What Africa Taught Me About Vitreoretinal Surgery: Part One

In Rwanda, vitreoretinal surgeon practices involve managing dense crystalline lenses that frequently drop during surgery, especially in trauma cases. Despite the fragmatome being the gold standard, its high ultrasound energy can damage the sclera. Perfluorocarbon liquid (PFCL) offers an alternative but has limitations and costs. A practical technique adopted from manual small incision cataract surgery involves creating a self-sealing scleral tunnel combined with needle levitation, effectively allowing controlled removal of difficult lenses while minimizing complications and costs in low-resource settings.

About the Author(s)

Michael Mikhail

Dr Michael Mikhail MBChB, FRCOphth Consultant Ophthalmologist and Vitreoretinal Surgeon, Kabgayi Eye Unit, Rwanda Senior Lecturer, School of Medicine and Pharmacy, University of Rwanda, Rwanda

More Articles by Michael Mikhail