal intraocular lenses, today, the introduction of toric or multifocal intraocular lenses allows to guarantee the patient not only optimal visual results, but also the correction of high astigmatism and presbyopia. “
The specialist also notes the great importance of “corneal donations and eye banks”. Italy “is the second country in the world for fabric withdrawals after the United States“, underlines Aiello. “It is therefore important to sensitize the population to organ donation – he concludes – especially in our field, because modern cornea transplantation techniques are able to guarantee not only an optimization of visual function, but a significant improvement in the quality of life. of affected patients “.