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“I have been able to translate theory into practice”

Alberto Recchioni discusses his PhD research, which examines the effect of corneal refractive surgery on the ocular surface

Alberto Recchioni
Dr Alberto Recchioni completed his PhD research project in dry eye with a cotutelle agreement between Aston University and the University of Valencia with the support of Optegra and a European Union research grant. His research involved using the latest technology to explore the effects of dry eye on clinical outcomes and patient satisfaction. Dr Recchioni speaks with OT.

What was the focus of your research?

The focus of my research has been divided into two main streams. In the first one, I have been investigating the role of dry eye in limiting the accuracy of the pre-surgical calculation in patients attending for lens surgery – for example, cataract and refractive lens exchange surgery. The second one was focussing more on a younger population understanding the impact of corneal refractive surgery on the ocular surface.

How did you become involved in dry eye research?

This is an area that I have been interested in since my first MSc in Madrid in 2012. I started working on dry eye and ocular surface disease in 2013 under the guidance of Professor Jesus Pintor and Dr Gonzalo Carracedo at the Department of Biochemistry and Molecular Biology of the Complutense University of Madrid, Spain.

At that time, our first research projects were focused on determining signs and symptoms of dry eye patients with keratoconus in comparison to healthy subjects with keratoconus before and after intrastromal corneal ring segments. Then, later, when I joined the European Dry Eye Network as a PhD student, this confirmed how important the topic was.

All the research that I have done has been through the eye hospital group, Optegra. I have been able to translate theory into practice working with ophthalmic surgeons, optometrists, researchers and technicians.

What would you highlight as your key findings?

Despite the safety and efficacy of corneal lens treatment to restore an optimal level of vision, there is still a significant proportion of the population who may develop some symptoms of dry eye even if the surgery is 100% successful. This can potentially affect quality of life, work productivity and social relationships. There is a link between age and dry eye. Patients who presented for cataract surgery were at risk of having sub-optimal post-operative refractive outcomes due to dry eye because this was linked to their age.

How did you design your study?

I was lucky – in 2017, when I started my PhD with Optegra, the Tear Film Ocular Society Dry Eye Workshop II report had been published. This is a sort of masterpiece in dry and ocular surface disease. We developed an evidence-based protocol based on the TFOS II. The majority of the tests that we used were previously validated and most of them were known to be minimally invasive.

How do you view the importance of this topic in the future?

The increasing prevalence of dry eye is something that we have to be aware of. Dry eye is not only linked to age and gender, but it is also connected to the use of devices such as smartphones and tablets. There are several different investigations that are being done to determine the prevalence of dry eye in younger subjects. The time spent with digital devices and the increasing use of technology in the workplace may be affecting dry eye patterns.