5 questions for Dr. Ticiana de Francesco

09 August 2022
by Stephanie Ramos
5 questions for Dr. Ticiana de Francesco

In Custom Surgical we work daily to make healthcare more accessible and easier worldwide - and so do our customers! There are several people discovering how MicroREC (an optical system that digitizes your microscope or slit lamp) can make their routine easier and provide more quality care for their patients and one of those people is dr. Ticiana De Franceso.

De Francesco is an ophthalmologist with subspecialty expertise in glaucoma and minimally invasive surgeries, with a Glaucoma Fellowship at the University of Campinas (UNICAMP) and a Glaucoma and Advanced Anterior Segment Fellowship under the mentorship of the world-renowned and pioneer in Microinvasive Glaucoma Surgery (MIGS) ophthalmologist Dr. Ike Ahmed at the University of Toronto.

Dr. Ticiana de Francesco, ophthalmologist. blond woman with blue eyes wearing a white coat
Dr. Ticiana de Francesco

MicroREC is already present on her daily work routine as an ophthalmologist, either receiving advice for her mentor during a surgery or using the recorded material for individual and collective learning. She was even invited by BRASCRS (Brazilian Association of Cataract and Refractive Surgery) to speak about MicroREC in the “innovation in ophthalmology” session this year.

We talked with her about how MicroREC improved her work as a surgeon, trends in ophthalmology for glaucoma and more. Check the interview below:

What do you think about MicroREC?

I believe that one of its main objectives is to bring people together, facilitating the access of professionals to quality education, in addition to bringing the patient closer to medical care. Recently I was performing a very complex surgery in Fortaleza (Brazil) and my former boss, Dr. Ike Ahmed was watching in Canada, at his house, as I was broadcasting with MicroREC and we were exchanging experiences and good practices. When would you ever imagine that one day you would not only broadcast surgery, but receive real-time advice from a very experienced surgeon halfway around the world?

And how is MicroREC part of your work routine?

I use MicroREC in the operating room and the most interesting thing is its portability. I operate in three different surgical centers and if I didn't have MicroREC, I would depend on the hospital to make these records. Sometimes the video system is not available or is not of good quality. I take my MicroREC, put it under the microscope in seconds and that leaves me independent to record my surgeries.

Another way the MicroREC is present in my daily life is when I put it on my slit lamp in my office. What I like to do is, let’s say I have a patient who has cataracts. Telling the patient that he has cataracts is one thing, but being able to show him a picture makes the patient understand better, so he adheres more satisfactorily to the treatment.

Sometimes I implant a multifocal lens and the patient wants to see what that lens looks like inside the eye. After the post-op, I show him the difference with the normal lens. It is very interesting to be able to bring more information to the patient, to bring him closer to his treatment.

And how does MicroREC influence your learning process?

I believe it comes in two ways: individual learning and I believe that every surgeon has an obligation to register their surgeries. It is not an option, I believe it is an obligation, for legal and learning purposes. When you are a surgeon, for example, your learning cycle never ends, there is always something more to learn. During surgery, in adrenaline, it is difficult to recognize points that you can improve in your surgical technique. But then, with MicroREC you can watch the procedure peacefully and see what can be worked on to improve your surgical technique.

It also influences collective learning. If you are testing a new technique and have the opportunity to record it and take it to a conference, you are promoting knowledge by teaching colleagues a new technique that can make us work even better.

When would you ever imagine that one day you would not only broadcast surgery, but receive real-time advice from a very experienced surgeon halfway around the world?

How does the quality of images influence the diagnosis and treatment of glaucoma?

Microinvasive glaucoma surgeries have very small structures: in addition to having to use a microscope to visualize the angle of the eye, we also have to use lenses. To capture these images you need a very good video system, otherwise the image won’t look good. For these surgeries this is very important.

What are the trends for the coming years in the treatment of glaucoma?

The future has two approaches: working on research, focusing on preventing the development of glaucoma in some way, with genetic modification, for example, or even being able to take some action at the level of neuroprotection in patients who already have glaucoma.

+ Check out the new ophthalmology tendencies for 2022

I also see the future in less invasive approaches; approaches that impact less on patients’ quality of life. In the past, surgeries were very aggressive, today we perform less violent surgeries with faster recovery. So I believe it will be about disease prevention, modifying the course of the disease in some way and earlier, less invasive treatments.

We also have Artificial Intelligence nowadays to help on early detection of glaucoma and equipment like OCT (Optical Coherence Tomography) that are also part of the future.

What are your tips for a good conference presentation?

A good presentation cannot be tiring. Although there are fifteen minutes of presentation, the spectator disperses very quickly. So I believe that one of the techniques to hold attention is to use surgical images and videos so that people always pay attention. And in this MicroREC helps me a lot because I can present videos with good quality, which makes all the difference.

De Francesco also gives a very good tip for opthamologists that are starting their career: “Have determination. In the beginning, mainly in the surgical area, it can be discouraging, but that’s exactly what differentiates who will be a surgeon or not”. And the best advice she ever received? “If you’ve been doing surgery the same way for years, you’re wrong. You have to find ways to improve. There’s always some point to be perfected.”

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