Outcome of cataract surgery at one year in Kenya, the Philippines and Bangladesh

Abstract

Adverse outcomes following cataract surgery were frequent in the three countries. Main causes were refractive error and preoperative comorbidities. Many patients are not attaining the outcomes available with modern surgery. Focus should be on correcting refractive error, through operative techniques or postoperative refraction, and on a system for assessing comorbidities and communicating risk to patients. These are only achievable with a commitment to ongoing surgical audit.

Outcomes of manual small-incision cataract surgery using standard 22 dioptre intraocular lenses at Nkhoma Eye Hospital, Malawi

“…Our most common causes of a poor outcome were ocular co-morbidities and URE. Similarly, ocular co-morbidities and URE were also considered to be the main causes of a poor outcome in a multi-national study performed in Kenya, Bangladesh and the Phillipines [22] although our duration of follow up was considerably shorter. In patients with advanced cataract, it is often difficult to assess the fundus, and three posterior segment co-morbidities were noted only after surgery.…”

Cataract surgery in developing countries

“…In Kenya, Bangladesh and Philippines, study was done to assess the outcome of cataract surgery in different centres over same period of time with preoperative and postoperative data. In 1-year follow-up study of operated patients, with PVA, good outcome was ranging from 65% to 81% and poor outcome was ranging from 7% to 15% [37]. With BCVA, good outcome was ranging from 77% to 87% and poor outcome was 7 to 13%.…”

“…In China, patients operated in provincial centres and specialized centres had better outcome than those operated in county hospitals [39]. In Bangladesh, the Philippines and Kenya, adverse outcomes were not related to age, sex, literacy, poverty or preoperative visual acuity [37].…”

Katarakt-Operationsergebnisse durch temporale Kleinschnitttechniken mit und ohne Phakoemulsifikation

“…Die Ergebnisse der Kataraktchirurgie in vielen Gegenden Afrikas entsprechen bislang nicht den Zielsetzungen der Weltgesundheitsorganisation (WHO; [12,13,22]), und es bedarf weiterer Anstrengungen, um die ehrgeizigen Ziele von Vision 2020 -nämlich alle Fälle von vermeidbarer Blindheit bis zum Jahre 2020 zu beseitigen -zu erreichen.…”

“…Unsere Ergebnisse sind mit Ergebnissen aus Studien aus dem Vereinigten Kö-nigreich, [2] China [20] und aus einem städtischen Zentrum in Indien vergleichbar [23] und übersteigen aktuelle Daten aus Afrika [12,13].…”