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AN EXPANDING ROLE

Incoming president of ESCRS believes that the difficulties as a result of the current economic climate can enhance the role of a leading society of surgeons

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Roberto Bellucci MD is the incoming president of the ESCRS. He spoke with EuroTimes contributing editor Roibeard O’hEineachain about the evolving role of the ESCRS in promoting the advancement of ophthalmology in Europe and throughout the world. My involvement with the ESCRS dates back to the very early days of the organisation.

I remember wanting to go to the meeting of the society in 1986 because I had started implanting intraocular lenses, but at that time I was so young I had to stay in the hospital working while other doctors went to the meeting. So my first presentation was in Zurich in 1989. Then in 1990 I had three presentations at the meeting in Dublin, and attended all the meetings thereafter. Then I joined the ESCRS Board as a co-opted member early in the year 2000. After a few years I became an elected member of the Board of ESCRS and a few years later I became secretary and now I am president of the society.

Over the years, the role of ESCRS in ophthalmology has changed a lot.

It started as a society for ophthalmic surgeons who were helping each other achieve a better understanding of surgical procedures and refining our techniques. Then the ESCRS began to adopt an educational role and the educational activities at meetings and on the Internet have been so effective that our society has become what I believe is the leading ophthalmological subspecialty society in the world. More recently, the ESCRS has become involved in research. First there was the Endophthalmitis Study led by our president Peter Barry and then the recently started Cystoid Macular Oedema research under Rudy Nuijts' direction. On top of that there is the EUREQUO system led by Mats Lundstrom and similar registry-based research initiatives which are providing helpful data to clinicians.

The ESCRS has also been expanding its activities to include other areas of ophthalmology.

We are accomplishing this by holding our meetings in conjunction with those of other sister societies like the World Society of Paediatric Ophthalmology and Strabismus, EURETINA, EuCornea and the European Glaucoma Society. In this way we can encourage our members to regard ophthalmology as a comprehensive speciality. Although we may focus on anterior segment surgery and on cataract and refractive surgery, we must also be aware that the needs of an eye, like the needs of a patient, are not restricted to anterior segment surgery.

Another role I think that the ESCRS can play is to use the Internet to provide patients with reliable information about cataract and refractive surgery.

The Internet is not controlled and contains a lot of misinformation about all branches of medicine. At present pubmed.com is the only reliable source of information available to doctors and to patients. Our society could do a great service by providing our patients with a freely accessible place online where they could find information that is valid from a scientific point of view about their eye conditions and the procedures they may undergo.

During the years of my participation in the ESCRS, techniques and technology have likewise changed.

Like many others of my generation I went through all the techniques of cataract surgery from intracapsular, to ECCE, to phaco. I started doing phaco in 1991 when I joined the hospital of Verona where I am the chief today, because Verona had the machine and the facility my previous hospital had not. I began to use topical anaesthesia around 1995 and I began doing MICS as early as 2006 and we began using femtosecond laser cataract surgery in 2012. In the long-term, femtosecond laserassisted cataract surgery will probably take over from MICS, although in the shortterm cost will be the barrier to its broader use. But once a technology demonstrates better results or safer results or an easier technique than previously available techniques it stays with us. This presents a special challenge to us as surgeons, because we will need to learn new techniques but must do so without forgetting the old ones.

Another challenge we face is the problem of increasing demands and decreasing resources to deal with them.

The difficult economic period that Europe is currently going through poses some restrictions on our work as ophthalmologists. Reimbursement is decreasing in public hospitals, and patients have less and less money to pay out-of-pocket for specific procedures. At the same time the number of conditions we can treat is increasing but the number of ophthalmologists to treat them is decreasing. These difficulties enhance the role of a leading society of surgeons.

In the meantime, the ESCRS is in very good health and is seen as a model of efficiency and organisation by other ophthalmic subspecialty societies.

During my tenure as president I would like the society to continue in its role as the leading ophthalmic society in this part of the world, and to continue to expand its educational activities through better videos (including 3-D videos) and better activities in order to deliver the benefits of the society into the homes of its members.

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