surgery

The treatment options for people with vision problems have changed dramatically over the past decade. New technologies have improved outcomes, reduced patient discomfort and brought an unprecedented level of choice for patients. We spoke with Dr Kaweh Schayan-Araghi, a consultant ophthalmologist at Artemis Klinik in Germany, about the progress he has witnessed and what the future may hold. How have treatment options changed for your patients? Over last ten years or so, the treatments available have improved for people with myopia (short-sightedness), astigmatism (defect in the eye resulting in distorted images), and cataract (a clouding of the lens). Looking back, the options for patients with astigmatism were especially few for those with low or moderate astigmatism – interocular lenses were really only used for people with much higher astigmatism and it was quite difficult to get a precise correction. Limbal relaxation incision was also used to correct astigmatism. This involves cutting into the cornea but, to be frank, the outcome was quite unpredictable and uncomfortable for patients. Most endured itching, rubbing and a feeling that there was something in their eye for three or four weeks. What is available today? The most dramatic change has been the evolution from implanting just clear lenses to implanting a refractive lens which actually corrects vision: we are now addressing cataracts and correcting vision in a single surgery. This would previously have required two separate operations. So, in a lot of cases we are not just clearing the cataract, the patient could be rid of glasses or have reduced dependency on glasses for the first time in decades. What kind of attitudinal shift have you seen in ophthalmology? In the past, the goal of surgery was to improve ‘best corrected vision’. This implies that patients continue to wear glasses. Today, surgeons want to achieve...
Roy Parker was not going to let arthritis interfere with the ‘golden years’ of retirement. When the joint condition became progressively worse in both his knees over the three years after retirement, he decided to see his doctor. “Instead of being able to use the additional time to enjoy outdoor pursuits like mountain biking and walking over the nearby South Downs, I found the pain in my knees was restricting my activities so much that I was becoming more socially isolated,” the 68-year-old from Worthing, UK tells This Is Medtech . “For example, my wife and I had not planned our usual holiday because I did not think I would be able to manage the inevitable walking around. Any distance over a few hundred metres was painful.” He was referred to an orthopaedic surgeon, who agreed with Roy that two knee replacements would be the best plan. “I was pleased at the speed of the process. The consultation was on the 15th May, my left knee was replaced on the 23rd May and the right on the 14th June,” Roy says. His doctor used cutting-edge artificial knee technology specifically designed to get patients back to their normal lives faster than ever by delivering a high level of stability and motion. Nevertheless, Roy was surprised by his speedy recovery. “Coming away from the consultation, I chatted to a man who had a knee replaced three weeks before, who was still using two sticks. I didn't use two sticks after leaving the hospital and only one for the first day home. I thought the feeling in my knees was immediately better after the operations than with my arthritic joints,” he explains. Roy also stunned his doctors when he cycled to his follow-up appointment two weeks after the first surgery. “I think I...
People with a rare eye disease known as retinitis pigmentosa (RP) suffer a gradual loss of vision; some become completely blind. Now, an innovative new approach to treatment has given dozens of people the chance to see again. With the help of a retinal implant, special glasses and intensive training, people who were blind have a new way of viewing the world which could one day benefit people with other degenerative eye diseases. We spoke to Professor Marie-Noelle Delyfer, University Hospital of Bordeaux, who has already performed eight such operations. What is retinitis pigmentosa (RP) and what is the prognosis for patients? RP is actually around 300 distinct genetic disorders that lead to the loss of photoreceptors on the retina. Some affected individuals have a reduction in their visual field while others become blind. With such a rare disease, it is difficult to describe a typical patient. Some lose their sight early in life or in early adulthood but there are others who become blind only in their 70s or 80s. Until 20 years ago, there were no treatments at all and the disease was not well understood. The first genetic cause of the disease was identified in 1984 – before that it was thought of as an inflammatory disease. What treatments are available? Some pharmaceutical therapies help to maintain photoreceptors but this only slows the progression of the disease – it’s not a cure. In the longer-term, there is some research on gene therapy targeting the mutations responsible for RP. How can technology help? I have used a new technology, from SecondSight, with eight carefully selected patients living with end-stage RP. These patients have an electrode array implanted in their retina. They wear glasses that are fitted with a camera that ‘sees’ their surrounding environment. This signal is sent...
Gaming and simulations can engage surgeons in ways that traditional medical education does not, says Professor Marlies Schijven who has shown the power of play in improving surgical skills. As a surgeon, game developer and app inventor – among other things – she is also on the cutting edge of using wearable technologies in the operating room and was the first person to live-stream abdominal surgery on YouTube via Google Glass. What is serious gaming? Serious gaming uses the principles of playful technology and the power of play to get an educational message across without people feeling as though they are being taught. The key is to wrap educational content into the game, in such a way that it is not perceived as ‘homework’. How can gaming and simulations help surgeons? This approach can be used to train anyone - but it has great potential in teaching surgical skills. It is very important to have game designers involved in developing the games otherwise it will just become another boring e-learning module or tedious task. I have shown that, compared to traditional training methods, well-designed simulations and games actually make for better, more competent surgeons. How did you become interested in working with game designers? For me, it was natural. Before I studied medicine, I studied for some time in a design academy so I can pretty much understand the way designers think and I value their approach. Good serious games are developed by good designers in collaboration with content experts. You have also been experimenting with wearable devices in the operating theatre. What do these technologies do for surgeons? To give one example, you often need to control computers or other devices whilst performing surgery. If this means typing on a keyboard or touching a mouse, you would have to...