ReGAE 12: preventing glaucoma blindness in the Caribbean through implementation of the Moorfields Safer Surgery System and skills transfer from the UK to Trinidad and Tobago

Desirée Murray,1,2 Peter Shah2–5 1Department of Clinical Surgical Sciences, The University of the West Indies, St Augustine, Trinidad and Tobago, West Indies; 2Birmingham Institute for Glaucoma Research, Institute of Translational Medicine, Birmingham, UK; 3University Hospitals...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Murray D, Shah P
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	glaucoma trabeculectomy Mitomycin C Caribbean African-Caribbean Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/79f4bb49eaac4b7d8cff5875b4a09d69
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:79f4bb49eaac4b7d8cff5875b4a09d69
record_format	dspace
spelling	oai:doaj.org-article:79f4bb49eaac4b7d8cff5875b4a09d692021-12-02T06:51:05ZReGAE 12: preventing glaucoma blindness in the Caribbean through implementation of the Moorfields Safer Surgery System and skills transfer from the UK to Trinidad and Tobago1177-5483https://doaj.org/article/79f4bb49eaac4b7d8cff5875b4a09d692018-09-01T00:00:00Zhttps://www.dovepress.com/regae-12-preventing-glaucoma-blindness-in-the-caribbean-through-implem-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Desirée Murray,1,2 Peter Shah2–5 1Department of Clinical Surgical Sciences, The University of the West Indies, St Augustine, Trinidad and Tobago, West Indies; 2Birmingham Institute for Glaucoma Research, Institute of Translational Medicine, Birmingham, UK; 3University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; 4University College London, London, UK; 5Centre for Health & Social Care Improvement, School of Health & Wellbeing, University of Wolverhampton, Wolverhampton, UK Objective: The objective of the study was to present evidence of successful skills transfer of the Moorfields Safer Surgery System (MSSS) from the UK to Trinidad and Tobago and the safety and efficacy of this technique.Methods: Hospital-based retrospective, consecutive, non-comparative case series study of 33 eyes (24 African-Caribbean patients; 16 male patients) with primary open-angle glaucoma undergoing trabeculectomy + mitomycin C (MSSS) by a single surgeon with UK Glaucoma Fellowship training. The clinical outcome measures included intraocular pressure (IOP), bleb morphology, postsurgical interventions, postoperative complications, and best-corrected visual acuity (BCVA) at the final follow-up.Results: All patients were self-identified as African-Caribbean. The median age was 56 years (range 34–79 years). The mean preoperative IOP on maximum tolerated medical treatment was 22.4 mmHg (SD=5.9 mmHg). With or without medication, IOP was ≤21 mmHg in 92.6% at 1 year and 87.5% at 5 years. At 1 year, IOP was ≤18 mmHg in 78%, ≤15 mmHg in 73% and ≤14 mmHg in 52%. Removal of scleral flap releasable suture(s) was performed in 84%, 5-fluorouracil injection(s) in 88% and bleb needling revision in 38%. The most common complication was early transient bleb leak (52%). No patient developed endophthalmitis, hypotony maculopathy, suprachoroidal hemorrhage, or malignant glaucoma. At the final follow-up, 91% had excellent or satisfactory bleb morphology, and 73% had equal or better BCVA.Conclusion: Skills transfer between different geographical and economic regions contributes to the prevention of avoidable blindness through disease control – one of the core strategies of the World Health Organization’s Vision 2020 initiative. In the Caribbean (Trinidad and Tobago), the MSSS was utilized by a surgeon with Glaucoma Fellowship training and achieved outcomes similar to best-published data. This success can be reproduced in other geographic locations. Keywords: glaucoma, trabeculectomy, mitomycin C, Caribbean, African CaribbeanMurray DShah PDove Medical PressarticleglaucomatrabeculectomyMitomycin CCaribbeanAfrican-CaribbeanOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 12, Pp 1775-1784 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	glaucoma trabeculectomy Mitomycin C Caribbean African-Caribbean Ophthalmology RE1-994
spellingShingle	glaucoma trabeculectomy Mitomycin C Caribbean African-Caribbean Ophthalmology RE1-994 Murray D Shah P ReGAE 12: preventing glaucoma blindness in the Caribbean through implementation of the Moorfields Safer Surgery System and skills transfer from the UK to Trinidad and Tobago
description	Desirée Murray,1,2 Peter Shah2–5 1Department of Clinical Surgical Sciences, The University of the West Indies, St Augustine, Trinidad and Tobago, West Indies; 2Birmingham Institute for Glaucoma Research, Institute of Translational Medicine, Birmingham, UK; 3University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; 4University College London, London, UK; 5Centre for Health & Social Care Improvement, School of Health & Wellbeing, University of Wolverhampton, Wolverhampton, UK Objective: The objective of the study was to present evidence of successful skills transfer of the Moorfields Safer Surgery System (MSSS) from the UK to Trinidad and Tobago and the safety and efficacy of this technique.Methods: Hospital-based retrospective, consecutive, non-comparative case series study of 33 eyes (24 African-Caribbean patients; 16 male patients) with primary open-angle glaucoma undergoing trabeculectomy + mitomycin C (MSSS) by a single surgeon with UK Glaucoma Fellowship training. The clinical outcome measures included intraocular pressure (IOP), bleb morphology, postsurgical interventions, postoperative complications, and best-corrected visual acuity (BCVA) at the final follow-up.Results: All patients were self-identified as African-Caribbean. The median age was 56 years (range 34–79 years). The mean preoperative IOP on maximum tolerated medical treatment was 22.4 mmHg (SD=5.9 mmHg). With or without medication, IOP was ≤21 mmHg in 92.6% at 1 year and 87.5% at 5 years. At 1 year, IOP was ≤18 mmHg in 78%, ≤15 mmHg in 73% and ≤14 mmHg in 52%. Removal of scleral flap releasable suture(s) was performed in 84%, 5-fluorouracil injection(s) in 88% and bleb needling revision in 38%. The most common complication was early transient bleb leak (52%). No patient developed endophthalmitis, hypotony maculopathy, suprachoroidal hemorrhage, or malignant glaucoma. At the final follow-up, 91% had excellent or satisfactory bleb morphology, and 73% had equal or better BCVA.Conclusion: Skills transfer between different geographical and economic regions contributes to the prevention of avoidable blindness through disease control – one of the core strategies of the World Health Organization’s Vision 2020 initiative. In the Caribbean (Trinidad and Tobago), the MSSS was utilized by a surgeon with Glaucoma Fellowship training and achieved outcomes similar to best-published data. This success can be reproduced in other geographic locations. Keywords: glaucoma, trabeculectomy, mitomycin C, Caribbean, African Caribbean
format	article
author	Murray D Shah P
author_facet	Murray D Shah P
author_sort	Murray D
title	ReGAE 12: preventing glaucoma blindness in the Caribbean through implementation of the Moorfields Safer Surgery System and skills transfer from the UK to Trinidad and Tobago
title_short	ReGAE 12: preventing glaucoma blindness in the Caribbean through implementation of the Moorfields Safer Surgery System and skills transfer from the UK to Trinidad and Tobago
title_full	ReGAE 12: preventing glaucoma blindness in the Caribbean through implementation of the Moorfields Safer Surgery System and skills transfer from the UK to Trinidad and Tobago
title_fullStr	ReGAE 12: preventing glaucoma blindness in the Caribbean through implementation of the Moorfields Safer Surgery System and skills transfer from the UK to Trinidad and Tobago
title_full_unstemmed	ReGAE 12: preventing glaucoma blindness in the Caribbean through implementation of the Moorfields Safer Surgery System and skills transfer from the UK to Trinidad and Tobago
title_sort	regae 12: preventing glaucoma blindness in the caribbean through implementation of the moorfields safer surgery system and skills transfer from the uk to trinidad and tobago
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/79f4bb49eaac4b7d8cff5875b4a09d69
work_keys_str_mv	AT murrayd regae12preventingglaucomablindnessinthecaribbeanthroughimplementationofthemoorfieldssafersurgerysystemandskillstransferfromtheuktotrinidadandtobago AT shahp regae12preventingglaucomablindnessinthecaribbeanthroughimplementationofthemoorfieldssafersurgerysystemandskillstransferfromtheuktotrinidadandtobago
_version_	1718399698593644544

ReGAE 12: preventing glaucoma blindness in the Caribbean through implementation of the Moorfields Safer Surgery System and skills transfer from the UK to Trinidad and Tobago

Ejemplares similares