Cataract patients benefit from modern surgery at GPHC

Feb 11, 2017 News

Cataract, a medical condition in which the lens of the eye becomes progressively opaque, resulting in blurred vision, has long been a challenge that the public health sector has been battling to address.

Consultant Ophthalmologist, Dr. Shailendra Sugrim

But the Georgetown Public Hospital Corporation (GPHC), the country’s premier health institution, has been making significant strides in its quest to combat this condition.
At the helm of this movement is Dr. Shailendra Sugrim, the Consultant Ophthalmologist who heads the GPHC’s Department of Ophthalmology.
Among the measures that have been incorporated to advance the treatment of cataract is the introduction of phacoemulsification.
Phacoemulsification is a modern cataract surgery in which the eye’s internal lens is emulsified with an ultrasonic hand piece and aspirated from the eye. Aspirated fluids are replaced with irrigation of balanced salt solution to maintain the anterior chamber.
But according to Dr. Sugrim, a form of the procedure was reportedly first introduced at the GPHC about 12 years ago by the Chinese Medical Brigade. However, the machine used to facilitate this procedure became inoperable thus resulting in the halting of its offering to patients.
With advocacy from Dr. Sugrim, the modern form of phacoemulsification procedure was reintroduced at the GPHC a few years ago. But acquiring the machine to do this came at no small cost, according to Dr. Sugrim.
Although unable to give the precise cost of the machine, he did recall that the hospital was able to procure it at a discounted cost. “I had to lobby the company to give us at a lower price since we’re a Third World country.”
He, however, did note that consumables and attachments to keep the machine running come at a high cost to the hospital.
“It is a very good machine being used by most centres in the United States so we are lucky to have it,” said Dr. Sugrim. He added that offering the phacoemulsification procedure is seen as important as it gives patients another option to tackle their cataract.
Patients are also offered a manual procedure, according to Dr. Sugrim, even as he dispelled the belief that the phacoemulsification procedure is a laser surgery.
“The phacoemulsification is doing cataract surgery with ultra sound power. A lot of people call it laser surgery for cataract but it is actually an ultrasound. It is a modern method of doing cataract surgery,” explained Dr. Sugrim.
Not all patients are eligible for this procedure even though it is offered free of cost as are all other services offered within the Ophthalmology Department.
The procedure, Dr. Sugrim said, is dependent on a number of factors. “We decide clinically if the patient can withstand that procedure…Not everybody can qualify for a phaco procedure, it depends on whom we decide are clinically able,” asserted Dr. Sugrim.
Part of the clinical observation, according to Dr. Sugrim, is dependent on the stage of the cataract, the age of the patient and it is also dependent on the strength of the patient’s eye “because ultrasound is heat and not everybody can withstand that kind of pressure.”
“We look at all of these factors to decide and also the cooperation of the patient. So a patient who has a really hard cataract we wouldn’t advise them to do it because it might cause more damage than good.
“If they are young it could be more suitable because the tissues are young and healthy…Usually those (young people) cataracts are not hard. They are easier for phaco but in the older patients we have to be careful how we select,” related Dr. Sugrim.
“We have a lot of older patients; we have had a few complications because of their inability to withstand the pressure and there were some damage to the cornea,” said Dr. Sugrim of phaco procedures that have been conducted.
While Dr. Sugrim is skilled to conduct this procedure, he disclosed that the hospital will soon have an increased number of doctors who will also be able to do so.
This, according to the Consultant, Ophthalmology will be made possible through strategic partnership. “Last week we had a visit from the Jesus Christ of Latter Day Saints (representatives) and I invited them to come and train three of our doctors to do the procedure…so they are now in the virgin stage of trying to do phaco so we are going to have more doctors able to perform that,” said Dr. Sugrim.
According to the Consultant Ophthalmologist, the success rate of the phacoemulsification surgery offered at the GPHC is on par with manual surgery characterised by a 95 per cent success rate.

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