Wednesday, August 7, 2013

Piggyback IOL Implantation of Toric and Rayner Sulcoflex Multifocal IOL by Dr Suresh K Pandey, SuVi Eye Institute Lasik Laser Center Kota India



Dear All, We are pleased to share with you surgical pearls for Piggyback IOL Implantation of Toric and Rayner Sulcoflex Multifocal IOL in Pediatric Zonular Cataract. Thanks. 
Dr. Suresh K. Pandey, Director, SuVi Eye Institute & Lasik Laser Centre,
C 13 Talwandi,
KOTA, RAJ., INDIA
Ph: +(91) - 744- 2433575,
+(91) 93514-12449 (mobile)
E-mail:suresh.pandey@gmail.com
Website: www.suvieye.com

Social Media and Ophthalmology:The world at Your Fingertips by Dr Suresh K Pandey, SuVi Eye Institute Lasik Laser Center Kota India



Medical Tourism and Social Media: Medical Treatment Beyond Borders

By Vidushi Sharma, MD (AIIMS), FRCS (UK); and Suresh K. Pandey, MS (PGIMER), ASF (USA), Directors, SuVi Eye Institute and Lasik Laser Center, C 13 Talwandi, Kota, Rajasthan.
Email:suvieye@gmail.com; Phone 09351412449


The use of social media as a special tool for medical tourism by doctor to reach out more widely and build new relationships and professional associations. These interactions can sometimes reach internationally and help in building bridges across borders in what is increasingly becoming a global village. We all know that technology has undergone a huge revolution in recent times and has also impacted the field of medical education and treatment. The place of big, unwieldy books has been taken over in many instances by slim computers and sleek smartphones. With communication becoming so fast, social media has caught on and has attracted hoards of users all over the world. These sites as well as others help us remain in touch with professional colleagues and stay abreast of the latest developments. With the availability of sophisticated and inexpensive recording and editing devices and software, surgical videos can now be easily made and shared with colleagues through various websites and social media.

MEDICAL TOURISM-CONNECTING THROUGH YOUTUBE:  Our interest in documentation and sharing eye surgery prompted us to make a YouTube channel dedicated to ophthalmic surgical videos (http://www.youtube.com/user/Drsureshkpandey) which attracted many views (241,882) and subscribers (238). This helped us to make new connections with ophthalmic colleagues, and it was our privilege to have ophthalmologists come over to SuVi Eye Institute & Lasik Laser Center, Kota, India for surgical training from as far away as Azerbaijan, Saudi Arabia, Switzerland and Ireland. Their journey from a distant country to a small Indian city (Kota, Rajasthan) is a testament to the rising influence of social media interactions (Figure 1).
Figure 1. Medical Tourism and Medical Training- Dr Mubariz Qahramanov, an eye surgeon from Azerbaijan visited Kota, India for few weeks to learn & fine-tune his surgical skills in anterior segment and oculoplastic surgery. This is a testament to the rising influence of Internet, that the journey from Azarbaijan to Kota is possible despite the fact that there is no functioning airport in Kota. He watched our surgical videos on the net (YouTube) and visited SuVi Eye Institute, Kota, India.
Figure 2. Medical Tourism and Medical Training- Visiting ophthalmologists from Saudi Arabia, Dr. Hasan Al Taweel and Dr. Fahad Alwadni visited SuVi Eye Institute, Kota for 3 weeks. One of the reasons they came was to observe “a small city, small set-up, without frills where you could still deliver good services in the private practice set-up”.

TRANSCENDING BORDERS:  While connecting with doctors (eye surgeons) from far away is a great experience, the real adventure of social media is in being able to connect with patients and the general public. The medical profession has always moved beyond borders, an example being Doctors Sans Borders and ORBIS aircraft being another glorious example of teaching and medical services beyond borders.

MEDICAL TOURISM: A JOURNEY FROM KARACHI TO KOTA: India and Pakistan share a troubled border, despite many efforts for peace. Many patients, especially children, have come over to India from Pakistan to receive medical treatment as well as surgical procedures at some big institutions. However, ours is a story of a Mr Fahim Uddin, a software engineer (working at Orthopedic and Medical Institute) from Karachi, Pakistan, who was a myope and developed cataracts at about 40 years of age. His own Internet search led him through IOL websites, and he decided he wanted a particular multifocal IOL (Tecnis Multifocal IOL, Abbott Medical Optics, USA) that was not available in Pakistan. He then searched for the IOL in India and found many videos we had posted on the implantation of this IOL. He communicated with us through social media, and, after a few interactions, developed so much trust that he decided to come to India for the surgery (Figure 3). He came over on a medical VISA that was issued by Indian embassy in Karachi, Pakistan after thorough scrutiny. He underwent cataract surgery on both eyes with the multifocal IOL of his choice at SuVi Eye Institute, Kota and was extremely happy with the results. He even saw a Bollywood movie (Bol Bachchan) in the theater immediately after surgery and toured the city and was thrilled with the excellent vision he had at both distance and near without glasses, with no significant night vision problems either. The fact that he had come over from Karachi, Pakistan for his eye surgery made him somewhat of a mini celebrity, and his visit was well covered by local media. A program- “Spreading Light Across the Border” (Aman Ki Roshni) was organized during his visit and Mayor of the City, the Inspector General of Police and some other prominent personalities of city participated (Figure 3). The speakers emphasized that with the help of social media the patient came to know about the Center in India and he undertook this journey from Karachi to Kota. His visit to India was a unique case of human trust and empathy that knows no boundaries, neither political, nor religious. When it comes to people to people interaction, Indians and Pakistanis have always been very warm to each other and this was just another reinforcement of the need for the two neighbors to live like friendly neighbors.
 Figure. 3 A program, Spreading Light Across the Border (Aman Ki Roshni), was organized during the patient’s visit, in which the mayor of Kota, the Inspector General of Police, and other prominent personalities of the city participated. Left to right: Brahakumari Divisha, Mayor Dr. Ratna Jain, Mr. Amrit Kalash (IG Police), Shahar Kazi Anwar Ahmed, Mr. Fahim Uddin, Dr. Suresh K. Pandey, Mr. Tauqeer Bokhari, and Dr. Vidushi Sharma.


CONCLUSION: Social media has taken over our lives and has tremendous potential to be used as a networking tool to promote medical tourism. It provides us all a great opportunity to reach a wider audience, and eye surgery is especially suited for the sharing of surgical techniques and tips. These sites may prove to be just what the doctor ordered to bring about greater interaction and trust among people otherwise separated by manmade borders.
For a video on our experience using medical tourism and social media to transcend borders, visit www.youtube.com/watch?v=SO233GCcLZk&list=UU12vTF4P0xWnhvjGbG2h94w&index=1.

About the Authors: Dr. Vidushi Sharma, MD (AIIMS), FRCS (UK), is a Director at SuVi Eye Institute & Lasik, Laser Centre, Kota, Rajasthan, India. She may be reached at tel: +91 93514 12449; e-mail: suvieye@gmail.com.

Dr. Suresh K. Pandey, MS (PGIMER), ASF (USA), is a Director at SuVi Eye Institute & Lasik, Laser Centre, Kota, Rajasthan, India, a visiting Assistant Professor at John A. Moran Eye Center University of Utah, Salt Lake City, Utah, and a visiting surgeon at the Sydney Eye Hospital, Save Sight Institute, University of Sydney, Australia. He  may be reached at tel: +91 93514 12449; e-mail: suresh.pandey@gmail. com.

Topical Phaco and Multifocal IOL Implantation: Patient in Sitting Position and Surgeon in Standing Position by Dr Suresh K Pandey, SuVi Eye Institute and Lasik Laser Center, Kota, India



 Vision Recovered after Unique Eye Surgery Performed on Chair in Sitting Position

This 56 years old case has difficulty in lying flat on bed due to obesity and cardio-pulmonary problem. She noticed severe deterioration in vision and consulted eye doctors in hope of getting the vision. Unfortunately, she was unable to get operated for cataract  by several ophthalmologists as she was unable to lie flat on operation table.
 
She was unable to see due to significant cataract and she was unable to do her daily tasks since past 5 years. She consulted more than a dozen ophthalmologists in various cities (including Neemuch, Indore, Chennai, and Ahmedabad) and visited several eye camps in hope of getting vision, where doctors clearly refused to perform her cataract surgery as she was unable to lie flat on operation table. It was difficult to perform surgery under general anesthesia because of compromised cardio-pulmonary functions, making it a very high risk case. 
 
On advice from some relatives, she visited SuVi Eye Institute & Lasik Laser Center,Kota, Rajasthan in hope to get vision. Dr Suresh Pandey, eye surgeon, examined her eyes carefully. Dr Pandey took this challenge to operate her left eye. He took her in operation theater and  asked her to sit on plastic chair. Another plastic chair was used to support her legs.

After instillation of few drops of topical anesthetics, phacoemulsification surgery (sutureless micro incision cataract surgery) of left eye was performed by Dr Suesh Pandey in standing position. The surgery was extremely difficult and challenging due to unusual position for surgeon as well as for the patient, but fortunately went very well. The entire surgery took 10 minutes time..  Dr Pandey had implanted imported foldable  Multifocal Tecnis IOL (Tecnis lens of 19 Diopters). The patient and her family members  were pleasantly surprised to see very clearly after successful surgery. The post op vision was 20/20 (6/6) and N6 unaided. 
Thanks. Dr Suresh K Pandey, Dr Vidushi Sharma, 
SuVi Eye Institute Lasik Laser, C-13, Talwandi, Kota 
Near Treat Restaurant, Kota-324005 (Raj.), India
Mobile : +91 9351412449
E-mail:suvieye@gmail.com
Web:www.suvieye.com

Common Eye Diseases and Their Management: Television Interview- Dr Vidushi Sharma Pandey, Director SuVi Eye Institute and Lasik Laser Center, Kota, India



Dear All, We are pleased to share with you "Common Eye Diseases and Their Management". This was a Television Interview - Dr Vidushi Sharma Pandey, Director SuVi Eye Institute and Lasik Laser Center, Kota, India. Thanks, Dr. Suresh K. Pandey
Director, SuVi Eye Institute & Lasik Laser Centre,
C 13 Talwandi,
KOTA, RAJ., INDIA
Ph: +(91) - 744- 2433575,
+(91) 93514-12449 (mobile)
E-mail:suresh.pandey@gmail.com
Website: www.suvieye.com

Managing Cataract with Astigmatism: Pearls for Implantation of Tecnis Toric IOL by Dr Suresh K Pandey, SuVi Eye Institute and Lasik Laser Center, Kota, India



Dear All, We are pleased to share with you topical phaco and Tecnis Toric IOL implantation. Thanks, Dr. Suresh K. Pandey
Director, SuVi Eye Institute & Lasik Laser Centre,
C 13 Talwandi,
KOTA, RAJ., INDIA
Ph: +(91) - 744- 2433575,
+(91) 93514-12449 (mobile)
E-mail:suresh.pandey@gmail.com
Website: www.suvieye.comManaging 

Child Receive "Gift of Sight" After Free Eye Surgery Performed by Dr Suresh K Pandey at SuVi Eye Institute & Lasik Laser Center, Kota India



Dear All, 
We are pleased to share with you topical phaco and IOL implantation performed in a nine year old patient of traumatic cataract (left eye) as a result of thorn injury. This patient presented to us one year after injury. The preop vision (BCVA) was counting finger at 3 meters that improved to 20/30 and N9 after successful surgery. This child received Gift of Sight and entire surgery was performed without any charges as the family was facing financial constrain. Thanks, Dr Suresh K Pandey, Dr Vidushi Sharma, SuVi Eye Institute, Kota, India (Phone +91 9351412449; Website:www.suvieye.com; E-mail:suvieye@gmail.com)

Topical Phacoemulsification in Traumatic White Cataract with Iridolenticular Adhesion by Dr Suresh K Pandey SuVi Eye Institute Kota India



Dear All, 

We are pleased to share with you surgical pearls for Managing Challenging Case of Traumatic Cataract. This 30 years old case of traumatic cataract due to thorn injury to the right eye five years back. 

We faced several challenges while managing this case- small irregular pupil that failed to dilate (due to irido-lenticular adhesions), localized calcified cataract, and presence of posterior capsular plaque. Topical phaco (supplemented with preservative free intracameral lignocaine) and IOL implantation was performed. Anterior capsular staining was done and irido-lenticular synechie was released using blunt spatula. This was followed by ant. capsulorhexis. The soft lens matter was aspirated using low phaco power and fluidics parameters. 

The calcified capsule/lens matter was removed and posterior capsular plaque peeling was also done. The IOL was implanted in the capsular bag. Preservative free intracameral injection of triamcinolone acetonide (0.1 cc) and intracameral injection of moxifloxacin (Vigamox) was used. 

The best-corrected vision (BCVA) was 20/30 and N9. 

Thanks, Dr Suresh K Pandey, SuVi Eye Institute, Kota, India (Email:suvieye@gmail.com). Here is the link for video:https://www.youtube.com/watch?v=9lgu2Txv6jQ&feature=c4-overview&list=UU12vTF4P0xWnhvjGbG2h94w