In this first episode of the special two-episode series of the Interventional Glaucoma podcast, host Gok Ratnarajan is joined by esteemed guests Anselm Juenemann, Dan Lindfield, Jose Belda, and Nils Loewen to discuss key insights from their first 100 Elios cases. They share expert tips on technique, patient selection, and post-op management while exploring strategies to reduce the Elios learning curve. The conversation also delves into the safety and efficacy of the procedure and its impact on patient quality of life.
The Interventional Glaucoma Podcast
Episode 13: ELIOS – What I learned from my first 100 cases? Part 1
Key Takeaways
- Learning Curve for ELIOS : Surgeons found that only about five cases were needed to become proficient in performing ELIOS, making it relatively easy to adopt compared to other MIGS procedures.
- Patient Selection Matters : For beginners, selecting the right patients is crucial. Ideal candidates have shallow anterior chambers but not deep-set eyes, allowing better visualization of the trabecular meshwork during surgery.
- Advantages Over Other MIGS Procedures : ELIOS is seen as less traumatic than other MIGS techniques. It does not cause hyphema or synechiae, and the results suggest a more durable pressure-lowering effect, possibly due to preserving the trabecular meshwork’s natural pump function.
- Surgical Techniques & Optimization : Some surgeons, like Dan Lindfield, have refined their approach by spreading the laser shots more evenly across 180 degrees rather than clustering them in one quadrant, potentially leading to better results.
- Patient Communication & Expectations : Surgeons use relatable analogies to explain ELIOS to patients, such as comparing it to a kitchen sink strainer or refractive laser surgery. They emphasize its minimally invasive nature and the possibility of avoiding permanent implants while achieving long-lasting pressure reduction.
Guests
Mr Gok Ratnarajan
Mr Gok Ratnarajan is a Consultant Ophthalmic Surgeon specialising in Cataract, Glaucoma and Anterior Segment Reconstructive Surgery. He is Director of Glaucoma Services at the prestigious Queen Victoria Hospital.
Mr Ratnarajan is fellowship trained in glaucoma, complex cataract as well as anterior segment reconstructive surgery. He gained this experience during his 3 specialist surgical fellowships at The Oxford Eye Hospital, The Western Eye Hospital in London and at the University of Toronto, Canada.
Prof Nils Loewen
Prof. Dr. Nils Loewen is the Chair of the Artemis Cluster of Frankfurt. He specialises in glaucoma and cataract care and is renowned for providing innovative, minimally invasive procedures that simultaneously address cataract and refractive vision needs. His extensive research includes over 110 published works which focus on bioengineering the ocular outflow system to lower intraocular pressure. He actively contributes to the field through his roles in prominent ophthalmological societies and as a reviewer for 18 scientific journals.
Prof Anselm Juenemann
Prof. Dr Anselm Jünemann is a specialist for the posterior eye segment and has been working at the Viselle Eye Center Erlangen since 2019. At the University Eye Hospital Erlangen, he has led numerous scientific projects in glaucoma research since 2006. From 2014 to 2018, he was head physician at the Department and Polyclinic of Ophthalmology at the University Medical Center Rostock. Since 2019, he has been back in Erlangen as a glaucoma specialist at the Viselle Eye Center. In addition to his expertise in the diagnosis and treatment of diseases of the posterior eye segment, Prof. Jünemann also has many years of experience in the field of cataract surgery and refractive surgery. He also carries out various methods of corneal transplantation, ablation of superficial corneal scars, removal of pronounced astigmatism, and pterygium surgery.
Mr Dan Lindfield
Mr Dan Lindfield is a consultant ophthalmologist and cataract surgeon in Guildford and Farnham who specialises in cataracts and glaucoma surgery, including laser therapies for glaucoma, such as SLT, trabeculectomy, and minimally invasive glaucoma surgery (MIGS). He has an extensive portfolio of research and academic work which is published in leading peer-reviewed journals.
Dr Jose Belda
Dr Jose Belda is a Surgeon Ophthalmologist at Visionker Eye Clinic, Clínica Oftálica, and head of the Ophthalmology Service at the University Hospital of Torrevieja. He is a reference expert in the approach and treatment of Glaucoma, standing out for his great work in the different clinical and hospital centers where he has worked. His extensive training in ophthalmology includes stays in centers of international prestige such as the Bascom Palmer Eye Institute, Moorfields Eye Hospital, and the Hospital for the Prevention of Blindness in Mexico DF.
Additional Resources
Follow Dr Gok Ratnarajan on Social:
Gokulan Ratnarajan | LinkedIn
Follow Dr Anselm Juenemann on Social:
Anselm Jünemann | LinkedIn
Follow Mr Dan Lindfield on Social:
Dan Lindfield | LinkedIn
Follow Dr Jose Belda on Social:
Dr Jose Belda | LinkedIn
Follow Dr Nils Loewen on Social:
Nils Loewen | LinkedIn
Episode 13: ELIOS – What I learned from my first 100 cases (Part 2)
In this second episode of a special two-part series on the Interventional Glaucoma Podcast, host Gok Ratnarajan is joined by Anselm Juenemann, Dan Lindfield, Jose Belda, and Nils Loewen to
Episode 12: Captivating Cases: Reviewed by Prof Ike Ahmed
Prof. Ike Ahmed presents a series of ELIOS case studies recorded by Dr. Ana Miguel, Dr. Jose Belda, Dr. Karl Mercieca, and Ms. Nishani Amerasinghe.
Episode 11: Routine Phaco+ MIGS: Are we there yet?
Professor Gus Gazzard, Ms. Nishani Amerasinghe, and Dr Jose Belda discuss the concept of routine Phaco Plus.