OCT 2012

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

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Page 101 of 168

October 2012 EWINTERNATIONAL 99 helped 625 instead and set into motion something of a battle cry. "Free Indonesia of cataracts," proclaims Anewvision.org, the website of A New Vision. "You really have to go on a war path Anewvision.orgfor a few years" in order to make headway in elimi- nating cataract blindness in a given country, Dr. Ruit said. In fact, Dr. Ruit said his work was made possible on an army plat- form. "They wanted to do some social commitment in the face of the public," Dr. Ruit said. "They had extremely good networking, which was a fantastic thing for doing the initial elimination of cataract surgi- cal blindness because the country is so widespread." A diary kept by Ms. Jono suggests the same: "Tomorrow's event will be opened by General Leo Sieger. His staff didn't wish to take any chances if patients fail to turn up, so they brought 105 patients from rural areas and camped them in the hospital tonight. Patients sleep in a big hall on army canvas beds." Dr. Ruit said the first 5-10 years in Indonesia will be critical to get the problem under control. Ms. Jono's diary suggests one case- in-point for why tackling it is so critical. "[After surgery] we removed both eye caps on the lady who has been blind for 9 years … and placed her son in front of her," Ms. Jono wrote. "She asked, who is this man? When he spoke, they hugged and cried. He was only 13 when she became blind. He is now 22." It is this type of case where manual SICS is so important. "Dr. Ruit dispelled the myth that phaco (machine) is more supe- rior than the manual method SICS (small incision cataract surgery)," Ms. Jono wrote. "He said if we use only phaco in the 600 operations we did these past 6 days, half of the patients will remain blind. Phaco is most suitable for immature cataract. SICS is still better for mature cataract." Still, manual SICS isn't widely used everywhere in the developing world. "In China, a little more than 2 million cataract surgeries per year are done," Dr. Ruit said. "Of that, 70% are phaco and 30% are sutured and small incision surgery. In India, where 6.5 million cataract surgeries occur per year, the ratio is the oppo- site. So the efficiency in one country is about three times more than the other." Manual SICS has to be done properly, but when modern varia- tions are performed, they give very good results, he said. "On average, there are 80,000 cataract operations performed in Indonesia a year; at this rate, it will take 37.5 years to clear the cataract backlog in Indonesia, assuming there are no new cases," according to the charity's website. Meanwhile, A New Vision presses on. Dr. Ruit and colleagues operated again in June 2011 in north Sumatra, operating success- fully on 1,011 eyes. Patient ages ranged from 5 to 101. Three million more Indonesians currently blind due to cataracts are out there. EW Editors' note: Visit Anewvision.org to find out more about cataract blindness in Indonesia and how you can help. Contact information Jono: effijono@gmail.com Ruit: chaunri@yahoo.com Doctors screen patients before surgery 14-year-old girl getting screened Administering anesthesia to patient Operating room in the Medan facility Source (all): Effi Jono

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