|Year : 2015 | Volume
| Issue : 2 | Page : 123-124
Future and recent practices in ophthalmology
Department of Ophthalmology, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India
|Date of Web Publication||2-Sep-2015|
Department of Ophthalmology, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Singh S. Future and recent practices in ophthalmology. J Mahatma Gandhi Inst Med Sci 2015;20:123-4
Heraclitus had rightly said "There is nothing permanent except change"  and no other medical field is changing so fast as the world of Ophthalmology which is progressing with cutting edge technology for both the surgeons and the patients. This progress has been fast and dramatic. The lucky day may be here soon when no person will have to live with blindness, resigned to a world of darkness.
Ophthalmology with its various subspecialties such as refractive surgery, cornea, retina, intraocular lenses (IOLs) and various lasers is an exciting field to work and evolve in this present era. Significant advances have been made in the field of corneal surgeries with corneal transplant techniques evolving from there placement of the entire cornea; to only replacing the layer of cornea that is affected, leaving the undamaged corneal tissue untouched.  This has the advantage of faster recovery time and visual outcomes. With these new techniques like Descemet stripping endothelial keratoplasty (DSEK) and Deep anterior lamellar keratoplasty (DALK), the results of keratoplasty are vastly superior and one can think of using one donor cornea to rehabilitate two corneal blind persons by using specific layers of cornea. 
Another exciting recent development has been the report of the development of a new cornea made from synthetic, laboratory-produced collagen which has been implanted in patients. This search could help restore sight to millions of people worldwide. The scientists made their artificial cornea from collagen, a common connective tissue found in the human body. Instead of using natural collagen from humans, however, the scientists created synthetic collagen shaped like a human cornea. By using synthetic collagen, the researchers eliminated the need for donor corneas, which are often in short supply. 
LASIK surgery using Excimer laser is among the most successful performed elective procedures in medicine today.  It offers the patient the option of freedom from glasses. With the introduction of Femtosecond laser, Refractive corneal lenticular extraction (ReLEx) is replacing the"blade". LASIKwith a new procedure-ReLExSMILE (small incision lenticule extraction),  in which a lenticule and a small incision of 2-4 mm is created inside the intact cornea, enabling an 80% smaller side cut as compared to a LASIK flap. The major adnavtage is that flap related complications are not seen with Femtosecond Lasik or SMILE procedures. 
The older and presbyopic patients too are looking for freedom from glasses. Multifocal IOLs can be used for cataract patients to give optimum near and distant vision. The KAMRA inlay is one such device. The device is a polyvinylidene ring that is placed intrastromally in the cornea of the non dominant eye. It works like a camera, using a small aperture to expand the depth of focus. Unlike current refractive surgeries, the KAMRA inlay does not diminish distance vision, which remains binocular.  This gives the presbyopic persons adequate distance and near vision for functioning effectively without glasses. We hope that this or similar devices may be available soon in our country to address the needs of presbyopes.
The retinal blind need no longer despair and resign themselves to a life of darkness. Once the topic of folklore and science fiction, the notion of restoring vision to the blind is now approaching reality. Technological advances have inspired numerous multidisciplinary groups worldwide to develop visual neuro prosthetic devices that could potentially provide useful vision and improve the quality of life of profoundly blind individuals. Many types of devices are being developed, all sharing a common principle of creating visual sensations through the stimulation of visual neural elements using appropriate patterns of electrical stimulation. Human clinical trials are now well underway,and initial results have been promising. 
New technology has been developed for the cataract patients too. Using modern IOLs  optics like multifocal and accommodative IOLs for distant and near vision and toric IOLs for astigmatism the new generation of surgeons will ensure that in the near future that the old grandma operated for cataract can thread needle without glasses just as well as she used to in her youth.
Technology and technical advances have revolutionized diagnosis and treatment of eye diseases.
This will ensure that the quality of vision of all patients will remain optimal throughout life. We are indeed witnessing the "golden age"of ophthalmology.
| References|| |
Titiyal JS. Evolving trends in keratoplasty. DOS Times 2014; 20:7.
Solomon KD, Fernández de Castro LE, Sandoval HP, Biber JM, Groat B, Neff KD, et al.
LASIK world literature review: Quality of life and patient satisfaction. Ophthalmology 2009;116:691-701.
Vestergaard A, Ivarsen A, Asp S, Hjortdal JØ. Femtosecond (FS) laser vision correction procedure for moderate to high myopia: A prospective study of ReLEx(®) flex and comparison with a retrospective study of FS-laser in situ
keratomileusis. Acta Ophthalmol 2013;91:355-62.
Sharma C, Luci K, Vohra V, Vishal A, et al
. Femtosecond assisted corneal refractive surgeries. DOS Times 2014;20:437-50.
Merabet LB. Building the bionic eye: An emerging reality and opportunity. Prog Brain Res 2011;192:3-15.
Sinha R, Sachdev R, Sharma N, TitiyalJ S. Advances in intraocular lenses for cataract surgery: A review. Indian J Ophthalmol 2011;58:177-82.