Safety, efficacy and cost-effectiveness of consecutive bilateral cataract surgery on two successive days in tribes at base hospital through community outreach program: A prospective study of Aravali Mountain, North West India

Abstract

Purpose:The aim of the study was to evaluate the safety and efficacy of consecutive bilateral cataract surgery (CBCS) on two successive days in a single hospital visit.Methods:Prospective study was conducted on 565 patients of various tribes of hilly area of West Rajasthan who had come to our hospital through community outreach programmed (CORP) between January 2015 and March 2016. Patients with significant bilateral cataract without any other ocular morbidity were advised bilateral manual small incision cataract surgery on two consecutive days. Intraoperative and postoperative complications were evaluated, and follow-up was done at 1 week, 1 month, and 3 months.Results:Out of 565 patients, 519 underwent both eye surgeries. Second eye surgery was deferred for a later date in 46 cases. Because of intraoperative and postoperative complications in the first eye, 31 had delayed surgeries while 15 patients refused to undergo another eye surgery either because of postoperative day 1 poor vision in the operated eye due to retinal pathologies (n = 8) or unwillingness (n = 7). The second eye surgery was performed for 519 patients, out of whom six had intra or postoperative complications. At 1 month follow-up, four patients had unilateral cystoid macular edema and three had prolonged postoperative inflammation. At 3 months, all patients were satisfied and had no complications. None of the patients had sight-threatening complications such as endophthalmitis, corneal decompensation, or vitreoretinal complications.Conclusion:CBCS may be considered safe and cost-effective for patients living in remote locations, dependent on CORP.

Катарактасы Бар Науқастарға Офтальмологиялық Көмек Көрсетуді Ұйымдастыруды Оңтайландыру

“…Процесс оптимизации требуется так же на этапе после полученного лечения в стационарных и/или амбулаторных условиях. Множество исследований показали значительное снижение как расходов в вопросах менеджмента катаракты, так и развитие послеоперационных осложнений, при улучшенных условиях администрации [51][52][53][54][55][56][57][58]. Так, например, Borkar et al выявили, что послеоперационные обследования на 1-й неделе потенциально могут проводиться по мере необходимости в соответствующей подгруппе пациентов после операции по удалению катаракты [59].…”

“…Вопросы оптимизации после факоэмульсификации катаракты были и далее рассмотрены вышеуказанными авторами, но уже в рамках внедрения стандартного набора вопросов для пациентов, получивших хирургическое лечение [60]. Оптимизация послеоперационного наблюдения за катарактой повысит эффективность офтальмологической помощи и снизит ненужные затраты ресурсов пациентов и врачей [54][55][56][57]58]. Внедрение стандартного набора вопросов, описанного выше, дает офтальмологам возможность отказаться от повторных посещений пациентов, при которых маловероятно изменение протокола по ведению послеоперационной обсервации.…”