From couching to laser scalpel

August 2018

150 years ago the Ophthalmology Department was founded - today the department under the Medical Director Prof. Dr. Gerd Auffarth, is the international leader in surgical procedures of the anterior eye, in implant and biomaterials research. The Eye Clinic has ever since been a pacemaker in medical research and development of therapies: For example, the very first multifocal toric intraocular lens anywhere was implanted in Heidelberg. This lens corrects age-related long-sightedness and astigmatism simultaneously.

 

The 19th century was the century of ophthalmology, in which the youthful specialty rapidly developed and became emancipated. This trend was not missed in Heidelberg: Exactly 150 years ago, on 3 August 1868, the Department of Ophthalmology at Heidelberg University Hospital opened under the leadership of the newly appointed medical director Prof. Dr. Otto Becker, who also became the first chairman of Ophthalmology as an independent specialty. Thus, in addition to the special “round” birthday of the hospital this year, there is the bicentennial of ophthalmology at Heidelberg University Hospital.

New operative methods, modern biomaterials and great advances in implants

The number of cataract operations alone has increased fivefold in Germany over this period to just under 1,000,000 per year. “Overall, the methods used in eye surgery have changed completely - from manual techniques to image-guided procedures using ultrasound and femtosecond lasers. Today there is a variety of biomaterials and implants available. For example, there has been great progress in artificial lenses. Like bifocals, these now offer sharper vision at varying distances, and enable correction of vision defects or improved vision in age-related macular degeneration. The operative treatment of glaucoma as well as corneal transplant surgery has evolved dramatically in the past ten years. Heidelberg researchers were instrumental in all these areas,” says Auffarth. For example, the very first multifocal toric intraocular lens anywhere was implanted in Heidelberg. This lens corrects age-related long-sightedness and astigmatism simultaneously. Many other implants and surgical devices have been implemented for the first time at Heidelberg in the context of studies.

Laser instead of a scalpel in eye surgery

With the femtosecond laser, eye surgeons can cut into the eye cornea within a fraction of a second and with utmost precision. “In developing this technology, we worked together from the outset with local Heidelberg companies. First it was used in the laser correction of vision defects. In the meantime, the laser has replaced the scalpel also in corneal transplants and glaucoma surgery. Both procedures were co-developed here in Heidelberg, and some used for the first time in Germany,” explains Prof. Gerd Auffarth. More current focus is on the use of micro-stents for glaucoma. These improve chamber drainage and decrease eye pressure. Development was supported from the outset in Heidelberg. The Department of Ophthalmology is also a center for treatment of macular degeneration. A “SurgiCube,” an ultra-modern mini operating room into which the patient’s head is inserted, enables medications against macular degeneration to be administered directly to the eye under sterile operative conditions. Thus, the elaborate use of an operating room, with corresponding patient preparation, is no longer necessary. Because the hospital takes part in numerous international studies, the latest medications are typically available to Heidelberg patients.

Further Information:

Regarding research:

International Vision Correction Research Centre

David J. Apple International Laboratory for Ocular Pathology