Latest Developments in Minimally Invasive Surgery (MIS) in India’s Ophthalmology Sector

The inclusion of ophthalmology care in government insurance programmes such as Ayushman Bharat and the Yeshasvini Health Scheme has significantly improved access to treatments, particularly in rural India. Dr Sri Ganesh, Chairman and Managing Director of Nethradhama Super Speciality Hospital, discussed the various developments in ophthalmology that are being used to help patients achieve better surgical outcomes, as well as how resources and services are being prioritized for the ever-increasing number of eye-related ailments such as cataracts and glaucoma.

“Nethradhama has been at the forefront of introducing cutting-edge technology into India. We have brought cutting-edge technology to India, including the iStentW by Glaukos, the Artivo 800 machine, a 3D microscope developed by Carl Zeiss that was initially installed in India at Nethradhama, and CAPSULaser’s laser-assisted cataract,” he stated

“Collectively, these technologies not only improve hospital care but also help to strengthen India’s eye care ecosystem. We are changing the face of eye care in India by focusing on precision, efficiency, and patient comfort, ensuring that patients receive world-class treatment with fewer problems and exceptional post-operative care,” Dr. Sri Ganesh explained.

Nethradhama was among the first to use the iStent technology approximately two years ago. Glaukos recently introduced the iStentW, a revolutionary device for treating glaucoma alongside cataract surgery. Many of our patients getting cataract surgery are already receiving glaucoma drops. This presents a dilemma: either we do only the cataract surgery and patients continue to use the drops, risking adverse effects such as hyperpigmentation, increased lash growth, and dry eye, or we perform a more intrusive technique known as trabeculectomy to lower intraocular pressure. The iStent allows us to install two stents during catheter surgery. These stents drain fluid from the eye, which effectively lowers pressure.

Speaking of other emerging technologies in eye care, MIS is rapidly gaining traction in India’s ophthalmology sector, with significant developments leading to better surgical outcomes. The Visumax 800 machine is another example of a pioneering installation that demonstrates MIS advances. This technology offers rapid recovery times and a shallow rate of problems. Another advancement is the iStentW, which provides a minimally invasive alternative to trabeculectomy for glaucoma management. This tiny implant is intended to increase the outflow of eye fluid, effectively lowering intraocular pressure in glaucoma sufferers.

These MIS advancements use cutting-edge technology to help patients achieve improved surgical outcomes. Modern surgical procedures enhance patient experiences and improve the overall quality of care in India’s ophthalmology industry by allowing fewer incisions, minimising discomfort and scarring, minimising recovery time, and attaining faster healing.

The inclusion of ophthalmic care in government insurance programmes such as Ayushman Bharat and the Yeshasvini Health Scheme has significantly improved access to treatments, particularly in rural areas of India. These schemes have contributed to making eye care more affordable for patients by covering a percentage of the expenses associated with treatment and technologies. For example, the schemes frequently pay some of the cost of intraocular lenses required for cataract surgery. However, implementing these schemes presents obstacles. The high expense of eye care technologies and equipment is a significant challenge. Customs duties imposed on these technologies raise their price, making treatments more expensive. This can provide a barrier to access for patients, particularly in rural areas where affordability is a major problem. 

To solve these issues, there have been attempts to petition the government to exclude sight-saving equipment from customs taxes. This would assist in minimising the cost of technology acquisition, making eye care more inexpensive and accessible to a greater audience. Given that India has the world’s biggest blind population, with many cases reversible, ensuring access to cheap eye care is critical for treating blindness and visual impairment in the country. 

Nethradhama is dedicated to educating and training ophthalmic doctors in India through a variety of programmes. One such initiative is the introduction of courses such as graduation and master’s degrees in optometry, residency in ophthalmology (DNB), and postdoctoral fellowships. These programmes are intended to train applicants in the most recent technologies, utilising Nethradhama’s cutting-edge technology for patient care. 

For more than 20 years, Nethradhama has been running medical training programmes to ensure the sustainability and efficiency of these programmes. This long-term commitment demonstrates Nethradhama’s dedication to continuing education and skill development in the field of ophthalmology. We also operate the Nerd’s Eye View Programme, a one-of-a-kind initiative that provides hands-on training to young practitioners annually. It allows prospective eye care professionals to learn from seasoned practitioners and obtain practical skills for their future jobs. The incidence of glaucoma and cataracts in India is rapidly growing. In India, 12 million individuals suffer from glaucoma, whereas 3.8 million people are blinded by cataracts each year. We have invested in cutting-edge glaucoma and cataract treatments to address this rising issue. 

We also perform refractive cataract surgery using the Femtis Mplus technology, which combines the FEMTIS MPlus IOL with automated capsulotomy using femtolaser cataract surgery. This approach establishes a new standard for cataract and refractive treatment in India, offering patients innovative and effective treatment alternatives. We hope that by investing in these technology and treatment approaches, we can successfully address India’s burgeoning glaucoma and cataract challenges. These innovations not only enhance patient outcomes but also help to lessen the total illness burden by prioritising resources and services to meet the community’s most pressing needs.

Our eye hospital is actively involved in numerous research programmes that aim to advance ophthalmic care in India. We were one of eight facilities participating in the Global Clinical Trials (GCT) for SMILE hyperopia, which validated our LASIK surgery skills. Furthermore, we have been selected as one of five global centres for the robotic Visumax 800 flapless LASIK (SMILE Pro), demonstrating our expertise in cutting-edge surgery technology.

We have also made substantial contributions to ophthalmic research, with over 100 peer-reviewed papers in a variety of global journals. We hold patents for revolutionary intraocular lens (IOL) designs and surgical equipment, demonstrating our commitment to creating new technologies to enhance patient outcomes.

We collaborated with Carl Zeiss Meditec to create AI algorithms for remote screening and categorization of diabetic retinopathy using a portable fundus camera. We run several screening outreach activities in rural regions through our philanthropic arm, Shraddha Eye Care Trust, and screen over one lakh people each year for chronic eye illnesses including cataracts, glaucoma, and diabetic retinopathy.

Source : Economic Times

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