Browsing by Author "du Toit, Nagib"
Now showing 1 - 3 of 3
Results Per Page
Sort Options
- ItemOpen AccessA survey of the attitude towards research and research education among South African Ophthalmology trainees(2020) du Toit, Linett; du Toit, NagibBackground Completing a research dissertation or Master of Medicine (MMed) degree during ophthalmology specialist training has now become compulsory in order to qualify as an ophthalmologist in South Africa. At a national level there is currently no co-ordinated effort to standardize research training and resources for trainees. Objectives The primary objective was to determine if South African ophthalmology trainees were interested in doing research. Secondary objectives were to determine: whether they felt that their current research training was adequate; whether a national web-based research support system would be desirable; and whether such a support platform would stimulate involvement in further research once training was completed. Methods A questionnaire was designed and anonymously completed by the trainees in each training unit in South Africa. Categorical responses were summarized using crude and weighted means with 95% confidence intervals (CI). Free text responses were analyzed thematically using an inductive approach. Results Out of 81 trainees (registrars) in South Africa at the time of the survey, 64 fully completed the questionnaire - a response rate of 79%. Seventy-two percent (95% CI 57% to 87%) of the trainees reported that they were interested in doing research. Only 28% (95% CI 18% to 41%) of respondents felt that their current research training was adequate. Ninety five percent (95% CI 86% to 99%) of trainees advocate a web-based support platform would be beneficial an eighty six percent (95% CI 74% to 93%) reported such would motivate them to continue to do research once their training was complete. The themes from the qualitative data were in keeping with the quantitative results and identified variation between training institutions in terms of available research resources, supervision and allocated time to perform research. Conclusion The trainee ophthalmologists in South Africa are interested in performing research. They feel that their current research training programs are inadequate. There is a strong need for nationally standardised research guidance to eliminate the current variation between training institutions. Guidance on dedicated time allocation to complete the research component of training should be provided by regulatory bodies. A proposed web-based support system may be a good option to standardize selected available research resources and provide equal access to all trainees nationally as well as to supplement research output during and after specialist training. Further research should address the reported lack of supervision and elucidate additional barriers to performing research in South Africa.
- ItemOpen AccessOutcomes of corneal crosslinking for the treatment of keratoconus at a tertiary South African hospital(2022) Kriek, Jozef; du Toit, NagibObjectives. To describe and analyse the effectiveness of using accelerated epithelium-off corneal crosslinking (A-CXL), in a cohort of patients with progressive keratoconus (KC), presenting to Groote Schuur Hospital, South Africa. Methods. A retrospective review of patients who underwent A-CXL, using 6.4 mW/cm2 ultraviolet-A irradiation for 15 min, for progressive KC between 1 May 2017 and 1 June 2018. All patients completed 6 months minimum follow-up (Mean 9months, range 6-15). The diagnosis of keratoconus was based on corneal tomography and its clinical signs. Keratometry values and visual acuities were measured to ascertain if there was improvement in acuity or corneal curvature at 6 months post-procedure. Results. Nineteen eyes of 17 patients were included. The group consisted of 6 (32%) males and 13 (68%) females, with a mean age of 22.17 years (SD = 5.8). Zero eyes showed mild keratoconus, 8(42%) showed moderate keratoconus and 11(58%) showed severe keratoconus. At 6 months follow-up, results revealed that UCDVA improved from logMAR 0.96 to 0.83 (p = 0.068) and BCVA improved from logMAR 0.40 to 0.34 (p = 0.073). The mean UCDVA and BCVA Snellen line gain was 0.43 and 0.94. Overall the change in UCDVA and BCVA trended towards being statistically significant. The median Kmax value decreased from 57.7D to 55.9D. The mean Kmax value decreased from 59.46D to 58.85D (p = 0.137). The mean Kmean anterior increased from 50.26D to 50.86D (p = 0.139), the mean Kmean posterior from -7.48D to -7.67D (p = 0.026). There was a statistically significant change in Kmean post, but not so for Kmean ant and Kmax. Both severity groups showed a decrease in thinnest point corneal pachymetry from mean 445 micrometer(μm) to mean 422 μm (Moderate: p = 0.009; Severe: p = 0.003). KC progression was stopped or stabilised in 13 eyes (68%); 6 eyes (32%) showed progression. No complications were found. Conclusions. Our results show the effectiveness of 15-minute A-CXL (irradiance of 6.4 mW/cm2) in maintaining both corneal stability and visual acuity in our patient population at 6 months follow-up. In future, a larger study with prolonged follow-up would be required to elucidate this finding.
- ItemOpen AccessOutcomes of penetrating keratoplasty at a tertiary institution in South Africa.(2023) Theron, Yolande; du Toit, NagibAims: To determine corneal graft survival rates and visual outcomes of penetrating keratoplasty (PKP) in a South African setting. Methods: A retrospective review of 99 penetrating keratoplasties performed at Groote Schuur Hospital, South Africa over a 3-year period between February 2016 and February 2019. Results: The mean age of study participants was 38 years (14-85). The study included 60% females and 40% males. The main indications for surgery were keratoconus (58%), corneal scar (21%), regrafts (8%), pseudophakic bullous keratopathy (6%), corneal dystrophies (3%) and pellucid marginal degeneration (1%). The overall graft survival at 1-year follow up was 86%. A higher 1-year graft survival rate of 94% was seen in patients with keratoconus. The total number of patients diagnosed with graft failure at 1 year was 13.The Kaplan-Meier survival analysis was used to assess time to graft failure. The estimate was 11.7 months (mean time to graft failure) with a 95% CI confidence interval from 11.4 to 12 months. In our study, best corrected Snellen acuity in the category of 6/6-6/18 was found in 59.2% of patients 1-one year post-operatively, compared with 1% of patients in the same BCVA group pre-operatively. Patients with a BCVA equal to 3/60 or less reduced from 56% preoperatively to 20% postoperatively at 1 one year. Conclusion: Penetrating Keratoplasty is an effective long term treatment option to restore visual acuity in certain corneal disorders in a middle to low-income country. Our results demonstrated a comparable 1-year graft survival rate to high-income countries.