Eyeworld

EW NEWS & OPINION 30 June 2016 by Liz Hillman EyeWorld Staff Writer went for his first 6-month mission on the USNS Comfort last year, where he completed 200 cases. He acknowledged that many of his civilian counterparts might not think that's a lot during such a timeframe, but he pointed out that he was competing for OR time with every other subspecialty surgeon on the ship. The majority of Dr. Stolldorf's cases were cataract surger- ies (65%), 30% were pterygium, and 5% were strabismus. To perform cataract surgeries on the ship and in ports for countries that included Haiti, Guatemala, Jamaica, Nicaragua, and Colombia, Dr. Stolldorf had to learn an "old- school technique" that is generally not taught in U.S. residency pro- grams. That technique, sutureless manual small incision cataract sur- gery (MSICS), removes the cataract as a whole, rather than breaking it up with phacoemulsification. Dr. Stolldorf said this latter, more mod- ern technique, which has become the standard for cataract surgery in the U.S., is not as safe for most patients in these countries who gen- erally have more advanced cataracts. While the OR itself is "top notch," despite its relatively unusual setting, Dr. Stolldorf said performing surgery on a ship presents its own set of challenges. "The tides and currents affected if we could do surgery or not. The captain of the ship had to know when I was doing surgery under a microscope so that he could pay much closer attention to the move- ments of the ship," Dr. Stolldorf said. Surgery was delayed for a couple of hours due to rougher waters at least once during the trip. "What I thought was fasci- nating about [this work was] the importance of our eyesight," Mr. De Herrera said, noting that he's always had an interest in medicine and has experienced the OR environment before, photographing cleft lip pro- cedures. "The individuals they were helping would eventually lose their sight, and that obviously would be devastating for anyone in that situation. U.S. Navy's humanitarian work involves performing cataract surgeries in ports for countries in need T hough it might appear like a standard, well-equipped operating room, a closer look reveals tie rods on the floor for all equipment. On any given day, surgeries may be cancelled due to the weather. That's because this operating room is 1 of 12 located on the U.S. Navy's USNS Comfort. The nearly 900-foot-long ship with a home port in Norfolk, Virginia, is, like its sister ship the USNS Mercy on the West Coast, ready to deploy as a mobile, floating hospital in the event of a natural disaster or during wartime. In its otherwise "down time" though— and unbeknownst to the majority of civilians—these ships have sailed the seas conducting humanitarian work for decades. "The majority of the American public has no idea that the Navy is doing this because they don't get much publicity," said photojournal- ist Alan De Herrera, pointing out that he was the only media mem- ber to do a lengthy embed on the USNS Comfort for its recent mission, Continuing Promise 2015. This mission made 11 stops to develop- ing countries, bringing surgical and medical aid, as well as veterinary and construction services. In addition to missions like Continuing Promise, the USNS Comfort provided support after Hurricanes Katrina and Rita and responded to New York City after the 9/11 attacks. Wanting to drum up the recog- nition he thinks this type of work deserves, Mr. De Herrera spent a cou- ple of weeks on the ship, capturing images from the operating room. "It's a feel-good story in the sense that our military is doing some really good stuff, and it's nation building," he said. Lt. Cmdr. Hunter Stolldorf, MD, who is stationed at Naval Hospital Camp Lejeune in Jacksonville, North Carolina, Cataract surgery on a ship Dr. Stolldorf oversees a bilateral pterygia procedure performed by CPT Nicholas Lancaster, a U.S. Army ophthalmologist with Continuing Promise 2015. The U.S. Navy hospital ship USNS Comfort anchored in Port-au-Prince, Haiti during its last stop on the Continuing Promise 2015 humanitarian mission through Latin America. U.S. Army CPT Nicholas Lancaster performs eye surgery on 52-year-old Haitian patient Gene Gentil aboard the hospital ship USNS Comfort. Source: Alan De Herrera, www.alandeherrera.com

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