Visionary Foundation and Alberto Martinez, MD, carried out a successful surgical mission from November 24 to November 28, 2022, at “Fundación de Servicios Medicos Voluntarios” (FSMV) Hospital Leonardo Martinez, in San Pedro Sula, Honduras.

FSMV, a charity clinic led by Marcos Fajardo, MD, serves the impoverished population of San Pedro Sula. Dr. Fajardo provided the logistic support and infrastructure that allowed us to offer free surgical eye care. The patients who received surgery were pre-screened by Dr. Fajardo and other doctors in his group. 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 ultrasonography, was performed.

This year, Dr. Martinez spent time training local ophthalmologist Edgar Maldonado, MD, 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”. The principal focus of the training was clinical cornea, cataract, and corneal transplant surgeries. A total of 48 eye surgeries were performed:

• Seven corneal transplants. Three penetrating keratoplasties, four DSAEK
• 41 cataract surgeries
• Multiple clinical consultations and examinations of general ophthalmology, cornea, and external eye diseases and pre- and post-op evaluations

A noteworthy surgery was performed on J. Felipe, 13 years old, with severe bilateral keratoconus, who could barely ambulate because of severely impaired vision in both eyes. A Penetrating Keratoplasty was performed on his left eye. One day postop, Juan was seeing much better and asking whether he could return to school. We have followed up on his progress and all other transplants via text and photographs with Dr. Maldonado.

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 using WhatsApp’s app using high-quality photography and descriptions.

Logistical Complications:

Because of new regulations of the Health Department in Honduras, delays were experienced during customs in San Pedro Sula. Fortunately, with the help of our on-the-ground team, these problems were overcome, and we could bring into the country six large bags of consumables needed for the surgeries.

Adjustments in paperwork will be made to prevent this in the future.

On the same afternoon of the arrival, a large cornea clinic was held, examining approximately 30 patients, all in need of corneal transplants. They were examined, and our seven corneas were matched to the neediest patients. This is always challenging because many of these patients have been waiting for a transplant for years. Unfortunately, we could only obtain seven corneas from the eye banks this year due to Pandemic related disruptions in the tissue banks. A strategy was formed for the next year to try to obtain more corneas to catch up with the great need of the indigent people of Honduras.

Surgical Complications:

One surgical complication was encountered during this mission. While teaching a phacoemulsification technique to a local physician, the capsular bag was broken, and nuclear chips fell in the back of the eye. Fortunately, a well-positioned implant could be implanted, and the patient underwent a vitrectomy three days later. Her uncorrected vision is 20/30+.

We plan to return in August 2023, this time with two surgeons. One surgeon may focus exclusively on transplants, the other on cataract surgery. Thus, we hope to have a more significant surgical impact. One of the most challenging 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
• Cornea Gen Tissue Bank
• Nancy Cruz
• Vanessa Lemus
• The staff and physicians at Palisades Eye Surgery Center
• Loretta Scrub Technician and the OR staff at the Washington Hospital Center

In addition to the surgical mission, Anna Pigotti, with the support of the Visionary Foundation, provided funds to help maintain the facility’s infrastructure, where 70+ girls of all ages reside at the orphanage “Hogar San Jose,” directed by Sister Cilia. Plans in this area include visiting the orphanage in August 2023 and providing cash donations to cover some of the many basic needs.

We welcome anyone who would like to donate to visit our website: https://www.visionaryfoundation.net/donate/

Once again, thank you for your generous help. You have shone the light into the life of our fellow human beings.
May your contribution become a light of kindness, filling your heart with joy!