A GLOBAL VISION

When he finishes his term of office as ESCRS president in December 2013, Dr Peter Barry will have led ESCRS delegations to more than 20 ophthalmology meetings all over the world. The venues for these meetings stretched from Chicago to Tokyo and Rome to Tbilisi. These visits are not merely courtesy calls, but underpin a strategic goal of the ESCRS to build links and share scientific knowledge and know- how with colleagues across the globe. This level of outreach is a natural extension of the role ESCRS played in the last century consolidating education in cataract and refractive surgery across Europe.

Roberto Bellucci addressing the ASCRS/ESCRS/JCRS joint symposia during the 28th Annual Meeting of the Japanese of Cataract and Refractive Surgery in Tokyo

"We should distinguish first of all," Dr Barry told EuroTimes, "between the supraregional meetings hosted by ASCRS, APACRS, ALACCSA and ourselves in ESCRS. Supporting the participation of key ESCRS opinion leaders in these symposia facilitates global communication among leading clinicians in the field and provides outstanding learning opportunities for ophthalmologists across the globe. It also gives ESCRS the opportunity to promote the ethos of the society and to share with an international audience the scientific projects which are supported by ESCRS, including Guidelines on Endophthalmitis Prevention and Treatment, the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO) and the PREMED study on prevention of cystoid macular oedema," he said."These activities demonstrate to our colleagues that we have a strong research interest, not just in theory, but in practice."

Attending the supraregional meetings also offers ESCRS the opportunity to promote our annual congresses, said Dr Barry, which is reflected in a progressive increase in attendance from delegates who traditionally had not included the ESCRS meeting on their calendars. The recently published book, European Society of Cataract & Refractive Surgeons - A History (1982-2012), documents the origins of the society from its roots as the European Intraocular Implant Club, whose first meeting was held in The Hague in 1982. The burning clinical issue at that time was the future of the IOL and the glue that held this group together was a passionate belief that the IOL would change forever the practice of cataract surgery. The founders also knew that to bring about this change in the face of strong opposition they needed to support rigorous scientific research and communicate this scientific validation to the widest audience possible. This is the ethos that still permeates ESCRS.

National and regional societies

The ESCRS sends delegations to national and regional ophthalmology meetings every year. "We have something to offer these societies. Bringing an ESCRS symposium to a regional society is attractive to them because it gives their delegates an opportunity to interact with key European surgeons and opinion leaders,” said Dr Barry. "In the eyes of delegates in their own countries, the inclusion of ESCRS symposia enhances the quality of their meeting programme. The ESCRS members who present at these symposia are respected on the European and international stage and are welcomed warmly at these meetings."

There are also many regions around the world that do not have access to the newest technology or the quality of training that is available in Europe. "Those are the same areas where frequently doctors do not have the income or the funding to attend international meetings themselves," said Dr Barry. "While the ESCRS supports younger ophthalmologists to attend our meetings through special bursaries, it is very rewarding to attend those national meetings and reach out to doctors who are in many ways isolated from developments and technologies of Western Europe.” Past ESCRS president Thomas Neuhann has commented that while the ESCRS has been attending supranational and national and regional meetings since its foundation in 1982, the reason for these visits has changed. "Things have evolved considerably – in a most positive sense and direction – since my presidency," said Dr Neuhann. "When I travelled to national society meetings, it was to get the major players to support ESCRS to get things going and grown. Today ESCRS is well established," he said.

Last May, an ESCRS delegation attended the Black Sea Ophthalmological Society (BSOS) meeting in Tbilisi, Georgia. The BSOS is a federation of ophthalmic societies with representatives from a number of countries including Georgia, Russia, Ukraine, Bulgaria and Turkey. "In some of those countries," said Dr Barry, "medicine in general is very poor in terms of financing and ophthalmology is particularly poor. In some areas, the standard cataract operation is not accompanied by an intraocular lens implant and if patients require such an implant then the entire procedure becomes a private one which the patient must fund in its entirety. In that environment, it is very difficult for the ophthalmology leaders to sustain the development of their departments. Good trainees travel abroad for fellowships and are very reluctant to return because they are offered positions with a better standard of living for themselves and their families. By sending delegations to meetings like the BSOS we are elevating the level of ophthalmology training in those countries and hopefully in that way we are indirectly encouraging their trainees to return. I believe the ESCRS has a role and responsibility to help develop the practice of ophthalmology in poorer countries.”

Changing role

Another former ESCRS president Dr Marie-Jose Tassignon also reflected on the importance of these visits. "The president of the ESCRS is indeed invited by many societies to participate at national and international meetings," she said. "It is not the ESCRS asking for exposure. This is important to stress because this means that the ESCRS as a society is well respected and its scientific or political messages are considered important by the organisers and the delegates of the inviting society. However, the most important motivation of these national societies is to belong to the ESCRS network and be part of it because the ESCRS has many educational and research benefits to offer, including access to international opinion leaders," she said.

In recent years, the ESCRS has also supported ophthalmologists in developing regions in Europe by organising its winter meetings in eastern European countries. "At our last four winter meetings we have supported ophthalmologists from the local host countries in Hungary, Turkey, the Czech Republic and Poland and neighbouring countries by offering them a very reduced registration fee," said Dr Barry. "We are also giving trainees three years free membership of the society. We have an Observership Programme which offers bursaries to young ophthalmologists and our writing prize for young ophthalmologists, the John Henahan prize, has a first prize of a travel bursary to allow a young ophthalmologist attend our annual congress," he said.

Developing European Community

The ESCRS has always been conscious of the need to be part of the continually developing European community of nations and as that family has grown, so has the society. "If you go back to the very early years of the society and its foundation at The Hague in 1982, we had less than 200 delegates at our first meeting," said Dr Barry. "It was more of a club of those who were committed to the world of intraocular lens implantation. As the council developed and intraocular lens implantation became the norm, the whole stage changed and so did the role of the society. We were no longer pioneering the concept of intraocular lens implantation but the concept of progressively more sophisticated cataract surgery through phacoemulsification and refractive cataract surgery.

“Many of the innovations in cataract and refractive surgery have come from Europe and have been announced at the ESCRS annual meetings. That is why our meetings continue to attract the top ophthalmologists not only from Europe but also from America and the rest of the world," said Dr Barry. Dr Roberto Bellucci, takes up the position of president in January 2014. He looks forward to continuing this tradition of building educational links with ophthalmologists worldwide. "Attending international meetings is an important duty for the president," he said, "because ESCRS is introduced to local ophthalmologists, and the level of scientific discourse within the society is explained. They are happy to host us, and consider our lectures and symposia as ‘state of the art’. This communication of scientific knowledge whether through its annual meetings or its support of international and regional meetings is the most important role of the ESCRS.”