Our goal is to make cornea care safer and more effective. This is why we continue to innovate and improve the care we provide. We do this in the following ways:
- Continuing to refine and develop existing treatment methods
- Learning through intensive follow-up care by closely monitoring the clinical results for various types of treatment
- Exchanging knowledge with other (international) cornea experts / knowledge institutes
- Keeping an open mind – remaining open to ideas and feedback from each other, other (eye)care professionals and patients
1 | Continuing to refine and develop
Numerous treatment methods used in the clinic have been developed by us and are now international standards in cornea transplants. We collaborate with the Research and Development department at NIIOS, the umbrella organisation for Melles Cornea Clinic so that we can continue refining current treatment methods and develop new methods. We do not limit ourselves to the surgical techniques used but also focus on the donor tissue preparation process in collaboration with Amnitrans Eyebank. We simultaneously look at ways to improve the tools at our disposal during the surgery and the donor preparation phase. We are currently focussing on the further refinement and development of:
- Treatment of cornea ectasia, keratoconus and other cornea contour defects and/or scarring.
We treat keratoconus and other types of cornea ectasia with UV crosslinking, DALK and Bowman layer transplants. We recently developed a new method for performing a Bowman layer transplant using a Bowman layer onlay graft. This method dramatically reduces the associated risks. This fully extraocular procedure reduces cornea irregularities and helps create a smoother surface. At the same time, the need to perform a more invasive method of cornea transplant can be postponed or prevented, and the potential progression of the disorder may be slowed.
- Personalised treatment for Fuchs endothelial dystrophy and other corneal epithelial diseases.
Every patient and each situation is unique. We always examine your eyes closely and take your personal situation into account while doing so. Personalised DMEK, or tailor-made DMEK, is a personalised treatment for patients using Fuchs, where treatment focuses solely on the affected (part of the) tissue.
2 | Learning through intensive follow-up care
We offer our patients an intensive follow-up process before and after any treatment. During the check-ups, we thoroughly examine your vision and the condition of your cornea. All these tests will provide us with information about your conditions and gives us insight into the recovery of your cornea following treatment. The tests also teach us about the disease and recovery process of the cornea. Furthermore, these intensive check-ups allow us to learn more about the possible complications which may occur and which circumstances increase these risks. We are currently intensively researching:
- Are the results during and after DMEK different when used to treat different conditions, and does the severity of the disease play a role? Can specific results be predicted before the procedure?
Due to the increased amount of DMEK operations executed on eyes with advanced epithelial disorders, this study focuses on gaining more insight into surgery carried out on these complex eyes. In this study, we want to compare the surgical conditions and results between DMEK performed for Fuchs endothelial dystrophy and more complex diseases. The findings are directly translated into clinical practice for continuous improvement results after DMEK.
- What are the (long-term) clinical results of the various treatment options for keratoconus, like Bowman layer transplants?
Bowman layer transplantation is a relatively new technology for halting the progression of advanced keratoconus in patients who do not qualify for UV crosslinking. The application of the transplant as an onlay graft means the procedure is minimally invasive. This results in lower intraoperative and postoperative risks compared to invasive keratoplasty techniques like penetrating keratoplasty or DALK. The research results will be directly implemented in clinical practice to improve the prognosis for keratoconus patients.
- Can an eye exam be carried out remotely using an all-in-one ophthalmological device which allows the patient to collect ophthalmology data themselves?
A standard eye exam in our clinic consists of a slit lamp test and a fundoscopic exam, a visual acuity test and an eye pressure test. We are currently conducting research at the clinic into a portable, all-in-one ophthalmological diagnostic device (the E-device) that allows patients to carry out these eye tests themselves and collect data. During the ongoing tests, it will be determined whether or not the tests and exams carried out using the device are easy to perform and if they are just as reliable as a visit to our clinic.
- Permission is always sought from the relevant medical ethical standard commission if medical research is carried out.
3 | Sharing knowledge
To keep developing and innovating, sharing knowledge and exchanging ideas with other (international) eyecare professionals and cornea specialists is essential. Close collaboration with various (international) knowledge centres and between the various NIIOS departments benefits our knowledge levels and effectiveness. We present the results of our research at various (international) ophthalmology congresses, and we also publish our results in a variety of ophthalmology journals. Furthermore, we also regularly organise events like courses, reference evenings, patient meetings and online cornea events.
4 | An open-minded approach
Naturally, we keep a close eye on the latest developments in our field. We also consider the input from patients and other (eye)care professionals when improving our care. Furthermore, we also remain critical of ourselves and others.
Melles Research Foundation
The Melles Research Foundation was created by our umbrella organisation, NIIOS. The Melles Research Foundation aims to facilitate innovative research in the field of ophthalmology and to make this knowledge available by means of education. The focus is on diagnostic methods and surgical techniques in the domain of cornea transplants, cataracts, glaucoma (high eye pressure) and age-related macular degeneration.
Would you like to know more about the Melles Research Foundation and our ongoing research? Or would you like to donate? If so, please visit www.mellesresearchfonds.nl.
