Role of laser refractive surgery in cross-subsidization of nonprofit humanitarian eyecare and the burden of uncorrected refractive error in Nepal: Pilot project.

Abstract:

PURPOSE:To establish a refractive surgery unit at Tilganga Institute of Ophthalmology through support from international donations and provide knowledge transfer for doctors and management to make the unit self-sustaining, nonprofit laser refractive surgery, and financial support for other eyecare projects at Tilganga. SETTING:Tilganga Institute of Ophthalmology, Kathmandu, Nepal. DESIGN:Retrospective study. METHODS:A foundation was created to establish a refractive surgery unit using a cost-recovery model; that is, patients are charged according to their financial status to cover running costs, patients without funds to pay for surgery, and other eyecare projects for the underprivileged population of Kathmandu, Nepal. Donations were obtained to fund refurbishment within Tilganga Hospital and purchase equipment and technology. A Nepalese surgeon was selected from Tilganga and completed an 8-month fellowship and proctorship of the first series of surgeries. The refractive surgery unit was opened in January 2012, and the cost-recovery model was evaluated up to December 2016. RESULTS:During the period evaluated, 74.8% of patients were treated at full cost, 17.2% at subsidized cost, and 8.6% free of charge. The refractive surgery unit generated a profit representing 28% of the running cost in this period, which was used to reduce the deficit of the main hospital. Surgical outcomes achieved were comparable to those reported by groups in the developed world. CONCLUSION:A self-sustaining nonprofit laser refractive surgery clinic, operating with high quality, was successfully implemented supported by international donations for initial setup costs and a cost-recovery model thereafter.

authors

Reinstein DZ,Carp GI,Pradhan KR,Engelfried C,Archer TJ,Heintz J,Tabin G,Gurung R,Ruit S

doi

10.1016/j.jcrs.2018.05.023

subject

Has Abstract

pub_date

2018-08-01 00:00:00

pages

1012-1017

issue

8

eissn

0886-3350

issn

1873-4502

pii

S0886-3350(18)30471-1

journal_volume

44

pub_type

杂志文章
  • Slitlamp needle revision of capsular block syndrome.

    abstract::I describe a technique of slitlamp needle revision in eyes with capsular block syndrome (CBS) with distention of the capsular bag and forward displacement of the intraocular lens (IOL) in the capsular bag. After topical anesthesia and povidone-iodine are applied to the eye, a 30-gauge needle is introduced in a beveled...

    journal_title:Journal of cataract and refractive surgery

    pub_type: 杂志文章

    doi:10.1016/j.jcrs.2008.04.013

    authors: Mardelli PG

    更新日期:2008-07-01 00:00:00

  • Visual acuity tolerance to residual refractive errors in patients with an apodized diffractive intraocular lens.

    abstract:PURPOSE:To assess visual acuity tolerance to defocus caused by residual refractive errors after clear lens extraction (CLE) with apodized diffractive intraocular lens (IOL) implantation. SETTING:Fernández-Vega Ophthalmological Institute, Oviedo, Spain. METHODS:In this prospective study, 150 eyes of 75 consecutive pat...

    journal_title:Journal of cataract and refractive surgery

    pub_type: 杂志文章

    doi:10.1016/j.jcrs.2007.10.020

    authors: Fernández-Vega L,Alfonso JF,Montés-Micó R,Amhaz H

    更新日期:2008-02-01 00:00:00

  • Reduction in corneal haze and apoptosis by amniotic membrane matrix in excimer laser photoablation in rabbits.

    abstract:PURPOSE:To determine whether preserved human amniotic membrane can reduce corneal haze and keratocyte apoptosis induced by excimer laser photoablation in rabbit corneas. METHODS:Excimer photoablation was performed bilaterally in 30 rabbits with a 6.0 mm ablation zone and 120 microm depth using the VISX Star laser with...

    journal_title:Journal of cataract and refractive surgery

    pub_type: 杂志文章

    doi:10.1016/s0886-3350(00)00467-3

    authors: Wang MX,Gray TB,Park WC,Prabhasawat P,Culbertson W,Forster R,Hanna K,Tseng SC

    更新日期:2001-02-01 00:00:00

  • Excessive fibrin after cataract surgery associated with aminocaproic acid use.

    abstract::A 78-year-old woman developed a severe fibrinous anterior chamber reaction 1 day after uneventful clear corneal incision cataract extraction with intraocular lens implantation. There was no history of uveitis or diabetes, and the fibrin responded immediately to topical steroids. The patient was followed closely to rul...

    journal_title:Journal of cataract and refractive surgery

    pub_type: 杂志文章

    doi:10.1016/s0886-3350(03)00075-0

    authors: Jabbur NS

    更新日期:2003-08-01 00:00:00

  • Pediatric cataract surgery and intraocular lens implantation: a new technique for preventing or excising postoperative secondary membranes.

    abstract::This report describes a series of six children who had a retropseudophakic vitrectomy performed via a limbal approach (limbal approach retropseudophakic vitrectomy, LARV). This technique ensures a permanently clear visual axis when performed at the time of cataract/implant surgery and can also be used to excise second...

    journal_title:Journal of cataract and refractive surgery

    pub_type: 杂志文章

    doi:10.1016/s0886-3350(13)80985-6

    authors: Mackool RJ,Chhatiawala H

    更新日期:1991-01-01 00:00:00

  • Results of flap repositioning after laser in situ keratomileusis.

    abstract:PURPOSE:To determine the incidence and severity of flap folds and displacement after laser in situ keratomileusis (LASIK) and assess the outcome of the flap repositioning procedure. SETTING:Eye Institute of Utah, Salt Lake City, Utah, USA. METHODS:Charts of 91 eyes of 87 patients that had flap repositioning were revi...

    journal_title:Journal of cataract and refractive surgery

    pub_type: 杂志文章

    doi:10.1016/s0886-3350(00)00571-x

    authors: Lyle WA,Jin GJ

    更新日期:2000-10-01 00:00:00

  • Reproducibility of LASIK flap thickness using the Hansatome microkeratome.

    abstract:PURPOSE:To evaluate the actual versus the expected thickness of laser in situ keratomileusis (LASIK) flaps and to determine the factors that affect flap thickness. SETTING:Centre For Sight, Queen Victoria Hospital, East Grinstead, United Kingdom. METHODS:A retrospective analysis of LASIK procedures in 757 consecutive...

    journal_title:Journal of cataract and refractive surgery

    pub_type: 杂志文章

    doi:10.1016/j.jcrs.2003.09.070

    authors: Giledi O,Mulhern MG,Espinosa M,Kerr A,Daya SM

    更新日期:2004-05-01 00:00:00

  • Two opacification patterns of the same hydrophilic acrylic polymer: case reports and clinicopathological correlation.

    abstract::We report 2 intraocular lenses (IOLs) manufactured from the same hydrophilic acrylic polymer by Ioltech that developed optic opacification. In both cases, the postoperative course after implantation of the IOLs was complicated by significant inflammatory reaction with fibrin formation in the anterior chamber. Patholog...

    journal_title:Journal of cataract and refractive surgery

    pub_type: 杂志文章

    doi:10.1016/j.jcrs.2006.01.076

    authors: Neuhann IM,Stodulka P,Werner L,Mamalis N,Pandey SK,Kleinmann G,Apple DJ

    更新日期:2006-05-01 00:00:00

  • Ocular aberrations after cataract surgery with hydrophobic and hydrophilic acrylic intraocular lenses: comparative study.

    abstract:PURPOSE:To compare tilt and some higher-order aberrations (HOAs) in patients who had cataract surgery and implantation of 2 types of acrylic intraocular lens (IOL), the hydrophobic MA60AC (Alcon) or the hydrophilic XLSTABI (Ioltech). SETTING:Fondation Ophtalmologique Adolphe de Rothschild, Department of Pr Hoang-Xuan,...

    journal_title:Journal of cataract and refractive surgery

    pub_type: 杂志文章

    doi:10.1016/j.jcrs.2006.01.099

    authors: Rohart C,Lemarinel B,Thanh HX,Gatinel D

    更新日期:2006-07-01 00:00:00

  • Trypan blue capsule staining to visualize the capsulorhexis in cataract surgery.

    abstract::A capsulorhexis may be difficult to perform in the absence of a red fundus reflex. Using 0.1 mL of trypan blue 0.1% to stain the anterior capsule in 30 patients with a mature cataract enabled us to visualize the capsulorhexis during phacoemulsification. No adverse reactions were observed up to 12 months after surgery....

    journal_title:Journal of cataract and refractive surgery

    pub_type: 临床试验,杂志文章

    doi:10.1016/s0886-3350(99)80004-2

    authors: Melles GR,de Waard PW,Pameyer JH,Houdijn Beekhuis W

    更新日期:1999-01-01 00:00:00

  • Effect of partial and full correction of corneal spherical aberration on visual acuity and contrast sensitivity.

    abstract::A 60-year-old white man had cataract surgery with an AcrySof IQ intraocular lens (IOL) implanted in the right eye and a Tecnis IOL implanted in the left eye. The ocular spherical aberration (SA) target for a 6.0 mm pupil was +0.10 microm for the right eye and 0 microm for the left eye. After surgery, the ocular SA in ...

    journal_title:Journal of cataract and refractive surgery

    pub_type: 杂志文章

    doi:10.1016/j.jcrs.2008.12.041

    authors: Ferrer-Blasco T

    更新日期:2009-05-01 00:00:00

  • Photorefractive keratectomy for myopia with a 15 Hz repetition rate.

    abstract:PURPOSE:To evaluate excimer laser photorefractive keratectomy (PRK) for myopia using a repetition rate of 15 Hz instead of 10 Hz. SETTING:The Cornea and Laser Eye Institute, Teaneck, and Department of Ophthalmology, UMDNJ-New Jersey Medical School, Newark, New Jersey, USA. METHODS:Photorefractive keratectomy using a ...

    journal_title:Journal of cataract and refractive surgery

    pub_type: 临床试验,杂志文章

    doi:10.1016/s0886-3350(99)00406-x

    authors: Fisher EM,Ginsberg NE,Scher KS,Hersh PS

    更新日期:2000-03-01 00:00:00

  • Traumatic aniridia and aphakia after Artisan intraocular lens implantation.

    abstract::Traumatic aniridia and aphakia occurred in the left eye of a 22-year-old man who had had Artisan (Ophtec) phakic intraocular lens (IOL) implantation. Aniridia was probably the result of the relatively large wound used to implant the nonfoldable IOL. Although the eye had severe traumatic damage, vision was recoverable ...

    journal_title:Journal of cataract and refractive surgery

    pub_type: 杂志文章

    doi:10.1016/j.jcrs.2007.03.037

    authors: Lee SJ

    更新日期:2007-07-01 00:00:00

  • Photorefractive keratectomy with intraoperative mitomycin-C application.

    abstract:PURPOSE:To evaluate the efficacy and safety of photorefractive keratectomy (PRK) with intraoperative application of mitomycin-C (MMC). SETTING:Yonsei Eye Center, Seoul, South Korea. METHODS:This retrospective noncomparative case series included 536 patients (1011 eyes) who had had PRK with intraoperative application ...

    journal_title:Journal of cataract and refractive surgery

    pub_type: 杂志文章

    doi:10.1016/j.jcrs.2005.05.027

    authors: Lee DH,Chung HS,Jeon YC,Boo SD,Yoon YD,Kim JG

    更新日期:2005-12-01 00:00:00

  • Posterior continuous curvilinear capsulorhexis and optic capture of the intraocular lens to prevent secondary opacification in pediatric cataract surgery.

    abstract:PURPOSE:To evaluate the safety and efficacy of posterior continuous curvilinear capsulorhexis with optic capture n preventing secondary opacification of the visual axis in pediatric eyes having cataract surgery and intraocular lens (IOL) implantation. SETTING:Gimbel Eye Centre, Calgary, Alberta, Canada. METHOD:Poster...

    journal_title:Journal of cataract and refractive surgery

    pub_type: 杂志文章

    doi:10.1016/s0886-3350(97)80049-1

    authors: Gimbel HV

    更新日期:1997-01-01 00:00:00

  • Use of power modulations in phacoemulsification. Choo-choo chop and flip phacoemulsification.

    abstract::We used power modulations in addition to new technology available from 6 phacoemulsification manufacturers and altered our phacoemulsification techniques to take advantage of these technologies to significantly reduce the amount of ultrasound energy placed into the eye and enhance the rapidity and level of visual reha...

    journal_title:Journal of cataract and refractive surgery

    pub_type: 杂志文章

    doi:10.1016/s0886-3350(00)00834-8

    authors: Fine IH,Packer M,Hoffman RS

    更新日期:2001-02-01 00:00:00

  • Efficacy and safety of combined cataract surgery with 2 trabecular microbypass stents versus ab interno trabeculotomy.

    abstract:PURPOSE:To compare the outcomes of combined cataract surgery with trabecular microbypass stents and ab interno trabeculotomy in patients with open-angle glaucoma. SETTING:University of Toronto, Toronto, Ontario, and University of Montreal, Montreal, Quebec, Canada, and Glaucoma Associates of Texas, Dallas, Texas, USA....

    journal_title:Journal of cataract and refractive surgery

    pub_type: 杂志文章

    doi:10.1016/j.jcrs.2014.12.061

    authors: Khan M,Saheb H,Neelakantan A,Fellman R,Vest Z,Harasymowycz P,Ahmed II

    更新日期:2015-08-01 00:00:00

  • Anaphylactic reaction following intracameral cefuroxime injection during cataract surgery.

    abstract::We report a patient who developed an anaphylactic reaction several minutes after intracameral injection of cefuroxime at the end of uneventful phacoemulsification and intraocular lens implantation surgery. The patient had a known allergy to penicillin but not to cefuroxime. This rare life-threatening complication was ...

    journal_title:Journal of cataract and refractive surgery

    pub_type: 杂志文章

    doi:10.1016/j.jcrs.2013.06.008

    authors: Moisseiev E,Levinger E

    更新日期:2013-09-01 00:00:00

  • Factors related to corneal endothelial damage after phacoemulsification in eyes with occludable angles.

    abstract:PURPOSE:To evaluate the influence of preoperative variables and early postoperative intraocular pressure (IOP) on the loss of corneal endothelial cells after phacoemulsification in eyes with occludable angles. SETTING:Taipei Veterans General Hospital, Taipei, Taiwan. METHODS:Sixty patients with occludable angles havi...

    journal_title:Journal of cataract and refractive surgery

    pub_type: 杂志文章

    doi:10.1016/j.jcrs.2007.07.057

    authors: Ko YC,Liu CJ,Lau LI,Wu CW,Chou JC,Hsu WM

    更新日期:2008-01-01 00:00:00

  • Association between corneal hysteresis and the magnitude of intraocular pressure decrease after cataract surgery.

    abstract:PURPOSE:To evaluate the relationship between baseline corneal hysteresis (CH) and the change in intraocular pressure (IOP) before and after cataract extraction in patients without glaucoma. SETTING:Private practice, New York City, New York, USA. DESIGN:Retrospective cohort study. METHODS:Charts of consecutive patien...

    journal_title:Journal of cataract and refractive surgery

    pub_type: 杂志文章

    doi:10.1016/j.jcrs.2014.09.040

    authors: Deol M,Ehrlich JR,Shimmyo M,Radcliffe NM

    更新日期:2015-06-01 00:00:00

  • Lateral tarsorrhaphy for prevention of postoperative complications resulting from globe luxation.

    abstract::We present a case of spontaneous globe luxation and wound dehiscence that developed in a patient with proptosis 1 day after phacoemulsification with posterior chamber intraocular lens implantation. The wound was repaired and a lateral tarsorrhaphy was performed with successful prevention of further luxations. Upon cat...

    journal_title:Journal of cataract and refractive surgery

    pub_type: 杂志文章

    doi:10.1016/s0886-3350(03)00056-7

    authors: Johnson SM,Vestal RY

    更新日期:2003-09-01 00:00:00

  • Shark fin: a new sign of thermal injury.

    abstract::Three cases are described in which a curvilinear lucency in the corneal stroma signified a surgical thermal injury. The "shark fin" appearance represents focal shrinkage of tissue within the incisional tunnel. ...

    journal_title:Journal of cataract and refractive surgery

    pub_type: 杂志文章

    doi:10.1016/j.jcrs.2004.11.034

    authors: Osher RH

    更新日期:2005-03-01 00:00:00

  • Progressive opacification of hydrophilic acrylic intraocular lenses in diabetic patients.

    abstract::Four patients with diabetes mellitus had cataract extraction with implantation of a hydrophilic acrylic intraocular lens (IOL) (ACRL-C160, Ophthalmed). The IOLs showed progressive and generalized opacification 10 to 20 months after implantation, decreasing visual acuity. All 4 IOLs were removed. By light microscopic e...

    journal_title:Journal of cataract and refractive surgery

    pub_type: 杂志文章

    doi:10.1016/s0886-3350(02)01245-2

    authors: Lee DH,Seo Y,Joo CK

    更新日期:2002-07-01 00:00:00

  • Monoscleral fixated lens implantation in eyes with partial loss of capsular or zonular support.

    abstract::A technique is described in which a posterior chamber intraocular lens (IOL) is implanted in eyes with partial loss of posterior capsule or zonular support. The IOL's inferior haptic is placed over the residual capsule and the superior haptic is fixated to the ciliary sulcus with a polypropylene suture. In 17 eyes tha...

    journal_title:Journal of cataract and refractive surgery

    pub_type: 杂志文章

    doi:10.1016/s0886-3350(97)80278-7

    authors: Günenç U,Erkin EF,Maden A,Tekin N,Ergin MH

    更新日期:1997-06-01 00:00:00

  • Prevalence of ocular surface dysfunction in patients presenting for cataract surgery evaluation.

    abstract:PURPOSE:To report the prevalence of ocular surface dysfunction in patients presenting for cataract surgery evaluation. SETTING:Duke University Eye Center and Weill Cornell Ophthalmology, single-physician practices. DESIGN:Prospective case series. METHODS:Consecutive patients presenting for cataract surgery evaluatio...

    journal_title:Journal of cataract and refractive surgery

    pub_type: 杂志文章

    doi:10.1016/j.jcrs.2018.06.026

    authors: Gupta PK,Drinkwater OJ,VanDusen KW,Brissette AR,Starr CE

    更新日期:2018-09-01 00:00:00

  • Determining postoperative anterior chamber depth.

    abstract:PURPOSE:To compare measured and calculated postoperative anterior chamber depths (ACDs). SETTING:Department of Ophthalmology and Institute of Medical Physics, University of Vienna, Vienna, Austria, and Department of Ophthalmology, University of Mainz, Mainz, Germany. METHODS:The postoperative ACD was measured in 189 ...

    journal_title:Journal of cataract and refractive surgery

    pub_type: 杂志文章

    doi:10.1016/s0886-3350(03)00414-0

    authors: Kriechbaum K,Findl O,Preussner PR,Köppl C,Wahl J,Drexler W

    更新日期:2003-11-01 00:00:00

  • Correlation between intraoperative and early postoperative keratometry.

    abstract::A study to determine the correlation between intraoperative quantitative keratometry and one day postoperative office keratometry was performed. Prior reports have failed to demonstrate a positive statistical relationship between surgical and postoperative keratometry, weakening the value of quantitative intraoperativ...

    journal_title:Journal of cataract and refractive surgery

    pub_type: 临床试验,杂志文章

    doi:10.1016/s0886-3350(88)80116-0

    authors: Masket S

    更新日期:1988-05-01 00:00:00

  • Capsulorhexis contraction after cataract surgery: comparison of sharp anterior edge and modified anterior edge acrylic intraocular lenses.

    abstract:PURPOSE:To evaluate the reduction in the anterior capsule opening after phacoemulsification, continuous curvilinear capsulorhexis, and implantation of 1 of 2 acrylic intraocular lenses (IOLs). SETTING:Department of Ophthalmology, Vejle Hospital, Vejle, Denmark. METHODS:Eighty-four patients (84 eyes) were included in ...

    journal_title:Journal of cataract and refractive surgery

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.jcrs.2007.01.020

    authors: Corydon C,Lindholt M,Knudsen EB,Graakjaer J,Corydon TJ,Dam-Johansen M

    更新日期:2007-05-01 00:00:00

  • Male sex, erythema nodosum, and electroretinography as predictors of visual prognosis after cataract surgery in patients with Behçet disease.

    abstract:PURPOSE:To evaluate factors that predict the visual prognosis after cataract surgery in patients with Behçet disease. SETTING:The First Affiliated Hospital of Chongqing Medical University, Chongqing, China. DESIGN:Retrospective clinical study. METHODS:Patients with Behçet disease and complicated cataract had phacoem...

    journal_title:Journal of cataract and refractive surgery

    pub_type: 杂志文章

    doi:10.1016/j.jcrs.2012.04.027

    authors: Hu K,Lei B,Kijlstra A,Li P,Zhang X,Xiao X,Li F,Xu H,Yang P

    更新日期:2012-08-01 00:00:00

  • Technique to exclude temporal lash incursion in phacoemulsification surgery.

    abstract:UNLABELLED:We describe the use of a Steri-Strip to exclude lashes in cataract surgery cases in which the lashes impinge on the operative field. The technique has been used in 25 cases and achieved uniformly successful lash exclusion. In 6 cases, the strip became partially dislodged and required repositioning intraopera...

    journal_title:Journal of cataract and refractive surgery

    pub_type: 杂志文章

    doi:10.1016/j.jcrs.2012.09.005

    authors: Fox OJ,Sim BW,Win S,Singh R,Amjadi S,Agar A,Bank A,Francis IC

    更新日期:2012-11-01 00:00:00