Day 1 :
Keynote Forum
Silvia Bisti
PUC-Rio, Brazil
Keynote: New advances in innovations for skin expansion
Time : 10:40-11:10
Biography:
Djenane Pamplona is currently Visiting Professor at the Department of Mechanical Engineering, Catholic University of Rio de Janeiro-Brazil. She works in Biomechanical Engineering since 1989 when doing a post-doctoral at the Engineering Department of the University of Cambridge – England. She is a member of the Brazilian Academy of Engineering since 1995. Her present research mainly focuses on Experimental and Numerical Analysis of Biomembranes. She is an author of 25 publications in peer- review journals, several chapter and editions of books, performed several invited lectures in International Conferences and has more than 100 contributions to International and National Conferences.
Abstract:
Skin expansion is a physiological process based on the capacity of human skin to increase its superficial area in response to a stress, it is used in plastic reconstructive surgery every time that an extra flap of skin is needed to reconstruct burned areas, hide scars etc. The surgical procedure is performed by implanting skin expanders, Fig. 1(a), that are silicon bags, under the subcutaneous tissue and infiltrating them weekly with a saline solution. The physiology of skin expansion considers both the stretching of the skin and the relaxation process used to obtain the extra flap of skin that possesses the required characteristics needed to the reconstruction. Finite elements controlling the internal volume have been used to simulate numerically the whole process of skin expansion. During our research on the subject, some points were considered of great importance: the characterization of human skin as a viscoelastic material and the choice of the site to perform the expansion. To guide the surgeon in choosing the number and shape of skin expanders necessary to obtain the extra flap of skin, the application SKIN CALC was developed and is accessible in Play Store. Since the internal pressure in the skin expanders is dependent on the volume of liquid infiltrated, to aid surgeons in this topic an apparatus to measure the internal pressure before, during and after the skin expansion was processed, Fig. 1 (b). The frequently visits of the patients to the ambulatory, to perform the several infiltrations needed, are an issue and to avoid it a new portable apparatus, Fig. 1(c) was developed in a way that the patient can infiltrate himself in his house. The pressure and volume infiltrated are registered in a Simcard, and all the data can be recovered by the surgeon, which is fundamental for further research.
Keynote Forum
Djenane Pamplona
PUC-Rio, Brazil
Keynote: New advances in innovations for skin expansion
Time : 10:40-11:10
Biography:
Abstract:
Keynote Forum
Tatiana Shilova
Smile Eyes Augenklinik Moskau, Russia
Keynote: The outcomes of laser vision correction ReLEX SMILE under general anesthesia
Time : 11:30-11:55
Biography:
Abstract:
Keynote Forum
Suhail M Hadi
The Mount Sinai Medical Center, USA
Keynote: The use of 308-nm excimer laser for treatment of vitiligo
Time : 11:55-12:25
Biography:
Abstract:
- Workshop
Location: Rome, Italy
Session Introduction
Tatiana Shilova
Tatiana Shilova
Title: The outcomes of laser vision correction ReLEX SMILE under general anesthesia
Time : 11:30-11:55
Biography:
Tatiana Shilova is the Head of the "Dr. Shilova Clinics" and the Founder of the Russian branch of an international chain "SMILE EYES", the Clinical Expert of the company "Carl Zeiss" in cataract surgery. Her surgical activity is on average up to 200 cataracts, up to 30 vitreoretinal operations and about 100 laser operations per month, including all complex cases, cases of combined pathology and severe eye injuries. She combines clinical work with teaching activities-she works as a CLINICAL PROFESSOR and Training Surgeon in Cataract, Vitreoretinal and Refractive Surgery. She is the Member of the European Society of Cataract and Refractive Surgeons (ESCRS) and the American Academy of Ophthalmology (AAO). She is Russia's leading expert on laser vision correction ReLEx SMILE.
Abstract:
Purpose: To study results and features of laser vision correction ReLEX SMILE under general anesthesia.
Materials & Methods: The study included 24 eyes from 12 patients between the age groups of 28 and 35 years, undergoing bilateral surgery with ReLEx SMILE-for correction of myopia within the range of -1.65 to-8.15 D (-4.5 ±3.5 D), with astigmatism of 0 to -2.25 D (-1.15 D). Central corneal thickness (um) from 515 to 580, keratotopography in all cases were regular. Operations were performed under general intravenous anesthesia by fractional injection of «Propofol» at doses of 200 to 400 ml with monitoring of blood pressure, heart rate, saturation, and a moistened oxygen supply (3-4 liters per minute). The ReLEX SMILE was performed in the "Expert mode", the energy level from 26 to 28 MJ (*15), the mechanical centration of the pre-determined position of the optical axis on the aberrometer, taking into account the Kappa-angel. At the moment of laser-cuts the eye was fixed manually. The standard separation of the lenticule by Reinstein Lenticule Separator with the positioning of the eyeball with the help of an assistant.
Results: Visual Acuity in the first day after surgery was 0.95-1.5 (1.15) in all cases. The interface was clean. Patients were subjectively very satisfied. Keratotopography made after 1 week, 1 month and 3 months after correction showed a good centration of the optical zone. Comparative evaluation keratotopography data patients after correction by SMILE method under general anesthesia and patients after operation SMILE under local anesthesia revealed no significant differences.
Conclusion: ReLEX SMILE procedure under general anesthesia makes it possible to obtain high refractive results in patients with the inability to perform it under local anesthesia. However, it requires a competent anesthesia and high manual skill of the surgeon.
Recent Publications
1. Ganesh S, Brar S and Patel U (2018) Comparison of ReLEx SMILE and PRK in terms of visual and refractive outcomes for the correction of low myopia. Int Ophthalmol. 38(3):1147-1154.
2. Burazovitch J, Naguzeswski D, Beuste T and Guillard M J (2017) Visual outcomes four years after small incision lenticule extraction (SMILE) surgery on highly myopic eyes. Fr Ophtalmol. 40(7):561-570.
3. Blum M and Sekundo W (2017) Refractive lenticule extraction-The ReLEx/SMILE technique. Ophthalmologe. 114(9):851-856.
4. Marino G K, Santhiago M R and Wilson S E (2017) Femtosecond lasers and corneal surgical procedures. Asia Pac J Ophthalmol (Phila). 6(5):456-464.
Wang Y, Zhu Y, Jiang H and Huang Y (2014) Propofol and dexmedetomidine for monitored anesthesia care during laser in situ keratomileusis. Eye Contact Lens.