Medical Field: Ophthalmology
Award: Winner
Country: North Macedonia
Year: 2021
Research Work: Are changes in visual acuity and astigmatism after corneal cross-linking (CXL) in keratoconus predictable?
Published in: Graefes Archive for Clinical and Experimental Ophthalmology


Artificial intelligence liaison with research is the future of medicine.


The Northern Macedonian finalist in the field of Ophthalmology is Fanka Gilevska, MD. She works in the Department of Refractive Surgery at the Eye hospital Sistina Oftalmologija in Skopje. As North Macedonia has only a modest scientific experience and makes a small contribution to the global scientific community, she feels a great responsibility and is eager to continue her research. She is proud to be one of the finalists.

Currently, Fanka Gilevska, MD, is pursuing a PhD in Biomedicine and Health Sciences in Zagreb with a focus on ophthalmology. Within the program, her main interest is keratoconus and other corneal ectasias. While working with patients, she describes their interactions: 
"Keratoconus patients always ask the same questions: Will my visual acuity improve or worsen? Will I need a corneal transplant? Can you prevent deterioration? Can you make my eyes stable?" 

That is why she focused on predicting the outcomes of a biochemical cross-linking procedure for Keratoconus, a progressive disease. It affects 1 in 44 people in some communities and can lead to severe vision loss as the shape and clarity of the cornea deforms. Cross-linking (CXL) stiffens and flattens the cornea, slowing the progression of the disease and improving visual acuity.

We examined patients, performed the cross-linking procedure, collected data, and periodically analyzed changes in corneal curvature, corneal density, patient diopters, and best-corrected visual acuity before and after the cross-linking procedure. We found strong correlations and developed mathematical models to predict crosslinking outcomes of the cross-linking depending on these preoperative parameters.

This research is the first part of a bigger project to use mathematically precise details of pre- and postoperative corneal surface shape, clarity, and refractive error to predict the improvement in visual acuity that can be achieved after CXL treatment on a case-by-case basis. Understanding precisely how the cornea and vision change after CXL treatment on a case-by-case basis will allow us to customize treatment to further optimize clinical outcomes.

Artificial intelligence will play an important role in medicine in the future, and therefore also in ophthalmology for CXL treatment. Fanka Gilevska, MD, believes that all treatments will be customized and performed by robots controlled by doctors. She also predicts that her mathematical models will be used in these customized treatment algorithms.

Balancing clinical work, research and personal life can sometimes take a lot of time and understanding, which is why she is grateful to her family for being so supportive. She spends most of her free time with her son Ian and her partner Aleksandar, who give her superpowers to achieve anything she sets her mind to.