Greetings from Angola,
I hope all is well in your part of the globe. I was reminded via email that the AAO meeting is happening, and since I can't make it back to see you in person, I wanted to send a brief note to all my Cornea family.
The past year in Angola has gone by very quickly. In regards to surgeries, I performed 1,800 cataract surgeries myself, but am more satisfied that we were able to start a training program for Angolan cataract surgeons, the only program in the country, here at our center.
We are still in the beginning phase. We have only one trainee currently, he is progressing quickly and will soon (I hope) be doing surgeries independantly. We hope to make a significant impact on the level of preventable cataract blindness in this country through training qualified cataract surgeons.
I am now, more than ever, deeply grateful for your assistance during my own training. Sitting in the other chair, watching the struggles of the trainee, is not an easy task. I thank you for your contribution to my education, and the impact you have made on the country of Angola as well.
Though my time apart from cataracts is limited, I have been able to do 24 cornea grafts (tectonic only) as I am using glycerin preserved corneas. This tissue is quite different from fresh tissue, but keeps my suturing skills up, and serves its purpose well to secure an eye in the setting of large peripheral perforations.
I have found a cheap (less than 50 cents/ 2ml tube) chinese superglue, cyanoacrylate base, that works very well as tissue glue. With a large anterior chamber air bubble, I have found no toxicity and has worked very well for small perforations.
There are inumerable ptyergium and ocular surface tumors, and I squeeze in at least one ocular surface surgery every day. Our clinic is very busy considering that I am the only doctor. We see ~100 patients every day. I have one nurse who triages the dry eye patients and refractions in the morning, so that I only have to see the complicated cases in the afternoon.
We are planning on staying on here for another 2 years to help the fledging training program take flight. The plan will be to have one of the trainees take over the service at some point to free me to explore other options.
Lori and the boys are doing well. Attached is a photo taken at "Cristo Rei" statue here in Angola with Oliver (6 yrs), Zeke (4yrs) and Roman (2yrs).
You can read more about us at
Thank you again for the blessing you all have been to me personally
John Clements, MD - 7/2012
Drs Bouchard and Yoo,
Wanted to briefly update you on our situation here in Angola. After lots of prayer and soul searching, we have agreed in principle to stay for an additional two years here. With the specific aim of making training of doctors a reality in Angola. We have our first candidate scheduled to start training on the 15th of this month! I'm cautiously optimistic that the training will become reality. The course will be from 6-months to 1 year in duration depending on the apptitude of the candidate in surgical ability.
With training in mind I could think of nobody better than my mentors to ask for advice. What are some of your guiding principles in your approach to teaching surgery to the novice?
With respect to your time, I know you can't write down everything, but a few "axioms" would be much appreciated.
Also, I have a phaco unit on route from the USA. Really excited about the prospect of doing phaco again. I have done a little over 1,000 cataracts in the last 9 months, but all either SICS or some ICCE ! I would love to show some of the pathology here to your 3rd year residents.
Have been busy doing conjunctival flaps and patch grafts for cornea perforations. Am becoming all too familar with Conjunctival Neoplasia, Mooren's ulcer, pterygium and have even taken up doing trabeculectomies with 5-FU.
Lori and the boys are doing well. Oliver (6) is in a Portuguese speaking school and adapting well. Ezekiel (4) has tennis lessons daily. Roman is fast approaching 2 years. Lori is helping to coordinate a ministry to an association of persons with visual disabilities.
Well that's all from suprisingly cool and refreshing Angola. I hear the weather is quite balmy in the midwest right about now. '
John Clements, MD
Boa Vista Eye Clinic
Holiday Greetings from Shivan & Karis Tekwani!
Shivan & Karis Tekwani
celebrate the arrival of their firstborn child, "It's a boy!" - Dylan Tekwani, born Thursday July 8th at 5:04pm. Dylan is 5 lbs 4.5 oz. and 19 1/4 inches long. Mom & Dad & Baby Dylan are doing great!!