Cataract Surgery at Aravind

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November 21st 2018
Published: November 23rd 2018
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Aravind Cataract Surgery Operating RoomsAravind Cataract Surgery Operating RoomsAravind Cataract Surgery Operating Rooms

Operating rooms with two teams. Each surgeon operates with two tables (4 patients in a room at a time), swinging the microscope from bed to bed. Turnover time is eliminated. Concerns over quality are irrelevant as their complication rates are half of those in the UK. Here they are performing phacoemulsification. They now offer a full range of lenses (toric, multifocals) as well as femtosecond laser incisions to patients that want these and can pay for these enhanced surgeries. Basic cataract surgery is still offered for free for those who cannot pay.
November 21, 2018 (Madurai, India) Cataract surgery is quite structured and one of the most common surgeries performed. An opaque natural lens is removed and replaced with an artificial one. There are two primary ways of removing them: 1) manual small incision cataract surgery (MSICS pronounced em-six) and 2) phacoemulsification. In MSICS the lens is removed through a slightly larger incision because it is removed manually. The cataractous lens has a nucleus (which is harder) and an outer layer of softer tissue (cortex). Like a peach, the nucleus would be the seed and the pulp would be the cortex. It is wrapped in a bag that has to be opened but preserved with the opening so the artificial lens can go inside the bag. In phaco surgery, the nucleus is shattered using an ultrasonic tip that can be inserted into the eye through a smaller incision posing some advantages. The biggest difference is in the cost of doing surgery, and in the best hands costs much less to do MSICS and results six weeks out are comparable. Cataract surgery of both kinds are performed at Aravind, and done in very systematic fashion. Operating rooms have four beds, two microscopes and two
Cataract surgeryCataract surgeryCataract surgery

Surgeon injecting a lens after removal of the cataract.
surgeons operating simultaneously, each supported by their own surgical team. The workflow is designed to optimize the surgeons' time, so a patient is prepped for surgery on one table, while the surgeon is operating on the other table. The microscope is swung from side to side. Surgeons scrub once and then sterilize their gloves between cases and go from case to case. Scribes document the surgery in electronic charts, and the flow of patients is continuous.


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