A flying team of eye surgeons ends its fifth trip to Cuba, leaving behind -- as it does elsewhere -- medical expertise for host doctors and patients treated free of charge.

BY LARRY LUXNER
Special to The Herald

HAVANA - Eleven-year-old Giselle Pérez Elias lay in her hospital bed, doodling on an electronic sketch pad as she awaited cataract surgery on her right eye. Down the hall, doctors were operating on a 7-year-old girl, their powerful microscopes linked to video cameras broadcasting the surgery to 150 eye specialists in a nearby classroom.

A normal day for any eye hospital -- except that the procedures were taking place inside a U.S.-based white jet parked at Havana's international airport.

The DC-10 ''flying eye hospital'' is owned and operated by Orbis International, a New York-based nonprofit group that seeks to eradicate preventable blindness worldwide by 2020.

RANGE OF MALADIES

Orbis and its 42-member team of physicians recently wrapped up a four-week program in Havana and eastern Manzanillo, treating patients for everything from cataracts to glaucoma. Surgeries took place on the plane and at nearby hospitals, in an effort coordinated with Cuba's Ministry of Public Health.

Brooke Johnson, Orbis' communications manager, said the trip marked the fifth year Orbis has visited Cuba since 1991, averaging four specialized procedures a day on the DC-10 and three to five in land-based hospitals.

''The whole point of Orbis is not to come in and do 500 cataract surgeries in three days,'' she said. ``We do quality surgeries to teach new techniques or affirm techniques that are currently being used. In Cuba, the problem is access to international experts.''

That's why Orbis has some of the world's leading ophthalmologists and eye surgeons on its staff, including volunteers from Argentina, Canada, Israel, Great Britain and the United States. Since its founding in 1982, Orbis estimates it has trained more than 63,000 medical professionals through programs in 72 countries aboard the DC-10 and in hospital-based programs in 82 countries.

Carlos Solarte, the DC-10's Colombian-born chief ophthalmologist, said the organization first came to Cuba at the invitation of the island's quasi-governmental Ophthalmic Society. He said Cuba has about 40,000 cases of blindness that could have been prevented.

Orbis' DC-10, the only airborne medical facility of its kind, has a complete operating room, recovery room, technical training center, and a 48-seat classroom equipped with an audiovisual system.

Cuban President Fidel Castro and former President Bush have visited the aircraft on separate occasions, though Orbis tries to avoid becoming entangled in political or religious controversies.

But when it comes to Cuba, it's hard for Orbis completely to avoid controversy.

Marcelino Río Torres, director of Havana's Ramón Pando Ferrer Ophthalmological Hospital, alleged that when Orbis first proposed coming to Cuba in 1991, the U.S. State Department held up its permit for several months.

He also alleged that Miami's Bascom Palmer Eye Institute agreed in 1995 to host three Cuban doctors for 15-day training sessions, but Cuban exiles ''threatened to put a bomb in the hospital'' and the agreement was canceled. Bascom Palmer spokeswoman Cynthia Birch said her staff had no recollection of any such bomb threats.

More recently, Cuban government officials and the public have welcomed the return trips.

''With Orbis, we have the opportunity to have a scientific exchange with the United States,'' said Río Torres, whose Havana hospital employs 60 ophthalmologists and sees about 1,000 patients a day. ``The objective is not to operate on patients, but to pass along training and to demonstrate the latest techniques.''

CHOOSING THE CASES

Solarte said Orbis decides which specific cases it will handle on the basis of the topics and techniques that doctors in the host country want to learn.

''In Manzanillo, they wanted to learn more about adult cataracts, so we did two full weeks of surgery for cataracts, glaucoma and eyelid disorders,'' he said.

During the Havana surgeries, several dozen doctors in the plane's coach section watched the procedures on a large-screen TV. In a waiting room in the airport terminal, many more watched a video hookup. Orbis doctors speaking in English and Spanish narrated the procedures, pausing frequently to take questions from the audience.