Tartu University Hospital

Since opening the Eye Clinic under Prof. Georg von Oettingen in 1868, patients with eye problems have been treated in the building located at 1 J. Kuperjanovi Street.

All operations of the higher treatment stage of the anterior and posterior eye segment are performed in the clinic.

Since 1996 the phacoemulsification method has been used in cataract operations. Today the Eye Clinic uses only foldable artificial lenses, which enable them to decrease the wound channel even more, thus being more eye-friendly. The number of cataract operations performed annually is almost 2600 and these are performed as day surgery. Operations correcting squinting both in children and adults as well as plastic operations of the eyelids and operations of the retina and the vitreous body are also performed in the clinic.

Transplantations of corneas have posed a great challenge, as the restricting factor here is insufficient availability of donor material.

To enhance the effect of glaucoma surgery, the Eye Clinic has started using pharmaceuticals that model cicatrisation, and collagen implants.

With regard to diagnostic devices, over the last three years the clinic has acquired additional examination apparatus on par with the best in the world. It is worth mentioning here that these include coherent tomography of the retina. Thanks to this technology, the diagnostic accuracy of eye-ground diseases has improved considerably. Upon ascertaining any changes in the eye-ground and monitoring disease progress in the case of diabetics, the technology can provide patients with up-to-date laser treatment.

In addition to the Estonian Society of Ophthalmologists, the Estonian Society of Ophthalmologic Nurses has also launched activities to provide a detailed overview of the specialisation and ensure the opportunity for lifelong learning.

Achievements

• During the last few years the proportion of day surgery has increased to 56.6%.
• For diagnosing eye diseases, the coherent tomography of the retina, the Heidelberg Retinal Tomography and Angiograph and scanning polarimeter have been adopted.
• The earlier and more accurate diagnosis of eye-ground diseases has made it possible to start using Avastin (bevacizumab) intraocular injections in the treatment of neovascular diseases. Therefore from 2007 it is now possible to treat cicatrising necrosis of the eye-ground yellow spot as well as diabetic changes in the retina.
• In glaucoma laser treatment, most of the procedures during the last two years have been carried out using selective laser trabecular plastics.
• The ophthalmologists of the Eye Clinic of Tartu University Hospital have published articles in professional press and given presentations and poster lectures at international conferences. Professional in-service courses take place regularly for both representatives of their own specialisations and other specialities.

Plans

• etter diagnosis of eye-ground diseases will create real opportunities for further development of the microsurgery of the macula lutea.
• Preparations to increase the amount of surgery, opening a new operating room in 2007.
• It has been intended to launch wider instructional work in the field of cornea donorship.

Developers of the field

Narrower specialisation of doctors in the Eye Clinic in a certain part of pathology makes it possible to deal with groups of diseases in depth and also ensures a new generation in the field. The group of doctors engaged in cataract surgery is at an equally high level and, in the course of its work, younger colleagues are also trained. Along with strabismus surgery, the orthoptics office has also started its work successfully.

After a year of professional development in Switzerland, Maris Oll is actively engaged in the treatment of eye-ground diseases and is one of the people who has introduced Avastin intraocular injections.

Marko Pastak has been actively engaged in introducing drainage implants, which are used in glaucoma surgery. He is also engaged, at a scientific level, in examining post-operative physiological and anatomical changes at the glaucoma post-operative stage.

Kuldar Kaljurand is engaged in examining the spread of the exfoliation syndrome among the population of Estonia and examining its effect on eyes that have undergone cataract surgery. Furthermore, he is actively engaged in diagnostic methods of eye-ground diseases.