Twenty years from now when we look back on the COVID-19 pandemic (that is if we haven’t all been obliterated by the looming global warming crisis), what will the most memorable image be?
Some might point to row upon row of shuttered shops, bars and restaurants; others may immediately think of the grim images of overcrowded hospital wars and patients gasping to breathe on ventilators. However, it surely must be the global prominence of the humble face mask that for many — especially in the West — that most sums up the visible impact of the disease.
Many of our readers living in the Asia-Pacific region will of course be more accustomed to wearing a face mask on a daily basis, and it is to this region that the West looked for guidance. Where you should wear a face mask, how one should wear it, at what times it is most appropriate, etc., … for many of us, including your correspondent, felt rather clueless. It has been interesting to note the differences in wearing culture, and we experienced some of that on day two of the 33rd Asia-Pacific Association of Cataract and Refractive Surgeons and Singapore National Eye Centre 30th Anniversary virtual meeting (APACRS-SNEC 2021).
Welcome to Day 2 — A Preview of Today’s Highlights began the day’s proceedings with all three main attendees wearing masks, presumably as they were sitting close together. Singapore does have some of the toughest COVID-19 restrictions systems in the world, and for medical personnel, the rules must be even tighter. Kudos to the learned doctors for being so cautious. Who knows, perhaps the coronavirus could become virtual too.
Back to school for a masterclass
All of us, at some point, could do with going back to school to learn some new knowledge and APACRS Master Class: Mastering Refractive Surgery Complications offered some valuable back to basics instruction. One of the highlights of this symposium was a presentation by Dr. Cordelia Chan, a visiting senior consultant at SNEC, who spoke about how to react to and safely manage intraoperative LASIK complications. She recommended looking for the signs of a high-risk patient, namely squeezing during the administration of eye drops, claustrophobia and anxiety disorders.
Dr. Chan went on to describe how clinicians can react to various forms of complications while emphasizing that the most important factor throughout is to remain calm and present. For vertical glass breakthrough, for example, clinicians should avoid lifting the flap in question if a full bubble burst breaks. When it comes to gas bubbles in the anterior chamber, one should wait for spontaneous reabsorption of bubbles, then proceed with a flap lift the next day.
Now nobody wants to experience ocular trauma, indeed, we imagine it could be rather inconvenient, but it is a rather fascinating subject. SNEC Instruction Course: Managing Ocular Trauma — A Multidisciplinary Approach, explored this subject and included interesting discussions, fascinating insights and of course, some fantastic case study photography. Dr. Arundhati Anshu, a senior consultant in cornea and refractive surgery at SNEC, gave a great presentation on corneal ocular trauma.
Dr. Anshu offered her insights on suturing lacerations to the cornea, recommending that in the case of a full wound exposure, for example, one should follow the laceration to its apex and that the conjunctiva should be fully reflected away. When it comes to postoperative care, she recommended that one should evaluate other anterior segment structures and combined topical broad-spectrum antibiotics and steroids tapered over several weeks to months. Finally, if conservative measures are unsuccessful, then a corneal graft should be considered.
Are you willing to donate your corneas?
Corneal grafts can only be carried out if there is a healthy pool of cornea donors — but while people know about kidney and lung transplants, for example, public knowledge about the cornea is lacking. The rather mouthful-sized poster, Awareness, Knowledge and Willingness Toward Corneal Donation Among the Paramedical Staff, Public and Students from Tirunelveli District, Tamil Nadu, India, examined this phenomenon. Led by Dr. Anusha Rao Vemula, a team of researchers drew up a questionnaire that included 13 questions regarding knowledge, awareness and willingness of eye donation. This was presented in their local languages to the staff and students previously mentioned.
In good news, the study found that observed willingness to donate eyes was present in 58.4% of the subjects, however, lack of knowledge attributed to 58% of transplant unwillingness. The researchers stated that improved education could go a long way toward raising awareness and thus, increasing the number of those willing to donate. The researchers called on ophthalmologists, health care workers, religious leaders, general physicians and non-governmental organizations to work together to motivate people to donate their corneas.
We’ve all enjoyed APACRS, it’s been a veritable broadsheet in terms of quality content, which is perhaps why all the symposiums, posters and more have had such long informative names. Comparative Outcome Between Divide-and-Conquer and Stop-and-Chop Phaco.
Technique in Hard Cataract by A Resident Trainee Surgeon (and phew, breathe) is another good example. Ably presented by Dr. Rokhsanda Rehnuma of the Bangladesh Eye Trust Hospital (Dhaka, Bangladesh), the study compared divide-and-conquer and stop-and-chop techniques in cataract treatment.
A prospective observational study was conducted in Bangladesh Eye Trust Hospital between July 2018 to 30 July 2019 and examined 100 eyes. The divide-and-conquer technique requires phaco energy to make a groove, and then divide the nucleus into four quadrants to emulsify, whereas, in the stop-and-chop technique, the nucleus is divided into half and then chopped. Dr. Rehnuma reported that stop-and-chop is a better technique compared to divide-and-conquer due to less surgery time required, plus less chance of anterior chamber damage.
Another conference, another awesome opportunity to network with some of the best in the ophthalmology industry, and we certainly enjoyed the experience. Many of the APACRS sessions are still available to view on-demand, so make sure you continue to access the virtual platform. In the meantime, keep watching Media MICE for some of our seriously funky content. Ciao!
Editor’s Note: The 33rd Asia-Pacific Association of Cataract and Refractive Surgeons and Singapore National Eye Centre 30th Anniversary virtual meeting (APACRS-SNEC 2021) was held from July 30 to 31. Reporting for this story took place during the event.
