Education
Enhancing the level of vision healthcare
The pilot project of the MESCA Foundation in Uzbekistan was focused on the field of ophthalmology. As part of this project, Prof. Farhad Hafezi from the ELZA Institute AG (Zurich, Switzerland), provided a number of educational presentations and clinical trainings to local ophthalmologists in Uzbekistan. He also participated and spoke at the annual Uzbek National Ophthalmological Society (IOC) conference (2021, 2022 and 2024). Together with his clinical and research presentations, Prof. Hafezi also took the opportunity to present the mission and goals of the MESCA Foundation as they relate to enhancing the level of vision healthcare access in Uzbekistan and Central Asia region.
Research
Femto - CAIRS
The Femto – CAIRS project was launched in December 2022. The goal was to optimize the surgical settings and ultimately, the surgical outcome of CAIRS (Corneal Allograft Intrastromal Rings). This surgical treatment is used to improve the vision of patients after keratoconus treatment.
In the regions surrounding Uzbekistan, there is a suspected heightened prevalence of keratoconus in young people compared to the rest of the global population. While the diseased and compromised corneal tissue can now be treated, improving the quality of vision post treatment still remains difficult.
Saving vision for young people in Central Asia
As part of a pilot project, the MESCA Foundation Board selected Prof. Farad Hafezi from the ELZA Institute in Zurich, Switzerland, as the first recipient of research funds. Prof. Hafezi is a prominent ocular cell biology researcher and ophthalmic surgeon whose primary focus is medical and refractive corneal surgery. Specifically, Prof. Hafezi is focused on the complication management of refractive laser surgery and the treatment of corneal ectatic disorders. He has been instrumental in the clinical development and international establishment of corneal cross – linking (CXL) for the treatment of keratoconus, ectasia after LASIK and infectious keratitis.
The Femto – CAIRS project is focused on the development of technology and clinical applications related to the treatment of corneal dystrophies and diseases. MESCA believes that this treatment will address the growing need for vision rehabilitation in keratoconus and will be a means of saving vision for young people in Central Asia.
Outreach
1. Medical Training
Undergoing medical training using modern technology is one of the challenges faced by the physicians in Uzbekistan. They do not always have access to the latest technology or even highly qualified specialists conducting the training. This issue has been addressed with the support of the MESCA Foundation.
Alongside its pilot research project (Femto-CAIRS) aimed at improving vision care for the people with keratoconus, the MESCA Foundation and Prof. Farhad Hafezi have organized and supported a hands-on wet lab, which instructed medical students, residents and young doctors on how to perform corneal cross-linking (CXL) to treat arrest progression of keratoconus and infectious keratitis.
This highly sophisticated technology is part of the SMART (Small, Mobile, Affordable, Reliable Technology) portfolio, belonging to the series of new medical devices of Mrs. Nikki Hafezi’s companies. The medical device used to for CXL treatment is designed to be easy to use and to be less risky for the patient. As a result, patients will not only have a lower risk of complications but also more access because of the pre-existing and integrate integrated treatment protocols. Specifically, the number of clinical users increase because the learning curve for treatment is flattened, and the price of the medical device is a fraction of what is currently available in the market.
Teaching modern technology
Enhancing the level of vision healthcare
2. Keratoconus in Paediatric Patients with Down Syndrome
In August 2023, the MESCA Foundation collaborated with two organizations: The Light for Sight Foundation (Zurich, Switzerland) and Tabasuum, an Uzbek patient organization that supports families with children with Down syndrome. The goal of the collaboration was to screen for keratoconus among all children and adolescents with Down Syndrome. Keratoconus is the leading cause of preventable blindness in children globally.
Children with Down Syndrome are at a heightened risk for having keratoconus because of their pre-existing disposition to connective tissue disorders; the corneal tissue is comprised of connective tissue. It is also known that the paediatric population have a much higher rate of disease progression rate than adults, and therefore, children with Down Syndrome are a double risk group for keratoconus.
Through this collaboration, 117 families were registered, but only 65 children were compliant and eligible for keratoconus screening. The exclusion was either age or compliance to perform the measurement. The screening resulted in 11 children with suspicious corneas, and 6 months, these children were screened again, and three (3) of these children were diagnosed with keratoconus. The MESCA Foundation, in partnership with Light for Sight Foundation, provided resources to cover the screening, diagnosis, treatment and post-operative management.
To continue with this successful screening, the event was repeated in March 2024 in another populous city of Uzbekistan (Andijan). This time, the collaboration was together with the governmental Agency of Social Protection and Tabassum. The MESCA Foundation, with the assistance of the Light for Sight Foundation and the Tashkent International Medical Centre, conducted a screening examination of children with Down syndrome of different age groups. The aim of the screening was to identify irregular corneas to avoid serious impairment or permanent loss of vision if not treated in time. Approximately 94 children underwent the screening procedur; 20 patients presented with suspicious corneal measurements. A follow-up diagnosis day was conducted, and none of the suspicious corneas resulted in confirmed keratoconus. This finding was quite interesting from a statistical perspective, and further investigation about this finding is underway. A new addition to this screening was audiology. MESCA Foundation is dedicated to the entire field of medicine, and the Tashkent screening allowed the possibility of expanding the medical screening to another field.
Samarkand, Uzbekistan was the third city that a medical screening was conducted in June 2024, in collaboration with the local Agency of Social Protection, Tabassum and now with the Samarkand State Medical Institute. This screening was exemplary because the type of medical services was expanded beyond ophthalmology and audiology but now also dentistry. Dentistry and dental screenings were what the parents of the children with Down Syndrome were requesting most of all. Therefore, the MESCA Foundation strives to improve based on feedback of the patients and family members. Additionally, the MESCA Foundation worked together with the Agency of Social Protection to outreach to families with children with Down Syndrome that were not members of the Tabassum. This partnership between the private and public sectors demonstrated how to be more efficient with outreach activities, especially relating to children of special needs. Samarkand had 206 registered families, 136 children were screen, with a record number of patients who were screened; and three of the patients presented with suspicious corneas. The follow-up with the patient is underway.
Cooperation
Andijan State Medical Institute
In March 2024, MESCA and Andijan State Medical Institute signed a cooperation agreement in the field of medical education and research. The agreement implies the exchange of teachers, researchers and students, as well as the exchange of information and literature to develop the study of the field and medical practice. The cooperation will result in the development of new research ideas and modalities, clinical educational courses and surgical trainings, as well as public health initiatives.
