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Opening Lines

Surgical mission trip builds relationships across cultures

Vance Thompson Vision team demonstrates advanced surgical techniques in Honduras

Earlier this year, a team of surgeons and staff from Vance Thompson Vision, Sioux Falls, SD, traveled to Honduras on a surgical mission trip. Led by Russell Swan, MD, the team focused on teaching the residents advanced surgical techniques.

In addition to Dr. Swan, the surgeons included Drs. John Berdahl, Brandon Baartman and Dan Bettis. Ophthalmic professionals who volunteered for the trip included Susan DeGroot, Jessica Madson, Kaitlin Bruggeman, and Samantha Nielson, along with University of South Dakota medical student Tania Padilla.

The surgeons worked closely with Luis Lagos, MD, chairman of ophthalmology services at the San Felipe Hospital in Tegucigalpa, and Belinda Rivera, MD, the residency director, as well as the five Honduran resident training surgeons. (In Honduras, only two eye surgeons are trained each year.) The surgeons in training typically started their day at 6 a.m. and ended it at 7 p.m., serving nearly 400 patients each day.

The surgeons in training served nearly 400 patients each day.

“Even with the language barrier, a soft touch or a hug translated when we were working with these patients. Not knowing the patients didn’t matter as the unspoken gestures spoke the loudest,” says Ms. DeGroot.

The Vance Thompson Vision team worked closely with the team from San Felipe Hospital.

The Thompson team demonstrated advanced cataract techniques, such as phacoemulsification, that are less commonly employed in the emerging world. These were complemented by training on minimally invasive glaucoma surgeries, which benefits a country where medications are difficult to acquire.

The Vance Thompson Vision team also built relationships with the staff and local surgeon team, creating cross-cultural partnerships.

“For our team, we understood that in order to make an impact we needed to focus on developing relationships, training, and infrastructure support,” said Dr. Swan. “Long term, my hope is that San Felipe Hospital will serve as a model on how to transform eye-care delivery in emerging countries.” OP

InBrief

The FDA approved the Hydrus microstent, from Ivantis, for the treatment of mild-to-moderate primary open-angle glaucoma during cataract surgery. In the HORIZON clinical trial, 77.2% of the Hydrus group saw a greater than 20% unmedicated IOP reduction at 24 months.

Alcon launched two products. The Ngenuity 3D Visualization System with Datafusion software offers 3D visualization of the back of the eye. It integrates with Alcon’s Constellation platform for vitreoretinal surgery. The Finesse Sharkskin ILM Forceps have a large grasping platform and texturized tip to assist grasping and peeling the internal limited membrane.

Topcon received FDA clearance for its Pattern Scanning Laser Trabeculoplasty (PSLT) proprietary software. PSLT is used in a tissue-sparing laser treatment to reduce IOP in open-angle glaucoma patients. The program is cleared for use with the Synthesis and TwinStar models of Topcon’s pattern scanning lasers.

The Hawaiian Eye Foundation is in need of ophthalmic professionals for a Dominican Republic Teaching Mission in April. To apply, email darrah@hawaiianeyefoundation.org with the subject line “April DR volunteer.”

IJCAHPO announced Michael Chiang, MD, as the keynote speaker for the Harold A. Stein, MD Lecture during the organization’s 46th Annual Continuing Education Program, to take place Oct. 26-28 in Chicago.

CareCredit added 25 new markets where the card is accepted, including primary care and general practice, ambulatory surgery, durable medical equipment, and urgent care.

Mark Rosenberg joined BSM Consulting as senior consultant. Mr. Rosenberg previously served as vice chairman of the board of directors for American Vision Partners and CEO of Barnet Dulaney Perkins Eye Center.

BUILDING THE IDEAL SURGICAL ASSISTANT

Five traits that retina surgeons desire in their technicians

By Zack Tertel, Managing Editor

Surgical technicians are tasked with several responsibilities before, during, and after ophthalmic procedures. From preoperative setup and sterilization to assisting the surgeon with the necessary instrumentation as well as post-surgery clean up, these staff members fill a crucial role in the OR.

The technician and surgeon are partners, working side by side during the procedure to ensure a complication-free, streamlined patient experience. Because of this closeness, we asked retina surgeons the primary qualities they look for in a technician.

Efficient

This trait is very important for technicians, especially those who work in the ASC, says Pravin U. Dugel, MD, managing partner at Retinal Consultants of Arizona and Retinal Research Institute LLC in Phoenix, AZ, and a clinical professor at USC Roski Eye Institute, Keck School of Medicine, University of Southern California in Los Angeles, CA. Efficient technicians can work hard and understand the importance of achieving maximum productivity.

Part of this trait can be taught — a tech can learn the terminology and more about various instruments and devices. But, when it comes to hard work, “you have it or you don’t,” he says. “It’s a willingness to teach yourself and learn.”

Attention to detail

Prior to surgery, the technician should be familiar with the pathology of the patient and the surgery to be performed, says Maria H. Berrocal, MD, director of Berrocal & Associates and professor of ophthalmology at the University of Puerto Rico School of Medicine and practices in San Juan, Puerto Rico.

“All the necessary instrumentation should be readily accessible as well as the instruments needed for inadvertent complications,” she says.

Observant

“Observant technicians become familiar with the surgeon’s routine, so that they can predict what the surgeon is likely to ask for/do next as well as make suggestions of possible instruments based on past experience,” Dr. Berrocal says. For example, a surgeon may not notice the intraocular pressure being too low or high for too long. The alert, observant tech can frequently save a case, Dr. Berrocal says.

Focused

Retina surgery requires the surgeon and technician to concentrate and remained focused throughout the procedure, says Dr. Berrocal. “Devastating complications can ensue with even a slight distraction.”

Confident

While the qualities above are vital, Dr. Dugel says they don’t matter if the technician is not confident. When techs become more familiar with the practice, position, and surgeon, their confidence grows. But, this trait is more than just about knowledge and skills.

“It’s also about whether the person is ethical and courageous enough to stand up and say, ‘I saw something wrong there,’ or, ‘I saw that your hand touched the microscope inadvertently and we should start over’ — knowing that surgeon or other people in the room may not like that and still having the guts to do it,” Dr. Dugel says.

The confident technician also needs the right OR environment, Dr. Berrocal adds. They tech should be encouraged, not afraid, she says, to make suggestions or to alert the surgeon if an error is made. OP