Magrabi ICO Cameroon Eye Institute, Yaoundé, Cameroon: Ophthalmology Subspecialty Patient Care and Training Center in Central Africa.

PURPOSE: To report establishment of the Magrabi ICO Cameroon Eye Institute at Yaoundé, Cameroon, as an ophthalmology subspecialty patient care and training center in Central Africa. DESIGN: Perspective. METHODS: Assessment of unpublished and published material. RESULTS: To improve, preserve and restore eye health and vision in a region with world-high prevalence of functional vision impairment and blindness, the Africa Eye Foundation established the Magrabi ICO Cameroon Eye Institute as an ophthalmology subspecialty patient care center for all in need and a training center for ophthalmologists, ophthalmology subspecialists, and allied personnel. In 2017, the year of its inauguration and the first year of operation, the Magrabi ICO Cameroon Eye Institute provided ophthalmology subspecialty care to more than 25 000 patients and surgery for pediatric and adult cataract, glaucoma, retinal disease, oculoplastic disorders, and other vision-threatening conditions. Outreach programs extended care to an additional 2500 individuals in rural communities and 7 training courses were conducted for ophthalmologists and allied personnel. CONCLUSION: Through ophthalmology subspecialty patient care and the training of ophthalmologists and allied personnel, Magrabi ICO Cameroon Eye Institute is acting to enhance vision and the quality of life for individuals and families in all segments of society.

A prospective, randomized, contralateral eye comparison of epithelial laser in situ keratomileusis and photorefractive keratectomy in eyes prone to haze.

PURPOSE: To compare refractive outcome, subepithelial haze, and pain after epithelial laser in situ keratomileusis (epi-LASIK) and photorefractive keratectomy (PRK). METHODS: In this prospective, randomized study, 32 eyes of 16 patients were treated for myopia with epi-LASIK (epi-LASIK group) in one eye and PRK in the fellow eye (PRK group). All patients underwent ablation using the NIDEK EC-5000 CX II excimer laser platform. Mean patient age was 24.8 years (range: 19 to 35 years). Mean preoperative manifest refractive spherical equivalent (MRSE) was -2.76 diopters (D) (range: -1.00 to -4.88 D). Refractive outcome, subepithelial haze, and pain out to 6 months postoperatively were compared between groups. RESULTS: At 6 months postoperatively, the mean MRSE was -0.22 +/- 0.27 D (range: 0.25 to -0.88 D) in the epi-LASIK group and -0.23 +/- 0.29 D (range: 0.50 to -1.125 D) in the PRK group. There was no statistically significant difference in the refractive outcomes between groups. By postoperative day 4, 18% of the epi-LASIK group and 7% of the PRK group achieved the final uncorrected visual acuity (UCVA). On day 1 postoperatively, 14% fewer patients in the PRK group experienced pain compared with the epi-LASIK group. On postoperative day 2, 36% fewer patients in the epi-LASIK group experienced pain. Seventy-one percent of patients in the epi-LASIK group and 36% of patients in the PRK group had no haze postoperatively. CONCLUSIONS: Epi-LASIK and PRK produced similar refractive outcome. Patients who underwent epi-LASIK experienced faster recovery of vision, less haze, and less pain.

Comparison of iris-fixed Artisan lens implantation with excimer laser in situ keratomileusis in correcting myopia between -9.00 and -19.50 diopters: a randomized study.

OBJECTIVE: To compare Artisan lens implantation with laser in situ keratomileusis (LASIK) for the correction of myopia between -9.00 and -19.50 diopters. DESIGN: Prospective randomized clinical trial. PARTICIPANTS: Ninety eyes of 61 consecutive patients were enrolled in the study. INTERVENTION: Forty-five eyes (50%) received Artisan lens, and 45 eyes (50%) received LASIK; the procedure assigned to each eye was randomized. Eighteen patients (29.5%) received Artisan lens in one eye and LASIK in the other. MAIN OUTCOME MEASURES: Slit-lamp microscopy, manifest refraction, uncorrected and spectacle-corrected visual acuity, contrast sensitivity, and specular microscopy were performed before surgery, and 1, 3, 6, and 12 months after surgery. Patient satisfaction and preference were assessed by a subjective questionnaire. RESULTS: At 1 year, 43 eyes (95.6%) from the Artisan group and 41 eyes (91.1%) from the LASIK group were examined, the mean spherical equivalent refraction was -0.64 +/- 0.8 diopter in the Artisan eyes and -0.87 +/- 0.8 in the LASIK eyes. The uncorrected visual acuity was 20/20 or better in 9 Artisan eyes (20.9%) and 5 LASIK eyes (12.2%) and 20/40 or better in 38 Artisan eyes (88.4%) and 24 LASIK eyes (58.5%); no Artisan eyes and 5 LASIK eyes (12.2%) lost 2 or more Snellen lines of spectacle-corrected visual acuity. One Artisan eye (2.3%) and six LASIK eyes (14.6%) reported severe night glare; the Artisan lens was exchanged with a larger optic diameter lens. Mean endothelial cell loss at 1 year was 0.7 +/- 1.1 cells/mm(2) in the Artisan eyes and 0.3 +/- 0.9 cells/mm(2) in the LASIK eyes. Contrast sensitivity curve decreased by 2 or more lines in two Artisan (4.7%) and six LASIK eyes (14.6%). Of the 18 patients who received both surgeries, one in each eye, 13 patients (72.2%) preferred the Artisan procedure because of the better quality of vision. CONCLUSIONS: In this study, Artisan lens implantation and LASIK were found to be similarly effective, stable, and reasonably safe for the correction of myopia between -9.00 and -19.50 diopters. Better uncorrected and spectacle-corrected visual acuity and contrast sensitivity, a lower enhancement rate, and exchangeability are the main advantages of Artisan lens implantation. Thirteen (72.2%) of the 18 patients who received the Artisan lens in one eye and LASIK in the other preferred the Artisan lens to the LASIK, mainly because of the better quality of vision.