Thoughts on corneal disease
Dr Augustin: In recent years, developments in corneal surgery have increasingly been directed towards lamellar keratoplasty instead of penetrating surgery, especially for diseases involving the endothelium of the cornea.
Nowadays, Descemet membrane endothelial keratoplasty (DMEK) enables surgeons to transplant just a part of the corneal tissue (the Descement membrane and endothelium), which is proving to offer better postoperative visual acuity and also reduces the risk of graft rejection.
DMEK enables patients’ vision to recover more quickly after surgery and, therefore, patient satisfaction has grown, while surgeons have access to a fast, effective option. Thus, this type of surgery has been revolutionary for both surgeons and patients.
A further improvement might come from the opportunity to have pre-cut donor flaps. However, this technique is not easy to learn. In addition, tissue preparation requirements mean that new facilities will be needed.
Dr Kermani: Dry eye is a real problem in refractive and premium cataract surgery. It needs to be seriously addressed. Today there are many ways to do so and we are building up the armamentarium both in diagnostics and therapy. We are not letting dry eyes spoil our surgical results. We will fight back and we will prevail.