EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
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EW MEETING REPORTER 72 May 2015 Reporting from the 30th APAO Congress in conjunction with the 20th COS Congress, April 1–4, 2015 Guangzhou, China The Asia-Pacific Academy has 19 national members, he said, and the health spending in percentage of GDP varies from 1.9% in Myanmar to 9.8% in Malaysia (compared to 15.7% in the United States). Prashant Garg, MD, Hy- derabad, India, presented on the "Opportunities and Challenges in Developing Quality and High Impact Educational Programs in Developing Countries." There are 8.9 million people blind in India, he said. Together with those in Africa and China, this constitutes nearly 60% of global blindness. There are a number of chal- lenges facing medical programs in India. When considering medical college-based programs, Dr. Garg said that some of the obstacles are that health is a state issue and there is a lack of funds for these programs. There is also not enough time for training and education, and there is a lack of leadership, proper attitude, and accountability. This results in residents emerging from these programs without the competence to practice independently, Dr. Garg said. India also has an NBE program, however, it is not popular, there is variability in the standards of training, and it has a centralized ex- amination system with a poor pass percentage. Possible solutions to these chal- lenges are to provide more funding, more resources, and more time for education, he said. Areas to focus on are the training of trainers, revision of the curriculum, e-learning, and a centralized evaluation system. All of these things are being addressed, Dr. Garg said, however, there is very lit- tle or no effort at this point in time to have a centralized certification system besides the ICO conducted exam. There is some discussion with the All India Ophthalmological Society (AIOS) to have a national certification system so there can be some improvement and uniformity in the quality of residents coming out of residency programs, he said. In conclusion, Dr. Garg said there are a number of challenges fac- ing ophthalmic education in India. There are some good programs, but efforts need to be made to bridge the gap, and AIOS is working on this. Susruta Lecture focuses on cataract in uveitis Susruta lived in India around the 6th century B.C. Author of the Sanskrit text Susruta Samhita, he may have been the first to describe extracapsular cataract extraction (ECCE) surgery. The APAO honors this ancient physician with the Susruta Lecture. The Susruta Lecture recognizes "extraordinary contributions to the cataract subspecialty," prioritizing ophthalmologists who contribute substantially to the control and elimination of mass cataract blind- ness. Cataract remains one of the leading causes of avoidable blind- ness around the world, and blind- ness from the condition remains a perennial problem in the Asia-Pacific region in particular. This year, the honor of deliv- ering the Susruta Lecture went to Masahiko Usui, MD, Tokyo. Dr. Usui delivered his Susruta Lecture on "Cataract/IOL Surgery for Cataract with Intraocular Inflamm - tion." Specificall , Dr. Usui's lecture discussed cataract in cases of uveitis —a significant problem in Japan, he said. Describing the pathogenesis of cataract in uveitis, Dr. Usui said the condition begins with inflammato y changes in the aqueous humor. In- flammation results in characteristic posterior synechiae, and inflamm - tory changes occur in the vitreous body. Cataract, he said, is the side effect of steroid therapy for uveitis. Dr. Usui looked at 162 eyes (115 patients) with cataract in a back- ground of uveitis. Of these eyes, 157 eyes (96.9%) underwent phacoemul - sification with IOL implantation and 5 (3.1%) underwent planned ECCE with IOL implantation. The major causes of uveitis Dr. Usui found in these were Behçet's disease (40 eyes, 26 patients, 24.7%) and sarcoidosis (36 eyes, 28 pa- tients, 22.2%). However, the highest percentage of eyes had no discern- ible etiology (48 eyes, 31 patients, 29.6%). Out of the total 162 eyes, 69 (42.6%) had posterior synechiae. When performing cataract surgery in cases of uveitis, Dr. Usui said timing is important. He recom- mends performing cataract surgery when cells in the anterior chamber are minimal, either absent or less than +1, and when flare value is less than 100 pc/ms. Furthermore, he said, the eye should have been free of inflamm - tion for 3 to 6 months. In this study, postoperative treatment included systemic admin- istration of betamethasone (2–4 mg/ View videos from Thursday at APAO 2015: EWrePlay.org Boris Malyugin, MD, PhD, Moscow, explains how to identify factors leading to poor capsular support and how to use the capsule itself for IOL support.