RANZCO’s flagship ophthalmic Congress is underway in Perth, and there’s plenty of Opening Day action to go around.
The 54th Royal Australia and New Zealand College of Ophthalmologists Annual Scientific Congress (RANZCO 2023) kicked off on October 21st, 2023 under the banner of ‘Reconnecting Vision’. The Congress’ Opening Day did a lot of heavy lifting doing just that, with a wide-ranging program connecting the dots across all subspecialties of the ophthalmic spectrum. From retina updates to cutting-edge cornea, there was something for everyone on the dawning day of RANZCO 2023.
All eye care jockeys were to their positions for RANZCO 2023 on Saturday, October 21st as the Exhibition Hall gates swung open at 8:30 a.m. sharp at the Perth Convention and Exhibition Centre. The schedule was dense and the track through our ophthalmic world intense – and your roving correspondent was there to live as much as the Opening Day action as humanly possible!
The Congress Opening Lecture got the ball rolling in a big way with Dr. Craig Challen, a diver and medical professional who narrated his remarkable experience spearheading the rescue of the 2019 Tham Luang cave rescue. His inspiring narrative skillfully wove lessons about risk management and critical thinking into the life-altering decisions ophthalmologists must make every day.
Things picked up pace with the Glaucoma Update Lecture delivered by Prof. Tina Wong (Singapore), and it was all about the beautiful blebs that last a lifetime. For Prof. Wong, it’s time to look beyond the inhibition of fibrosis to harness the immune system and restore normal tissue health and architecture. Valproic acid with minimal mitomycin C (MMC) is one avenue she proposed, but collagen should remain the main target in anti-fibrotic drug development.
The Retina Update Lecture from esteemed Aussie Prof. Fred Chen rumbled on through to the lunch break. He stressed artificial intelligence’s role in the analysis of multimodal images and explained why molecular genetics is now the standard of care in ocular oncology and retinal dystrophy management. But all ears were at full attention when it came time for his opinion on complement factor inhibition therapy in geographic atrophy (GA). Even with the recent FDA approvals of two subretinal injections from Apellis and Iveric Bio, Prof. Chen thinks more must be done with complement factor inhibition to demonstrate meaningful results on visual acuity decline.
Speaking of GA, the Apellis booth was a moving experiential artistic installation that invited visitors to experience life with GA. Complete with placards and installations lamenting the loss that comes with GA’s insidious assault on the sight of sufferers, the exhibition was a simultaneously sobering and inspiring reminder of the solemn duty eye care professionals have to the patients they serve.
RANZCO never disappoints with food, and your correspondent gleefully inhaled a sumptuous lunch of salmon, pumpkin vegan wraps, gooey chocolate cake and much more. And with the ZEISS booth’s strategic location near the main buffet line, all delegates dug into the background track of a booth talk featuring Prof. Dan Reinstein’s silvery baritone passionately proclaiming the virtues of PRESBYOND.
The afternoon played host to a pair of star-studded sessions on presbyopia and telehealth, which Media MICE will be covering with full-length articles post-show. The presbyopia session featured the likes of Drs. Ben Lahood, Alison Chiu, Jacquie Beltz and Prof. Dan Reinstein discussing the need for presbyopia treatments and the options available for both public and private practice, from IOLs to laser. The telehealth session covered inspiring stories from Western Australia to Tamil Nadu (india) describing the massive impact that new tech is having on remote communities. The cherry on top, though, was fresh-off-the-plane AI rockstar Prof. Pearse Keane (UK) talking about how the accelerating AI revolution is taking it all to unimaginable – and, occasionally, frightening – new heights. So stay tuned for our full coverage after the show – you won’t want to miss it.
With the suitability of corneal cellular structures to regenerative medicine known for decades, where are we with this life-changing technology? Renowned Japanese clinician scientist, Prof. Shigeru Kinoshita provided an update for the Sir Norman Gregg Lecture, and the prospects are bright.
For Prof. Kinoshita, established techniques like corneal endothelial transplantation and deep lamellar keratoplasty (DLKP) have plateaued or are on the wane, and the time for corneal regenerative medicine has come. He outlined two approaches in his talk – cultivated corneal epithelial transplantation and cultured human corneal endothelial cell (CHCEC) injection therapy.
He skimmed over the first style, explaining the autologous cultivated oral mucosal epithelial transplantation (COMET) procedure. In this procedure, cells are suspended in oral mucosa. An amniotic membrane is then introduced, which outputs an oral mucosal epithelial sheet, which is then transplanted.
His own research, however, is in the other direction – CHCEC injection therapy, and it is this that he thinks holds the most promise. “This is truly thinking outside of the box in corneal therapies,” Prof. Kinoshita reflected. In this process, a single donor cornea is used in conjunction with rho-kinase (ROCK) inhibitor Y-27632 to proliferate high concentrations (up to 100%) of mature, differentiated corneal cells. The suspensions are then injected intracamerally to treat all varieties of corneal endothelial cells, which does not elicit allogeneic rejection.
So far over 150 procedures have been performed to date in Japan and El Salvador since 2013. And with its unprecedented success and a host of iron-clad follow-up data, the Japanese Ministry of Health, Labour and Welfare has given the treatment, commercialized as Vyznova by Aurion Biotech (Seattle, USA), approval for corneal endothelial failure as of March 17, 2023.