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Biomedical subjects

G Brian

Publications and source records attributed to G Brian.

14 recordsLinked to original sources

Modern surgery for global cataract blindness: preliminary considerations.

Unoperated cataract in the developing world remains ophthalmology's major unsolved problem. Recent developments have brought into question the assumptions of those who have thought that extracapsular surgery with implantation of a posterior chamber intraocular lens is an unrealistic approach to the treatment of global cataract blindness. High-quality 1-piece posterior chamber intraocular lenses are being manufactured locally for approximately $10 each. Most ophthalmologists can be trained to perform extracapsular surgery in a 1-month course. This process is particularly effective if outstanding local surgeons receive intensive training to become instructors. While the incidence and treatment of posterior capsule opacification requires further study, the development of a low-cost YAG laser may be a solution. Imaginative ways to recover costs will need to be developed if the staggering prevalence of cataract blindness is to be effectively addressed. The improved result of modern surgery may make patients more willing to pay for their operation.

Blindness

A case-control study of biometry in healthy and cataractous Eritrean eyes.

The keratometry and axial length readings of healthy eyes (405 subjects) and cataractous eyes (63 subjects) from a sample of Tigrinians living in the Eritrean capital of Asmara were obtained. All subjects were at least 40 years of age. The mean keratometry reading for healthy eyes was 43.37 diopters (SD +/- 1.61), while that for cataractous eyes was 43.57 diopters (SD +/- 1.79). These values were not significantly different. Similarly, there was no significant difference in the mean ocular axial length for the two groups (healthy eyes; 23.03 mm, SD +/- 1.24: cataractous eyes; 23.34 mm, SD +/- 1.54). There was no correlation between age and the biometry readings of healthy eyes. Data from this study has been used to calculate a standard intraocular lens power for use by Eritrea's Blindness Prevention Programme during cataract surgery on this population (22 diopters at A constant 118.3). With this intraocular lens, 48% of patients will be within +/- 1D of emmetropia when left without spectacle correction; 73% will need a spectacle correction within +/- 2D to produce emmetropia.

Biometry

Steroid-induced ocular hypertension in the presence of a functioning Molteno seton.

BACKGROUND: Steroid-induced ocular hypertension is generally attributed to alterations in the trabecular meshwork, reducing aqueous outflow. METHOD AND RESULTS: A case with several episodes of steroid-induced ocular hypertension is presented. Later, with unremitting intraocular pressures above 50 mmHg, despite maximal hypotensive medication, there is evidence of extensive failure of aqueous egress. A successful Molteno seton bypasses the failed trabecular meshwork to lower the pressure into the teens. The eye is then challenged with topical steroid on two occasions. The pressure rises, only to fall again with steroid withdrawal. CONCLUSION: Here is a case where the trabecular meshwork has been bypassed, but ocular hypertension was still induced with the application of topical steroid.

Adolescent

A "development aid" approach to Third World surgical blindness.

Establishing local production of intraocular lenses (IOLs) and sutures should be as much a part of surgical blindness prevention assistance to Third World countries as teaching extracapsular cataract extraction with IOL implantation, because it would increase financial independence and encourage economic growth.

Blindness

Basic ophthalmic assessment and care workshops for rural health workers.

The inequitable distribution of medical services in Australia means that many rural dwellers do not have easy access to ophthalmic care. In regions with no medical personnel, appropriately trained rural health workers may provide ophthalmic assessment, primary treatment, and, in some circumstances, definitive care. In areas with overburdened services, these rural health workers may augment facilities already established. In an attempt to improve the accessibility and quality of ophthalmic services available to presently disadvantaged rural inhabitants, the aims, curriculum, and structure of a 'Basic Ophthalmic Assessment and Care Workshop', for the transfer of knowledge and skills to such rural health workers, is presented.

Allied Health Personnel

On the practicalities of eye camp cataract extraction and intraocular lens implantation in Nepal.

Based on our experience in Nepal, we discuss the practicalities of performing extracapsular cataract extraction (ECCE) with intraocular lens (IOL) implantation in the context of the third-world eye camp. At slightly less than 30 minutes per case, while not as quick as an intracapsular cataract extraction (ICCE) with a Graefe section, the trade-off between vision result and operation time, according to patients, is very much in favor of the ECCE/IOL technique. Also, although IOLs remain expensive, by using donated lenses, the overall costs of providing ECCE/IOL surgery need not exceed those of providing ICCE.

Cataract Extraction

Intraocular lens implantation: a model for the Third World.

Intracapsular cataract extraction has long been thought of as the appropriate technique to deal with the backlog of Third World cataract blindness. However, this operation may not be as sight effective as many believe. The authors offer their experience of intraocular lens implantation in the Torres Strait as a model for a more visually appropriate surgical cure for Third World cataract.

Cataract Extraction