Interview
Providing state of the art eye care in the region
Professor Donald Tan, Director - Singapore National Eye Centre
Recently, Director of Singapore National Eye Centre (SNEC) Professor Donald Tan visited Bangladesh. On his first visit to the country, he shared his views with Star Health and highlighted some latest advancement of eye care in the region, especially at his centre. Singapore made huge advancement in cornea transplant. They also have developed a state of the art eye banks in collaboration with Sri Lanka which can meet a large portion of demand in the region. In terms of setting up an eye bank, Prof Tan says that it is a huge effort which is time consuming at the same time. For example, Singapore needed about 10 years setting up such a centre, and Sri Lanka needed 4 years more on top of that 10 years with the experience of Singapore. Prof Tan said that increasing public awareness for eye banking might be a potential contributor to the huge number of people waiting for cornea transplant in countries like Bangladesh. Prof Tan said that the most important factor that contributed Sri Lanka to set up such good quality eye bank is a special form of Buddhism that promotes posthumous eye donation. They are proactive to promote tissue and organ donation in after life which make a unique difference. Other advancement in corneal transplant is preventing the risk of rejection. If the graft is rejected, the transplanted cornea becomes cloudy within short time, and the patient can not see again. Now there are advancement in the horizon that does not require transplantation of the whole cornea — just a partial transplantation of the particular area or layer affected serves the purpose more effectively and in sustainable way. Consequently the rejection is now much less in these cases with much better outcome. All transplants are almost a day case procedure now. No longer general anesthesia is required — simply local anesthesia is sufficient for cornea transplant in ambulatory procedure within 20-30 min. As a result the recovery is faster within shorter hospital stay. In many cases no suture is required. Key whole surgery is another advancement. As the population of Singapore is much less in comparison to most of the countries in the region, the main patient-load is from abroad; and Prof Tan informed that Bangladesh is among the top 5 countries from where people visit SNEC for eye care. It is noted that patients are coming not only from the Asia Pacific region, but also from some Western countries. Sub-specialisation in the different areas of ophthalmology is a key strength of SNEC. So when it comes to more sophisticated eye care, these sub-specilisation help a lot. Thus SNEC can act as a tertiary or quaternary referral centre. Cataract is a very common eye problem everywhere in the world. The latest advancement is laser treatment for more precise cataract surgeries. Moreover, it helps in cutting lens easily and accurately with less bleeding and faster healing. Laser has another great contribution in treating diabetic retinopathy. With changing lifestyle and increasing obesity, the problem related to diabetes is also increasing. Laser helps preventing the rupture of growing micro capillaries of eyes in diabetic patients. Along with clinical care, they train many ophthalmologists in the region. Prof Tan expressed their willingness to train Bangladeshi ophthalmologists also.
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