Cataract surgery in camp patients: a study on visual outcomes

Pai, Shobha G; Kedia, V; Shruthi, K; Pai, Aravinda

doi:10.3126/nepjoph.v3i2.5270

Cited by 9 publications

(5 citation statements)

References 14 publications

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“…Even though the postoperative UCVA of both surgical techniques did not match the WHO recommended standards (8), because many post-cataract patients in developing countries do not wear or cannot afford spectacles after surgery and thus rely on their UCVA to carry out their everyday functions (9,15), it is worth stating that in the current study, UCVA at 4-6 weeks' follow-up suggested that PHACO reduced the dependency of many patients on distance spectacle correction or other interventions to correct ametropias compared to MSICS. The significantly higher total astigmatic change in the MSICS group corroborates findings reported by some studies mentioned in the literature (11,16,17). This difference in total astigmatic change between the two surgical techniques could be explained by the longer incision in MSICS.…”

Section: Discussionsupporting

confidence: 89%

Comparison of the Outcomes of Manual Small Incision Cataract Surgery (MSICS) and Phacoemulsification (PHACO) in Ghana

Kyei¹,

Zaabaar²,

Assiamah³

et al. 2021

Ann Afr Surg.

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Background: The growing middle-class population of Ghana has seen more people being employed in visually demanding occupations and hence there is an increased desire for quality post-cataract surgical visual outcomes. This study aimed at comparing the outcomes of manual small incision cataract surgery (MSICS) and phacoemulsification (PHACO) among Ghanaians. Methods: This was a retrospective cross-sectional study in which records of patients who underwent MSCIS or phacoemulsification by the same surgeon were reviewed. Results: Medical records of 248 eyes were reviewed, out of which 132 underwent PHACO and 116 had MSICS. A significant number of the PHACO group had good (6/6–6/18) uncorrected visual acuity (UCVA) compared to the MSICS group at 1–2 weeks follow-up (p = 0.003) and 4–6 weeks follow-up (p = 0.002). MSICS resulted in a higher total astigmatic change compared to PHACO (p < 0.001). The PHACO grouphad a higher number of postoperative complications compared with the MSICS group (p <0.001). Postoperative borderline and poor uncorrected visual acuity were associated with age, total astigmatic change, and postoperative complications. Conclusion: The postoperative UCVA outcomes at 4–6 weeks’ follow-up indicates that PHACO resulted in noticeably less spectacle dependency when compared to MSICS.

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Section: Discussionsupporting

confidence: 89%

Comparison of the Outcomes of Manual Small Incision Cataract Surgery (MSICS) and Phacoemulsification (PHACO) in Ghana

Kyei¹,

Zaabaar²,

Assiamah³

et al. 2021

Ann Afr Surg.

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“…[ 20 ] found that 89.3% of patients had visual acuity between 6/6 and 6/18 after cataract surgery. [ 15 ] Our study shows that out of 315 patients who underwent cataract surgery, 10 (3.16%) patients had PCR with vitreous loss in which 5 (1.58%) were implanted with IOL but the remaining 5 (1.58%) were planned for secondary IOL due to inadequate ciliary sulcus support. Out of 10 surgeries having PCR, nine were performed by resident doctors.…”

Section: Discussionmentioning

confidence: 91%

Visual outcome and complications of small-incision cataract surgery

Jha

Priya²,

Solu

et al. 2023

Oman Journal of Ophthalmology

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BACKGROUND AND OBJECTIVES: Small-incision cataract surgery (SICS) is a commonly performed procedure in developing countries. It does not require expensive machines and can be safely done in high-volume centers also yielding good visual outcomes in the majority of patients. The objective of our study was to assess visual outcomes after SICS conducted at a tertiary care center in South Gujarat and also assessment of various complications responsible for poor visual outcomes. MATERIALS AND METHODS: Three hundred and fifteen cataract patients were included in the study. An assessment of intraoperative and postoperative complications was done. Postoperative visual acuity assessment was done and compared with preoperative visual acuity of the patient and factors responsible for poor visual outcomes were assessed. A follow-up examination was done on days 1, 3, 7, 14, and 30. RESULTS: The mean age group of patients was 59.3 years. Females were slightly more (53.3%) in number as compared to males. The most common surgical complication encountered were striate keratopathy (6.35%), followed by iris damage (5.71%), posterior capsular rent (PCR) with vitreous loss (3.14%), hypotony (0.63%), intraocular lens decentration (0.63%), surgery-induced astigmatism (0.63%), choroidal detachment (0.32%), endophthalmitis (0.32%), and hyphema (0.32%). About 95.87% of patients had vision better than 6/18. Complications associated with poor visual outcome (<6/18) were PCR, endophthalmitis, choroidal detachment, and surgical-induced astigmatism. CONCLUSIONS: Although SICS can have a significant chance of complications, good visual outcomes can be attained in the majority of patients.

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“…Despite these factors, the outcomes between larger, recognised cataract units and cataract camps are not dissimilar with respect to visual acuity and complication rates. 19 This might be explained by the fact that the same local ophthalmic professionals that operate in larger units, or privately, may undertake charitable work in cataract camps. There is also an increasing influx of foreign ophthalmologists that are running charitable organisations and outreach programmes to contribute to the improvement of reversable causes of blindness.…”

Section: Discussionmentioning

confidence: 99%

A National Survey of Endophthalmitis Prophylaxis during Cataract Surgery in Pakistan: A 2020 Perspective

et al. 2021

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Purpose: To assess national endophthalmitis prophylaxis practice patterns during phacoemulsification surgery in Pakistan. Study Design: Cross sectional survey. Place and Duration of Study: Eye units registered with the British Pakistani Ophthalmic Society (BPOS) between September and November 2020. Methods: A survey-based cross sectional study was conducted in Pakistan between September and November 2020. A proforma was designed using a survey client (Survey Monkey) and distributed to the eye units registered with the British Pakistani Ophthalmic Society (BPOS). The survey explored demographic factors, current antibiotic prophylaxis practice during cataract surgery and audit practice in Pakistan. Results: A total of 339 respondents completed the survey. The survey was representative of ophthalmic surgeons working in the major provinces of Pakistan. A small majority of ophthalmic surgeons provided some form of routine antibiotic prophylaxis (n = 140, 53.8%). Povidone iodine 5% (PVP-I) solution on skin and in the conjunctival sac proved the most popular protocol (n = 163, 66.3%). This was followed by immediate postoperative topical antibiotics (n = 101, 41.1%). Intracameral antibiotic prophylaxis accounted for less than half of current antibiotic practice during cataract surgery in Pakistan (n=99, 40.3%). Most of the respondents did not conduct any audit regarding endophthalmitis (n = 119, 55.6%). Conclusion: Our survey provides an up-to-date view on the state of antibiotic prophylaxis during cataract surgery in Pakistan and highlights several areas for improvement. This includes policy changes to increase adherence to gold standard antibiotic prophylaxis guidelines, improvement in transparency of surgical outcomes and to audit current postoperative outcomes. Key Words: Acute postoperative endophthalmitis, Surgical wound infection, Antibiotic, Cataract, Pakistan.

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Cataract surgery in camp patients: a study on visual outcomes

Abstract: High quality cataract surgery with a low rate of intra-operative complications and good visual outcome can be attained in camp patients operated in the base hospitals, thus justifying more similar screening camps to clear the vast cataract backlog.

Cited by 9 publications

References 14 publications

Comparison of the Outcomes of Manual Small Incision Cataract Surgery (MSICS) and Phacoemulsification (PHACO) in Ghana

Comparison of the Outcomes of Manual Small Incision Cataract Surgery (MSICS) and Phacoemulsification (PHACO) in Ghana

Visual outcome and complications of small-incision cataract surgery

A National Survey of Endophthalmitis Prophylaxis during Cataract Surgery in Pakistan: A 2020 Perspective

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