High-Fidelity Cataract Surgery Simulation and Third World Blindness

Singh, Ajay Kumar; Strauss, Glenn H.

doi:10.1177/1553350614537120

Cited by 25 publications

(19 citation statements)

References 26 publications

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“…This is in contrast to our previous work9,10,13–15 and clearly is a feature of the fluidics system which is likely an inherent safety feature 16. Complications with phaco on the mature and dense lenses frequently encountered in outreach settings are common 17,18. By allowing for nearly equivalent efficiency at lower flow levels, this system likely decreases the amplitude of post-occlusion surge events and decreases the likelihood that the posterior capsule is contacted by the vibrating tip and broken.…”

Section: Discussioncontrasting

confidence: 77%

“…It is desirable to utilize the minimum amount of ultrasound energy needed to remove lens material, as excessive power results in increased intraoperative ultrasound delivery to the eye and potentially poorer post-operative outcomes secondary to posterior capsule rupture and/or corneal endothelial damage 20. In this study, the power range with increasing efficiency is quite broad, potentially allowing dense mature cataracts encountered in outreach settings to be removed at lower ultrasound settings 4,17,18. In regard to chatter there was variation in the number of chatter events across the levels tested, but only at 100% power was chatter consistently and significantly elevated.…”

Section: Discussionmentioning

confidence: 99%

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Optimization of the Oertli CataRhex 3® phacoemulsification machine

Stutz

Heczko

Bird

et al. 2019

OPTH

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Purpose The aim of this study was to determine optimal bottle height, vacuum, aspiration rate, and power settings of the Oertli CataRhex 3 ® phacoemulsification machine. Methods Porcine lens nuclei were hardened with formalin and cut into 2.0 mm cubes. Lens cubes were emulsified using the easyTip ® 2.2 mm at 30°. Fragment removal time (efficiency) and fragment bounces off the tip (chatter) were measured. Settings tested included bottle height of 60, 80, 100 and 120 cm; aspiration rate of 40, 45, and 50 mL/min; vacuum of 400, 500, and 600 mmHg; and power of 50, 60, 70, 80, 90, and 100%. Results Efficiency and chatter increased in a linear fashion with increasing vacuum to 600 mmHg ( P =0.017, P =0.046, respectively). The most efficient aspiration rate was 50 mL/min, although this finding lacked statistical significance ( P =0.66). Increasing power increased efficiency up to 80% without increasing chatter ( P =0.042, P =0.71, respectively). Compared to all other power settings, chatter was increased at 100% ( P =0.014). Conclusion The most efficient machine settings were vacuum at 600 mmHg, aspiration rate at 50 mL/min, and power at 80%.

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Section: Discussioncontrasting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Optimization of the Oertli CataRhex 3® phacoemulsification machine

Stutz

Heczko

Bird

et al. 2019

OPTH

View full text Add to dashboard Cite

show abstract

“…[ 22 ] These simulators permit trainees to practice surgical procedures repeatedly in order to improve their surgical skills. [ 23 ] Some simulators also allow objective measures of performance and trainees can experience a wide range of clinical scenarios without any actual risk to the patients.…”

Section: Discussionmentioning

confidence: 99%

The impact of COVID-19 related lockdown on ophthalmology training programs in India – Outcomes of a survey

Mishra

Nair

Gandhi³

et al. 2020

Indian J Ophthalmol

145

101

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Purpose: In 2020, in response to the emergence and global spread of the disease COVID-19, caused by a new variant of coronavirus 2019-nCoV, the government of India ordered a nationwide lockdown for 21 days, which was then extended to a total of over 50 days. The aim of this study is to assess the effect of the lockdown on ophthalmic training programs across India. Methods: An online survey was sent across to trainee ophthalmologists across India through various social media platforms. Results: In all, 716 trainees responded; the average age was 29.1 years. Results showed that majority of the respondents were enrolled in residency programs (95.6%; 685/716) and the others were in fellowship programs. About 24.6% (176/716) of the trainees had been deployed on 'COVID-19 screening' duties. Nearly 80.7% (578/716) of the trainees felt that the COVID-19 lockdown had negatively impacted their surgical training. Furthermore, 54.8% (392/716) of the trainees perceived an increase in stress levels during the COVID-19 lockdown and 77.4% (554/716) reported that their family members had expressed an increased concern for their safety and wellbeing since the lockdown began. In all, 75.7% (542/716) of the respondents felt that online classes and webinars were useful during the lockdown period. Conclusion: Our survey showed that majority ophthalmology trainees across the country felt that the COVID-19 lockdown adversely affected their learning, especially surgical training. While most found online classes and webinars useful, the trainees' perceived stress levels were higher than normal during the lockdown. Training hospitals should take cognizance of this and reassure trainees; formulate guidelines to augment training to compensate for the lost time as well as mitigate the stress levels upon resumption of regular hospital services and training. Going ahead, permanent changes such as virtual classrooms and simulation-based training should be considered.

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“…Properly trained eye-care personnel producing high-quality and high-volume CS is a primary need, in order to halt and eventually reduce the rising backlog of cataract blindness in Africa. 18 Highly trained doctors and eye-care teams are inextricably linked to the quality of services rendered. Excellent high-quality outcomes in turn generate patient demand for these services, regardless of the environment.…”

Section: Barriers To Implementing Care In Ssamentioning

confidence: 99%

Elimination of preventable blindness: can success in Nepal be replicated in Africa?

Nikpoor¹,

Hansen²,

Oliva³

et al. 2018

IEH

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There are an estimated 36 million people who are blind worldwide: ~1 in every 200 people. A third of these are blind from cataracts and could have perfect vision restored with a simple operation costing less than US$25. Ninety percent of the blind and visually impaired live in the developing world, with particular concentrations seen in South Asia and sub-Saharan Africa (SSA). Innovations in surgical techniques, delivery systems, and material production, developed first in Nepal and India, have provided a viable blueprint to address treatable blindness in the developing world. In fact, Nepal was the first developing country to reverse its trajectory of blindness. This was largely possible because of a collective effort by many international nongovernmental organizations to support Sanduk Ruit and his colleagues as they developed a sustainable eye care-delivery model anchored at Tilganga Institute of Ophthalmology. This model is similar to that of LV Prasad Eye Institute and Aravind Eye Hospital in India, which is also being successfully utilized to combat the enormous burden of needless blindness in Africa. Over the last decade, there have been early successes in transferring the Nepali model of care to Ethiopia and Ghana, and there have been other models successfully implemented across Africa as well. Though there has been significant progress in restoring sight in SSA, the prevalence of avoidable blindness in Africa is higher than any other continent, with about 4.8 million people living blind.

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High-Fidelity Cataract Surgery Simulation and Third World Blindness

Cited by 25 publications

References 26 publications

<p>Optimization of the Oertli CataRhex 3<sup>®</sup> phacoemulsification machine</p>

<p>Optimization of the Oertli CataRhex 3<sup>®</sup> phacoemulsification machine</p>

The impact of COVID-19 related lockdown on ophthalmology training programs in India – Outcomes of a survey

Elimination of preventable blindness: can success in Nepal be replicated in Africa?

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High-Fidelity Cataract Surgery Simulation and Third World Blindness

Cited by 25 publications

References 26 publications

<p>Optimization of the Oertli CataRhex 3<sup>&reg;</sup> phacoemulsification machine</p>

<p>Optimization of the Oertli CataRhex 3<sup>&reg;</sup> phacoemulsification machine</p>

The impact of COVID-19 related lockdown on ophthalmology training programs in India – Outcomes of a survey

Elimination of preventable blindness: can success in Nepal be replicated in Africa?

Contact Info

Product

Resources

About

<p>Optimization of the Oertli CataRhex 3<sup>®</sup> phacoemulsification machine</p>

<p>Optimization of the Oertli CataRhex 3<sup>®</sup> phacoemulsification machine</p>