Honduras Surgical Eye Mission – 2016

2018 Impact Statement Honduras Surgical Eye Mission

October 26 – November 2 2016

A very successful surgical mission was carried out by Visionary Foundation and Alberto Martinez, MD from October 26 to November 2, 2016 at “Fundación de Servicios Medicos Voluntarios” (FSMV) Hospital Leonardo Martinez, San Pedro Sula, Honduras. 

FSMV, a charity clinic led by Marcos Fajardo, MD, serves the indigent population of San Pedro Sula. Dr. Fajardo provided the logistic support and infrastructure that allowed us to provide free surgical eye care. The patients who received surgery were pre-screened by Dr. Fajardo. Pre-surgical screening consisted of a complete eye exam, diagnosis and plan. Once the need for surgery was determined, appropriate testing such as axial eye length measurement, corneal topography and B-Scan ultra-sonography were performed. 

Following the principle of “When you give a fish to a man, you feed him for a day. When you teach him how to fish, you feed him for a lifetime,” Dr. Martinez spent time training local ophthalmologists Marvin Barahona, MD and Celios Ramirez, MD. The principal focus of training was clinical cornea, cataract and corneal transplant surgeries. 

A total of 54 eye surgeries were performed:

  • 12 corneal transplants (6 Penetrating, 6 Partial or DSAEK)
  • 2 lamellar keratectomies for external corneal pathology
  • 1 limbal stem cell transplantation 
  • 7 iStent device implantations for glaucoma
  • 32 cataract surgeries (7 phaco with iStent, 2 phaco with DSAEK, 3 extracapsular)
  • Multiple clinical consultations and examinations of general ophthalmology, cornea and external eye diseases

Patients were seen on their first postoperative day.  Cornea patients were seen again three days later, at the end of the surgical mission. All medications needed for postoperative care were provided for free.  Postoperative care of these transplants will continue via telemedicine with the wonderful help of WhatsApp, by means of high quality photography and descriptions.

Of special note, was the performance of a limbal stem cell transplant in the form of a Kerato-Limbal Allograft (KLAL). This was an unplanned surgery. Three days before the mission was to end, we examined a 32 year old woman with severe, symptomatic Steven Johnson’s Syndrome. She had a painful corneal ulcer, impending perforation and a completely vascularized, opaque right cornea. Through sustained, relentless efforts, we were able to obtain two corneas immediately donated by Tissue Banks International and amniotic membrane donated by Bio-Tissue. These tissues were shipped and shepherded through reluctant local customs. The extensive surgery (2 ½ hours) was performed just in time, the night before our departure. On the first postoperative day, the patient’s vision had improved slightly and the transplants were in good position.  Thanks to the generosity and collaboration of many, her eye was saved.

Surgical Complications:

  • One DSAEK had a partial flat chamber. The chamber deepened two days after surgery and the transplanted button is clearing.
  • One penetrating keratoplasty had a small leak on postoperative day one, cleared by postoperative day three.

We plan to return during the first week of April 2017, this time with 2 surgeons. One surgeon may focus exclusively on transplants the other on cataract surgery. Thus, we hope to have a larger surgical impact. One of the most difficult parts of the mission was the heart wrenching process of turning down many people who direly needed a corneal transplant because we did not have enough cornea tissue.

We are thankful to the numerous individuals and organizations that helped us with the success of this mission: 

  • Alcon Laboratories
  • SightLife Tissue Bank
  • Tissue Banks International
  • Glaukos
  • Bio-Tissue 
  • Vanessa Lemus 
  • Palisades Eye Surgery Center
  • Dr. Berny Kreutz

In addition to the surgical mission, Anna Pigotti with the support of Visionary Foundation provided funds to help maintain the infrastructure of the facility where 80+ girls of all ages reside at the orphanage “Hogar San Jose” directed by Sister Thelma. Thanks to Amanda Townsend and her staff at Potomac Physician Associates and Dr. William Saway and his staff at Columbia Medical Practice who donated 80+ backpacks for the orphan girls. Future plans in this area include visiting the orphanage in April 2017 and providing cash donations their additional needs. This year, Dr. Santos Cruz, ophthalmologist and resident of San Pedro Sula, has promised to help find and fund a psychologist to help the girls cope with psychological trauma such as abandonment, and physical and sexual abuse. Sister Thelma and Dr. Cruz will meet in the near future to plan and execute this much needed help.

Once again, thank you for your generous help. You have literally shone light into the life of our fellow human beings. 

May your contribution become a light of kindness filling your heart with joy!

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