New vision in eye-care surgery

The University of the West Indies (UWI), the University of Toronto and Alcon in partnership with Cari-Med Limited (Cari-Med) hosted Jamaica's first phacoemulsification course at the Alcon Wet Lab facility at Cari-Med's head office recently.

Dr William Macrae from Toronto and Dr Orlando Gonzalez from Puerto Rico were the main presenters and they were supported by senior consultant ophthalmologists lead by Dr Lizette Mowatt, senior lecturer at the UWI.

The training is geared to help ophthalmologists transition from extracapsular cataract extraction, which is the large incision cataract surgery, to phacoemulsification; a modern sutureless cataract surgery, which is routinely performed in the United States and the United Kingdom. It offers a faster recovery from cataract surgery and return to driving and work at an earlier stage as the operation is done via a <3mm incision into the eye.

This technique of cataract surgery is now becoming more common in other Caribbean islands. Ophthalmologists from over the island were able to participate in a hands-on wet lab with the latest phacoemulsification machines and equipment.

Removing cataracts with phacoemulsification

Globally, cataracts are the leading cause of blindness, affecting 18 million people. A cataract is a cloudiness in the lens of the eye that blocks the passage of light to the retina, (the back of the eye), which causes vision impairment. Patients may suffer from mistiness in their vision, which affects their reading of fine print or they may have problems with glare while driving at night.

Cataracts are treated with surgery if visual problems are interfering with the person's quality of life. Cataract surgery is very common and currently has the highest success rate of any surgical procedure. It involves removing the natural lens of the eye, which is the cataract. The lens is then replaced with an artificial lens called an intraocular lens (IOL) implant.

Modern cataract surgery, phacoemulsification, is done through a <3mm incision by a special ultrasound probe (Phaco probe). After the cataract is removed, the ophthalmologist will insert an IOL into the eye which will help to restore vision.

The benefits of phacoemulsification compared to the most traditional techniques performed in Jamaica include shorter surgical time, faster healing, less induced astigmatism (distortion) and less complications.

In the rest of the Caribbean countries, the phacomulsification technique is used 70 per cent in Trinidad, 80 per cent in Barbados, to 95 per cent in Puerto Rico, Curaçao, Aruba and Suriname, whilst the use in Jamaica is less than 10 per cent.

The participants were taught the basics and techniques of phacoemulsification in a structured manner, with the methodology first being familiarised with the techniques through lectures. The lectures provided information about the machine, the various steps in surgery, the principles of phacoemulsification surgery, the pre- and post-operative care of the patients and the management of complications.

The learning curve may take several months, but there are Jamaican ophthalmologists already using the technology in Jamaica, so there is no need to go to other countries to have modern cataract surgery.

The phacoemulsification course was organised by Dr Mowatt, the University of Toronto and Alcon in partnership with Cari-Med. Alcon is a leader in eye care with a wide array of product offerings in surgical, pharmaceuticals and vision care.