Niue's first "phaco" cataract surgery
Dr Penny McAllum, Crystal Siva, Raina Tutini, Dr Sarah Welch and optometrist Deborah Chan

Niue's first "phaco" cataract surgery

June 10, 2019 Dr Penny McAllum

Niue is a unique Pacific nation, consisting of a single coral island, which is home to about 1500 people, with many more Niueans living in New Zealand and Australia.

While Niueans are New Zealand citizens, the cost of flying patients to Auckland for health care is high, so teams from various specialties visit from Auckland, often on a yearly basis.

Myself and my Auckland-based colleague, Dr Sarah Welch, have been visiting Niue since 2009 and over recent years the team has grown to include retinal screener, Raina Tutini, as there are now more than 300 diabetics on the island, and optometrist, Deborah Chan.

This year’s visit was once again a very successful and enjoyable volunteer trip, which had the added excitement of introducing small incision phacoemulsification cataract surgery to the island for the first time. This was achieved thanks to the generous donation of a quality operating microscope from Zeiss and a phacoemulsification ultrasound machine from Alcon. Experienced ophthalmic theatre nurse, Crystal Siva, also joined the team for the first time to ensure the operating ran smoothly.

There were some initial challenges, particularly with the operating microscope, which required some urgent advice from New Zealand-based Zeiss engineer, Andre Smith, plus the skills of a local electrician to get it working. The hospital autoclaves also struggled to keep pace with the surgery, as there were only three sets of surgical instruments. But it all came together well in the end and the team were able to see several hundred patients and undertake 34 cataract operations.

As there had been no cataract surgery on the island since the last extracapsular cataract extractions in 2015, most of the cataracts were very advanced, and there are many patients already on the surgery waiting list for our next visit.

This trip also allowed us to teach two of the three local hospital doctors to do intravitreal avastin injections for patients with severe diabetic maculopathy. There are a handful of patients who previously needed to be flown to Auckland for monthly injections, but now that these are available locally, the cost and time savings will be significant. The local doctors keep in email contact with the visiting surgeons between trips to help manage the more complex cases.

Niue has a relaxed charm and its people are very friendly and always make the eye team feel welcome. We are all looking forward to our next visit in 2020.

Dr Penny McCallum is an Auckland-based ophthalmologist with Counties Manukau District Health Board and Eye Doctors, specialising in cataract and pterygium surgery, keratoconus and allergies management, and corneal transplant.