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Sneak Peek: APAO 2019

Industry Updates, Award Lectures… and more

In celebration of the “Arts and Sciences of Ophthalmology”, the 34th annual meeting of the Asia-Pacific Academy of Ophthalmology (APAO) returns to Bangkok this year. Held from March 6 to 9, 2019, and in conjunction with the 43rd meeting of the Royal College of Ophthalmologists of Thailand, the Congress is expected to attract more than 6,000 delegates from around the world.

The APAO Congress was first held in Bangkok in 2003 – and since then, it has grown substantially. Dr. Paisan Ruamviboonsuk, the Congress president of APAO 2019, remembers the first event: “It was the most successful APAO Congress ever, with more than 1,200 delegates, over 300 submitted abstracts and more than 40 exhibitors.” Today, attendance has increased by nearly 4,800 delegates, with more than 1,500 submitted abstracts and an estimated 250 exhibitors.

This success is a credit to APAO’s scientific program – which Dr. Dennis Lam, APAO 2019 scientific program committee chair, says is the backbone of the Congress. “Our committee strives to engineer a first-class scientific program, covering all major areas of ophthalmology and visual sciences, which will help delegates to keep abreast of the latest developments in the science, knowledge and technology of ophthalmology,” he said, noting that more than 600 experts from 46 countries are expected to speak at the Congress.

Each year, a few of those leading experts are recognized for their contributions to the field. This year, delegates can look forward to four award lectures: the Jose Rizal Medal, the International Council of Ophthalmology (ICO) Mark Tso Golden Apple Award, the Holmes Lecture, and the Nakajima Award. 

The Latest in Diabetic Retinopathy

The Jose Rizal Medal, which recognizes an outstanding ophthalmologist in Asia-Pacific, has been awarded to Prof. Tien-Yen Wong, academic chair and medical director for Singapore National Eye Centre (SNEC) and chairman of the board for its research division, the Singapore Eye Research Institute (SERI). Prof. Wong is a retinal specialist, with a clinical and research focus on macular and retinal diseases, particularly on diabetic retinopathy and age-related macular degeneration. 

His lecture is titled, “The War on Diabetic Retinopathy: Where are We Now?”, and will discuss the recent developments in the prevention, screening, and management of the disease, as well and the challenges that remain. [Prof. Wong’s lecture is at Plenary Hall 3 on March 6 from 11 a.m. to 12:30 pm.]

Exploring FLACS in China

In commitment to improving ophthalmic education worldwide, the ICO Mark Tso Golden Apple Award is given to the most dedicated clinical teacher in Asia-Pacific. This year’s recipient is Prof. Ke Yao, a special-grade expert of Zhejiang Province, director of Eye Institute of Zhejiang University, and chief of Eye Center, Second Affiliated Hospital of Zhejiang University School of Medicine. 

In China, Prof. Yao was the first surgeon to design and use the asphero-iseikonic intraocular lens (IOL) nationwide, and he was one of the first surgeons to perform cataract phacoemulsification. With a special interest in anterior segment diseases, he also invented manual small-incision cataract surgery and improved the technique for combined viscocanalostomy and phacoemulsification surgery.

His lecture is called “Cataract Surgery in China: Femtosecond Laser-Assisted Cataract Surgery (FLACS), Conquering the Rock-Hard Cataract”, and discusses the advances in FLACS in China, where the use of femtosecond laser has recently become popular. 

According to Prof. Yao, there were more than 20,000 FLACS cases in China in 2016. “In our eye center, there are more than 1,000 FLACS cases each year, accounting for 10% of the overall cataract surgeries last year,” he said, adding that femtosecond laser technology was used to perform lens fragmentation, anterior capsulotomy, and self-sealing corneal incisions in cataract surgery. 

FLACS has its advantages and disadvantages. Some of the procedure’s benefits over current surgical techniques were explained by two recent meta-analyses. They found that FLACS was more effective than conventional phacoemulsification in reducing endothelial cell loss and postoperative central corneal thickening. It also achieved better visual outcomes.

In addition, patients with hard nucleus cataract may also benefit from FLACS. Another study found that when compared with conventional phacoemulsification surgery, FLACS can save phacoemulsification power and reduce corneal edema and endothelial cell loss. This provides faster visual rehabilitation for those patients.

Of course, there are patients who do not tolerate the procedure as well. Cases with pre-existing dry eye who underwent FLACS had more severe ocular surface staining that those with conventional phacoemulsification. There was also more surgically induced astigmatism with femtosecond laser-created clear corneal incisions (CCIs) than manually created CCIs. Prof. Yao speculates this could have resulted from inaccurate or uncertain corneal incision positioning of the femtosecond machine and says, therefore, “we should treat FLACS dialectically”. [For more on this topic, catch his full lecture at Plenary Hall 2 on March 6 from 9 to 10:30 a.m.]

Tuning into Tumors

The Holmes Lecture is the highest award for exceptional contributions to preventive ophthalmology, especially in the prevention of blindness in the Asia-Pacific region. This year, Prof. Nila Moeloek, the Minister of Health from Republic of Indonesia, will deliver this prestigious lecture for her work in the field.

Her lecture, titled “Tumor of the Eye in Indonesia: Recent Advances in Orbital and Oculoplastics,” looks at developments in managing this sight and appearance-threatening condition, which has unknown causes and requires comprehensive management. According to Prof. Moeloek, 68% of blindness from tumors are mostly caused by eyelid and conjunctival tumors.

“The ideal situation is early detection to prevent the unwanted result of radical treatment,” said Prof. Moeloek. “Unlike cataract, the treatment of an eye tumor on most occasions ends in blindness, aesthetic issues or even worse, death in patients with malignancy.”

For patients, to have their eye removed or exenterated, is a worst-case scenario – and she says the rate of exenteration at one Indonesian referral hospital is high, averaging 12 to 18 eyes per year (from 2016 to 2018). So, how can we avoid this? Prof. Moeloek says it’s time to start asking ourselves some questions: “Should we study neoplasms in molecular biology, or influence people’s way of thinking and get them to come in earlier for treatment?”  [To learn more, see her lecture at Lotus Room on March 7, from 11 a.m. to 12:30 p.m.]

War Against Myopia

The fourth and final award – the Nakajima Award – honors young individuals for their outstanding international work in ophthalmology. This year, the award has been presented to Dr. Jason Yam, head of Pediatric Ophthalmology and Strabismus Services at the Hong Kong Eye Hospital and assistant professor at the Chinese University of Hong Kong, for his enormous contributions to developments in children’s eye care throughout Asia-Pacific and the world. He is an active member of numerous ophthalmic organizations throughout the region, including serving as 2017 Congress president for the Asia-Pacific Strabismus and Paediatric Ophthalmology Society (APSPOS).

Dr. Yam says myopia is a global health threat, and that a comprehensive approach to study its prevalence, risk factors and clinical interventions is important for effective myopia control. He notes that high myopia is associated with sight-threatening complications, including presenile cataract, glaucoma, retinal detachment and choroidal neovascularization.

During his lecture, “Combating Myopia – From Epidemiology to Clinical Interventions Prevention of Myopia Progression”, he will discuss the results from two of his trials: the Low-Concentration Atropine for Myopia Progression (LAMP) trial and the Hong Kong Children Eye Study (HKCES). LAMP was the first placebo-controlled randomized controlled trial to provide evidence for 0.05% atropine on myopia control, which could have a clinical impact on millions of children worldwide. Meanwhile, HKCES is an epidemiological cohort of 30,000 children and their parents for detailed phenotypic and genotypic characterization. 

In the LAMP study, 438 children aged four- to 12-years-old were divided into groups and put on low concentration atropine of 0.05, 0.025 and 0.01%, and placebo. “Our first phase has proven that low-concentration atropine is effective compared with placebo control, and that 0.05, 0.025, and 0.01% atropine reduces myopia progression along a concentration-dependent response, and were all well tolerated,” said Dr. Yam. Their results showed that compared with placebo group at one year, 0.05, 0.025 and 0.01% atropine eye drops confer a respective reduction of 67, 43 and 27 percent in spherical equivalent progression, and 51, 29, and 12% in axial length elongation, respectively. Dr. Yam will also discuss the HKCES study – which is ongoing population-based cohort of children aged six- to eight-years-old and their parents. “Our first phase has determined the prevalence and risk factors of childhood myopia, together with its parental influences,” said 

Dr. Yam. The study, now entering its second phase, is recruiting a total of 30,000 families for detailed phenotype and genotype evaluations, and biobank establishment. [Hear his full lecture at Meeting Room 2 on March 7 from 9 to 10:30 a.m.]

A Venue for Learning, Collaboration, and Sharing Best Practices

Clearly, the award lectures shouldn’t be missed. However, attendees should also peruse their program to view the various sessions, symposiums, instructional courses., and free papers at APAO 2019. In addition to the extensive opportunities to learn, discuss, and debate the newest innovations in ophthalmology, the APAO Congress is also a time to come together as an international community to share ideas and best practices.

“The APAO Congress is certainly an outstanding platform to promote, foster, and disseminate our research in a collegial and friendly atmosphere. It is where local meets global,” said Dr. Anuchit Poonyathalang, president, The Royal College of Ophthalmologists of Thailand. “We would like to express our satisfaction at hosting this congress which has a program that condenses the knowledge, dynamics, challenges, and relevant contribution of ophthalmological research in the region.”

These numerous sessions and symposiums, and well as the exhibition hall, all provide a platform to network and share vital information.  In addition, the Congress’s social platform also offers an avenue for collaboration through its ceremonies, receptions, dinners, and other events.

“As ophthalmologists, we need to be open-minded to gather and share new insights in our field to let our patients benefit from the cross-fertilization of knowledge. I trust that we shall all enjoy a wonderful Congress for international friendship,” added Dr. Jan Tjeerd De Faber, president, European Society of Ophthalmology. 

For more information about APAO 2019, visit http://2019.apaophth.org.

Welcome Reception

Date: March 6, 2019 (Wednesday) Time : 17:30 – 18:30H

Venue: Exhibition Hall, Coffee Corner at C-Second Level, Queen Sirikit National Convention Center

Open to All Delegates

CAKE Magazine Issue 01X: The ebook version (ARVO 2019 Edition)

CAKE (Cataract – Anterior Segment – Kudos – Enlightenment) is Asia-Pacific’s Most Delicious Magazine on The Anterior Segment. CAKE Magazine is published by Media MICE Pte Ltd (Singapore).

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