Intraocular Lens Implantation in Rural India/COMMENTARY

Civerchia, Linda L.; Apoorvananda, S W; Natchiar, G; Balent, Alvan; Ramakrishnan, Rengappa; Aquavella, James V.

doi:10.3928/1542-8877-19931001-04

Cited by 3 publications

(1 citation statement)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Short-term, disease-specific surgical missions are myriad [27]: from ''eye camps'' in India [28][29][30][31][32][33] to ''ear camps'' in Namibia [34]; from organizations focused on facial clefting [19][20][21][22][23] to those focused on hernias [35], cardiac surgery [36], and endemic goiter [37]-services rendered, lengths of surgical trips, and resultant efficacies vary.…”

Section: Short-term Surgical Tripsmentioning

confidence: 99%

Charitable Platforms in Global Surgery: A Systematic Review of their Effectiveness, Cost‐Effectiveness, Sustainability, and Role Training

2014

View full text Add to dashboard Cite

ObjectiveThis study was designed to propose a classification scheme for platforms of surgical delivery in low- and middle-income countries (LMICs) and to review the literature documenting their effectiveness, cost-effectiveness, sustainability, and role in training. Approximately 28 % of the global burden of disease is surgical. In LMICs, much of this burden is borne by a rapidly growing international charitable sector, in fragmented platforms ranging from short-term trips to specialized hospitals. Systematic reviews of these platforms, across regions and across disease conditions, have not been performed.MethodsA systematic review of MEDLINE and EMBASE databases was performed from 1960 to 2013. Inclusion and exclusion criteria were defined a priori. Bibliographies of retrieved studies were searched by hand. Of the 8,854 publications retrieved, 104 were included.ResultsSurgery by international charitable organizations is delivered under two, specialized hospitals and temporary platforms. Among the latter, short-term surgical missions were the most common and appeared beneficial when no other option was available. Compared to other platforms, however, worse results and a lack of cost-effectiveness curtailed their role. Self-contained temporary platforms that did not rely on local infrastructure showed promise, based on very few studies. Specialized hospitals provided effective treatment and appeared sustainable; cost-effectiveness evidence was limited.ConclusionsBecause the charitable sector delivers surgery in vastly divergent ways, systematic review of these platforms has been difficult. This paper provides a framework from which to study these platforms for surgery in LMICs. Given the available evidence, self-contained temporary platforms and specialized surgical centers appear to provide more effective and cost-effective care than short-term surgical mission trips, except when no other delivery platform exists.

show abstract

Section: Short-term Surgical Tripsmentioning

confidence: 99%

Charitable Platforms in Global Surgery: A Systematic Review of their Effectiveness, Cost‐Effectiveness, Sustainability, and Role Training

2014

View full text Add to dashboard Cite

show abstract

High-volume Intraocular Lens Surgery in a Rural Eye Camp in India

Civerchia¹,

Ravindran²,

Apoorvananda³

et al. 1996

Ophthalmic Surg Lasers Imaging

View full text Add to dashboard Cite

* BACKGROUND AND OBJECTIVE: The appropriate surgical treatment for the enormous number of patients in developing nations who are blind due to cataract is a hody debated issue. The authors' objective is to demonstrate that modern surgical techniques (extracapsular cataract extraction and intraocular lens implantation, phacoemulsification and intraocular lens implantation) can be performed in a high-volume, costeffective manner, even in temporary settings. The authors believe that the approach to cataract blindness is not simple intracapsular cataract extraction, but rather the challenge of (1) training all ophthalmic personnel in modern techniques (microsurgery, biometry), (2) training managers in higher levels of organizational skill, and (3) doing these things in the face of limited resources. * PATIENTS AND METHODS: A total of 1298 surgeries were performed in a public eye camp in Ganeshpuri, India (50 miles north of Bombay). Of these, 1214 (93.5%) of the patients received intraocular lens (IOL) implants. Ninety-three percent (1032/1 108) of the patients who underwent extracapsular cataract extraction (ECCE) and IOL implantation and 89% (83/93) of the patients who underwent phacoemulsification and IOL implantation returned for follow-up. * RESULTS: Postoperatively, 48% (498/1032) of the patients who underwent ECCE and IOL implantation achieved corrected vision of 6/12 or better and 65% (671/1032) attained corrected vision of 6/ 1 8 or better. Of the patients who underwent phacoemulsification and IOL implantation, 59 of 83 (71%) attained vision of 6/12 or better with correction and 68 of 83 (79%) achieved vision of 6/18 or better with correction. These results are almost identical to those obtained by the authors in their Ganeshpuri 1991 camp. Surgical complication rates were comparable to those reported in hospitalbased studies. * CONCLUSION: For this type of camp to operate efficiently, there must be standardization of skills among ophthalmic personnel, costs must be contained, and the organizational skills necessary to ensure smooth functioning of the camp must exist. However, on the basis of their data, these authors believe that with suitable organizational and surgical facilities, IOL implantation can be successfully performed in high-volume surgical eye camps. [Ophthalmic Surg Lasers 1996;27:200-208.]

show abstract

High Volume Sutureless Intraocular Lens Surgery in a Rural Eye Camp in India

Balent¹,

Narendrum²,

Patel³

et al. 2001

Ophthalmic Surg Lasers Imaging

View full text Add to dashboard Cite

* BACKGROUND AND OBJECTIVE: To describe the use of small incision sutureless cataract surgery (SISCS) that permits high-volume, high-quality, and low-cost surgery. * PATIENTS AND METHODS: We compared the speed, safety, and visual results of 1 1 90 surgical techniques performed in a public eye camp in India. Intraocular lenses were received by 97% of patients (1154). Surgical techniques used were SISCS, phacoemulsification, and standard extracapsular cataract extraction (ECCE) technique. * RESULTS: Postoperatively, 60.0% attained uncorrected vision of 6/24 or better. There was little difference in visual results or complication rates among the three techniques. The most striking finding is the speed of SISCS, which enables experienced surgeons to perform the technique in 3.8 to 4.2 minutes. * CONCLUSION: We believe this surgical technique is of major importance especially in developing nations facing enormous surgical volumes and limited resources. [Ophthalmic Surg Lasers 2001;32:446-455]

show abstract

Intraocular Lens Implantation in Rural India/COMMENTARY

Cited by 3 publications

References 0 publications

Charitable Platforms in Global Surgery: A Systematic Review of their Effectiveness, Cost‐Effectiveness, Sustainability, and Role Training

Charitable Platforms in Global Surgery: A Systematic Review of their Effectiveness, Cost‐Effectiveness, Sustainability, and Role Training

High-volume Intraocular Lens Surgery in a Rural Eye Camp in India

High Volume Sutureless Intraocular Lens Surgery in a Rural Eye Camp in India

Contact Info

Product

Resources

About