Volunteer Surgeon in Third World Countries

I did my residency in ophthalmology from 1968 through 1971 at the Washington Hospital Center in Washington DC. I had previously graduated from UCLA Medical School and completed a one-year internship. I turned down a residency at UCLA’s Jules Stein Eye Institute, Baylor and a few other institutions to go to a program in Washington DC that provided wonderful clinical experience and tons of surgery. At that time many programs provided great teaching, but little surgical practice. I had heard that the Mayo clinic residents were lucky to do 20 cataracts. I did close to 10 times that. Our program had ONE paid faculty member, all the others were volunteers. I decided that if they were willing to teach me voluntarily, it would only be fair to pass on the gift. To that end, I have been teaching at the Long Beach Veterans Hospital since 1974, part of the training program of UCLA initially, and for the past 30+ years at UCI. My first experience was in 1976 when I accompanied a UCLA resident to Honduras and assisted in his training, along with the local (USA trained) ophthalmologist. The experience was fulfilling and made a difference in the lives of local patients as well as in the training of the UCLA resident. The next trip was to Mexico in the late 1980′s. I went with a group
from S.E.E. (Surgical Eye Expeditions). We paid our own expenses and brought donated supplies, intraocular lenses, medications, etc. These were long weekend trips. They included Zacatecas three times, a wonderful city north of Mexico City that once was the capital of Mexico and the center of silver mining. The local Lions Club provided some assistance and the locals were very grateful. Often, they showed their gratitude by trying to get us drunk, a tradition we found all over the third world. They were not successful, as it might have had problems for us to drink and then operate the next day. The Mexicans were quite vocal about their happiness with greatly improved vision.

In contrast, in some countries, patients were stoic and reserved afterwards, even though they could now see and enjoy their families. I believe some felt that if they were too happy, the gift of sight could be taken away. We also did a trip to Parral, in the northern state of Chihuahua. This is where Pacho Villa was assassinated. These trips were all fulfilling, fascinating and memorable. I can easily remember these trips better than other things I did in those years, including trips to Europe, Mexico or Hawaii.

Growing up, I was a stamp collector, not just pasting stamps in spaces in an album, but trying to learn about the individual countries. Doing volunteer surgery has allowed me to complete some of this knowledge and see countries in a way the usual tourist never does, as the hosts invariably go out of their way to show us unusual sites and provide insight into their culture. I was at an American Academy of Ophthalmology annual meeting in Anaheim several years ago and a well dressed foreign physician kept looking at me, then introduced himself as someone I had helped teach when I was in Katmandu Nepal teaching at the medical school. I then remembered him. He thanked me profusely as the “father of modern cataract surgery in Nepal” as I had taught the faculty how to do surgery with ultrasound (phacoemulsification), like we have been doing it in the USA for the past 30+ years.

Over the past seven years I have spent about two weeks per year in Zambia, a poor sub-Saharan African country with 13 million people and only 10 ophthalmologists.
In the future I will discuss my experiences there, contrast them to trips to
Borneo, Mongolia, Nepal, Tibet, Vietnam, Philippines, etc. I will share with you the difficulties getting supplies into different countries and the types of eye problems we handle.

-Michael R. Kaplan, M.D.

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LASIK vs. Custom LASIK vs. PRK

If you’re tired of relying on eyeglasses or contact lenses to be able to read, drive and perform other everyday tasks, laser eye surgery is most likely the best solution for your needs. Though there are different variations and techniques of laser eye surgery, the common goal is to correct refractive errors, including myopia (nearsightedness), hyperopia (farsightedness) or astigmatism (misshapen cornea). This is achieved by reshaping the corneal tissue with an excimer laser.

During a LASIK procedure, the eye surgeon creates a flap in the cornea and carefully pulls it back to expose the underlying layers of tissue. A very precise laser beam vaporizes a small amount of cells to reshape the cornea. Then, the flap is repositioned and the eye heals itself.

Customized LASIK Surgery, or Wavefront Guided LASIK, addresses higher order aberrations (subtle imperfections) that cannot be treated by conventional LASIK, glasses or contact lenses. Custom LASIK is special because it makes a very detailed map of the eye, including its unique measurements and curvature. This information makes it easier to accurately correct the aberrations.

The alternative to LASIK is Photorefractive Keratectomy, or PRK, which uses a different treatment approach to access the underlying layers of corneal tissue. Instead of creating a flap with a laser or blade, the eye surgeon gently removes the top layer of cells (the epithelium) in the cornea. PRK is more suitable for patients whose corneas are either too thin or too irregular to handle the creation of the flap made during LASIK. The disadvantages to PRK are that it can require a longer recovery period than LASIK and the downtime can be more uncomfortable. LASEK is a variation of PRK in which laser energy is used to lift the epithelium before the cornea is reshaped. It is later replaced.

To learn more about LASIK in Orange County, and to determine which procedure may be right for your needs, contact Clarity Eye Group today.

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Cataract Surgery with Premium Lenses

Cataracts are extremely common in older adults. Over time, the proteins in the eye start to build up and create a cloud over the lens, making it difficult for light to pass through. Cataracts, coupled with the natural visual deterioration that occurs with age, can significantly hamper your ability to see without the assistance of glasses or contacts. In fact, at the advanced stage, visual aids may no longer have an effect. During cataract surgery, the natural lens is removed and replaced with an artificial intraocular lens implant (IOL). Traditional IOLs improve vision, but only at one distance, so eyeglasses or contacts are still necessary in some situations. Premium IOLs, on the other hand, not only improve vision at multiple distances, but they also treat age-related loss of reading vision (known as presbyopia). Clarity Eye Group proudly offers a selection of premium IOLs to improve vision and eliminate your dependence on glasses.

The ReSTOR® IOL improves near, intermediate and distance vision, but is particularly great for reading and other close-up activities.

The Tecnis Multifocal IOL also restores vision at multiple distances, and works well in most light conditions.

The Crystalens® IOL is an accommodating lens. Its unique feature is that it shifts position according to the movement of the eye muscle. Crystalens® provides the most normal replication of the form and function of a natural lens, according to some experts.

The Toric IOL also corrects astigmatism, a visual defect caused by the irregular curvature of the cornea.

Phakic IOLs are similar to the premium IOLs placed during cataract surgery; they are used for patients who need vision correction but are not suitable LASIK candidates. The difference between premium and phakic IOLs is that a phakic IOL does not replace the natural lens; rather, it is placed over the natural lens to work with it to improve vision.

The Visian implantable collamer lens (ICL) has the ability to create sharper, clearer and more vivid vision almost immediately after its placement. The Visian ICL™ is placed just behind the iris and in front of the lens; the implantation takes no longer than 15 minutes.

The Verisyse™ Phakic Intraocular Lens safely and effectively treats moderate to high myopia and astigmatism. It is attached to the iris during a six-minute procedure.

To learn more about the premium and phakic IOLs available at Clarity Eye Group and to schedule a consultation with an Orange County cataract surgeon, please contact us today.

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