High levels of medical specialisation and cutting-edge technology: the two main focal points that are making ocular surgery safer and less invasive. We talked it over with Anna Altomare, CEO of Blue Eye, an ocular microsurgery centre that recently opened a new facility in Vimercate, Brianza. With over 500 square metres dedicated to the prevention, diagnosis and treatment of different diseases, it was created on the back of the extensive experience of the original Milan clinic, which, having performed approximately 25 thousand cataract procedures and over 10 thousand refractive procedures since 1998, has become a landmark private facility in the prevention and treatment of different eye diseases thanks to its pool of highly specialised doctors and the use of cutting-edge technology
Does the fact that your centre focuses exclusively on the eye represent an advantage?
“Today there seems to be a trend towards multi-specialist centres, while we choose to define ourselves as an eye care centre where patients can find appropriate, accurate and personalised solutions thanks to the pool of doctors who work with our facility and our highly qualified staff who are able to evaluate patient queries from the very first phone conversation.”
How do you handle urgent cases?
“We have a specialised internal staff member who carries out an initial telephone consultation and then directs the patient to the relevant specialist. When the disease in question is particularly serious we always try to arrange an appointment within 2 or 3 days thanks to the wide availability of clinics, offices and doctors.”
So it’s a clinic of many doctors?
“Yes, our pool of around sixty doctors means that we can solve a wide variety of different issues and diseases, managing patient requests on a personalised basis by putting them in the care of one specific professional. There are so many different eye diseases, and we therefore rely on doctors who focus on more general areas as well as others who are more specialised in specific fields.”
How do you combine medical specialisation with advanced equipment?
“Technology is absolutely essential because it supports the surgeon’s abilities and makes the procedures safer and more effective. Eye surgery is actually microsurgery, because it deals with millimetres or even thousandths of a millimetre. This is why our centre is equipped with advanced instruments such as a femtosecond laser that allows surgeons to perform cataract operations according to a safer and more reproducible procedure as well as the soon-to-be-installed 3D system for retinal surgery, which will allow surgeons to perform surgery while watching their work on a high definition 3D screen.”
How widespread are retinal and general ocular diseases?
“Increasing life expectancy has also increased the prevalence of ocular and retinal diseases and those affecting the optic nerve. Cataracts, age-related macular degeneration, glaucoma and retinopathy linked to diabetes and vascular disorders are diseases with a significant social impact, and their diagnostic and therapeutic management will play a key role in future health management decisions.”
And in the elderly?
“Our eyes age just like the rest of us and, while there may not be any major issues at play, they are not as young as they once were: just think of how many elderly patients suffer from dry eye syndrome.”
What does it involve?
“Dry eye syndrome is an increasingly common eye disease that can present itself in a wide variety of ways. The risk factors at stake range from environmental factors to the use of some medications, as well as the presence of other ocular and systemic diseases, but there is currently a wide variety of therapeutic options, from eye drops to the latest thermal or pulsed light treatments aimed at improving the functioning of the glands that produce the main components of tears. The same age group may also undergo changes to the normal balance of the tear film, which represents the first line of defence against microorganisms, irritants and allergens. Surgery such as cataract removal or the correction of refractive errors using an excimer laser can worsen this condition. The role of the ophthalmologist is essential in diagnosing these changes and identifying the best care for the patient.”
What are the most frequently requested procedures?
“Cataract surgery is definitely the most requested procedure, and over the past 20 years Blue Eye has carried out over 25 thousand operations. Refractive surgery for the correction of refractive errors such as myopia, hypermetropia and astigmatism and requests for intraocular lens implants are all on the rise.”
Is there still room for error when it comes to refractive surgery?
“Today, refractive surgery has reached a very high standard. Refractive surgery with excimer lasers is a safe, effective and permanent surgical technique, but an eye examination is absolutely vital in order to identify the actual vision defect. A series of instrumental diagnostic tests are performed with the aim of verifying whether the patient is eligible for surgery. During the operation, the laser is completely guided by a computer that follows the information entered by the surgeon with nanometric precision.”
Do you see refractive surgery as a choice or a necessity?
“It definitely does improve the patient’s quality of life, because freeing yourself from glasses or contact lenses can make many activities a lot easier. It also helps that these are outpatient procedures that only take up half a day, and even post-operative care is becoming less and less of an issue.”
What are the most common diseases affecting young people?
“The most common disease is keratoconus, a degenerative corneal disease that involves the more or less asymmetrical deformation of the surface of the cornea, typically combined with irregular myopic astigmatism, as well as a reduction in corneal thickness at the apex of the deformation, resulting in the progressive reduction of the visual capacity. Keratoconus usually occurs in adolescence, between the ages of 14 and 20, and typically presents asymmetrically, first affecting one eye and then the other a few years later. It is a progressive disease for which the most recent treatment is Cross-linking, which strengthens the collagen fibres that make up the cornea through the instillation of vitamin B2 (riboflavin) followed by the use of an ultraviolet laser on the ocular surface to activate the drug.”
Can prevention make a difference?
“Prevention always makes a difference, especially for diseases that have not yet manifested. We always recommend that people with vision defects visit an ophthalmologist at least once a year, but even those with no obvious problems should go for a checkup every two years.”
What part do opticians and optometrists play in all this?
“Their work complements ours, and we rely on their collaboration because they represent a valid means of transferring patients between different areas of expertise. If a patient needs visual correction that cannot be achieved with surgical treatment, we address it with a trusted optician. We also work with contact lens specialists who build custom lenses according to the vision defect in question and teach the patient how to use and treat their lenses.”
At what age should we stop wearing contact lenses?
“Contact lenses should always be used under the joint supervision of your optician and ophthalmologist. There is no universal limit, as the use of contact lenses depends on aspects relating to the patient’s behaviour and management, as well as the characteristics and health of the eyes. We believe that contact lenses can be worn throughout your life, but never for more than 8 hours a day.”
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