UKPGS 2021 Meeting report
This year previous Noel Rice Lecturers were invited back to give us their ‘Pearls of Wisdom’. The first invited lecture was delivered by Julian Garcia-Feijóo from Madrid who spoke about ‘New bleb forming surgeries. New indications in complex cases?’ An important theme of the day began here with a discussion the role of micro-shunts in various contexts and Dr Garcia-Feijóo shared a fascinating series of challenging patients and their surgical management.
The second invited speaker was Professor Sharon Freedman, Duke Eye Centre, USA. She gave a wonderfully candid account of pitfalls in managing glaucoma and tips as to how to avoid them, ranging from surgical tips to psychological techniques to get optimal outcomes for our patients.
On 23rd January 2021, the UK Paediatric Glaucoma Society (UKPGS) hosted its annual meeting in a ‘virtual’ format for the first time. The online environment saw attendees from six continents participating. More delegates attended than ever before. We enjoyed a mixture of invited lectures and short presentations of clinical cases, research and surgical videos, covering a huge range of topics. Each section allowed questions to be put to the panel of speakers in a live question and answer format. The earlier sessions featured delegates from The East and Australia and later moved to speakers from The West in keeping with international time zones.
The first session began with a warm welcome from Professor Sir Peng Khaw, president of the UKPGS. Professor Kaushik (Chandigarh, India) presented fascinating work correlating genotype with outcome and the commonality of north-west India and Pakistan’s populations. We heard about Australian findings regarding FOXC1 and PITX2 mutations from Dr Ruddle (Melbourne). Ken Yau (Manchester, UK) presented promising results following Paul glaucoma implants in children. We heard from Dr Senthill (L V Prasad, India) about a series of childhood corneal grafts with impressive survival at 5 years and the glaucoma management thereof. There was a prize-winning abstract presented by Miss Shah (Leicester and Birmingham, UK) on hand-held OCT in childhood glaucomas. We learned about the use of cross-linked hyaluronic acid for hypotony from Dr Agorogiannis (Birmingham, UK) and experience with the Ahmed and Aurolab glaucoma implants was compared by Dr Khan (King Khaled Hospital, Riyadh).
Highlights of the second session were an analysis of tonometry; rebound and applanation from Dr Perez-Garcia (Madrid), who won a prize for her abstract. We then heard about a series of keratoglobus, and their tendency to perforation following trivial trauma from Dr Senthil (LV Prasad, India). We learned about success rates of goniotomy in the Indian population. Dr Sesma (Saudi Arabia) presented a study of the association of microbial keratitis following cyclo-diode laser. There was a nice explanation of the Preserflo-Baerveldt implant and how it is suited to certain cases which require early pressure lowering from Ms Ning (Moorfields, London). Dr Chen (Boston, USA) gave the audience challenging questions raised by a case of suprachoroidal fluid after travel-by-air in a child with Sturge-Weber syndrome. We then discussed the challenges of establishing national glaucoma registries in the experience of Dr Hoffman and colleagues (Mainz, Germany).
The final session included a salutary case from Dr Chang (Miami), illustrating the possibility of GATT cannulation unseen, prematurely exiting Schlemm’s, and a rare series of glaucoma in children with Down syndrome from Dr Areaux Jr (Minneapolis, USA). Mr Masood (Birmingham) showed a comparative video in a single patient of microshunts and Baerveldt devices, and Dr Berger (Moorfields, London) described greater axial length-change outcomes from trabeculotomy ab-externo vs goniotomy. Professor Shue (Stanford, USA) presented results from a population survey looking at paediatric glaucoma surgery incidence in the USA, Dr Koenig (Moorfields, London) showed long-term results from tube surgery in children and Dr Areaux Jr told us about the different presentations of glaucoma and nasolacrimal duct obstruction. The prize for this section was awarded to Dr McSoley (Miami, USA) for work on the effect of image light exposure on cup to disc ratios.
The final lecture was from the very first Noel Rice lecturer, Professor James D Brandt from Sacramento, USA. He outlined the difficulties we all face in adopting a robust evidence-based approach to childhood glaucoma surgery, but presented ways in which he has overcome these challenges by introducing the micro-shunt for children with glaucoma. His memorable lecture included specific issues pertinent to the device, and generic means by which we can facilitate on-going innovation in the challenging but rewarding field of childhood glaucoma.
The event was a great success with very positive feedback from delegates. Like many academic and clinical societies, the UKPGS has responded to the pandemic with an updated website, which now is a repository for delegates to access the lectures and discussions from the meeting and a fulcrum for on-line networking. It was wonderful to bring together the paediatric glaucoma community from around the globe. The hope is that next year we can keep the benefits in terms of access and reach of an on-line meeting, but also be able to meet friends and colleagues in person at the UKPGS meeting in January 2022 in London.