Audit of outcome of an extracapsular cataract extraction and posterior chamber intraocular lens training course

Abstract

Background-A training course for cataract surgery with intraocular lens implantation was organised in April 1997 at the National Eye Centre, Kaduna, Nigeria. Operations were performed by six Nigerian consultant ophthalmologists under the supervision of two surgeons from Aravind Eye Hospital, India. Methods-A total of 175 eyes with uncomplicated cataracts were operated on after careful selection. All but six patients had extracapsular cataract extraction with posterior chamber intraocular lens insertion during the training programme. Results-The mean age of the patients at operation was 54.2 years. One hundred and forty five of the operated eyes (85.8%) were blind before surgery of which six (3.6%) remained blind postoperatively. An uncorrected visual acuity of 6/60 or better was achieved in 87.3% eyes after surgery. Forty one patients (24.3%) were blind before surgery, two of whom (1.2%) remained blind afterwards. The most common intraoperative complication was posterior capsular rent which occurred in 10 eyes (5.7%); striate keratopathy/corneal oedema and cortical remnant were the most common immediate postoperative complications, occurring in 44.6% and 8.0%, respectively. Conclusion-With adequate surgical skills, extracapsular cataract extraction with posterior chamber intraocular lens implantation oVers good visual rehabilitation even under training conditions. (Br J Ophthalmol 2000;84:848-851) Cataract continues to be the major cause of blindness worldwide and the major cause of treatable blindness in Nigeria, accounting for about 50% of blind patients.

Final visual outcome following re exploration of cataracts performed by trainee surgeons in India0

“…Surgical complications were more common among doctors who are undertrained, as indicated in earlier reports. [6][7][8] Similar findings have been reported from training centers that have trainees with different skill levels. [6][7][8] Visual rehabilitation is difficult in cases of aphakia.…”

“…[6][7][8] Similar findings have been reported from training centers that have trainees with different skill levels. [6][7][8] Visual rehabilitation is difficult in cases of aphakia. Long-term contact lens use may be attempted, but this is not a practical solution, as it is associated with numerous problems.…”

Demographic characteristics and visual status of patients undergoing cataract surgery at a tertiary hospital in Kano, Nigeria

“…[ 6 ] By contrast, studies conducted in other parts of Nigeria in Ago Iwoye, Kaduna, Orlu, and Port Harcourt showed slight male predominance. [ 7 8 9 10 ] A hospital-based study conducted in Auckland, New Zealand, and Lahan district of Nepal, respectively, also reported female predominance in uptake of cataract surgery. [ 11 12 ] This higher number of females in our study may be due to increasing awareness about cataract surgical services in our facility from community health talks, free eye camps conducted at various times or from increased financial support from the friends of Hospital or other philanthropists.…”

<p>Outcomes and Associated Factors of Cataract Surgery Among Adults Attending a Tertiary Hospital in Addis Ababa, Ethiopia</p>

“…20 Poor visual outcomes following extracapsular cataract extraction (ECCE) with IOL have been reported in 9.7-15.5% of operated eyes in multiple hospital-based reports from Nigeria. [21][22][23] Another study from Gondar (northwest Ethiopia) showed good, borderline and poor visual outcomes in 26.6%, 28.9% and 44.5% of operated eyes, respectively. 24 That we saw relatively better outcomes in our study might be due to the fact that the majority of surgeries were performed by senior ophthalmologists and the final vision assessment being at 6-8 weeks (versus 1-4 weeks for two-thirds of patients in the Gondar study).…”