High-volume surgery in developing countries

Yorston, David

doi:10.1038/sj.eye.6701966

Cited by 65 publications

(66 citation statements)

References 27 publications

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“…Its success lies in its quick recovery, reduction of post-operative (against-the-rule) astigmatism, costeffectiveness and high success rates [18]. Additionally, it is associated with a lower incidence of fibrinous anterior uveitis and rounder pupils than standard ECCE surgery.…”

Section: Discussionmentioning

confidence: 97%

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

Sherwin

Dean

Schaefers³

et al. 2012

Int Ophthalmol

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The aim of this study was to investigate the outcomes of sutureless, manual small-incision cataract surgery (SICS) in rural sub-Saharan Africa using standard intraocular lenses (IOLs). In order to assess the quality of surgery, we prospectively evaluated the visual outcomes of 1455 consecutive cataract operations performed in 2006 in patients ≥40 years at Nkhoma Eye Hospital, Malawi. All operations used standard 22-dioptre IOLs without pre-operative biometry. Outcomes were categorised according to the World Health Organization criteria, and causes of a poor outcome were recorded. Mean age of patients was 71.5 ± 9.5 years, and 53 % were female. Pre-operatively, 64 % of eyes had a visual acuity (VA) <6/60, and 41.3 % of eyes were blind (VA < 3/60). Without correction (uncorrected VA), nearly eighty percent (78.7 %) achieved a 'good' outcome (VA 6/6-6/18), 19.8 % were 'borderline' (VA < 6/18-6/60), and 1.5 % had a poor (VA < 6/60) outcome. With pinhole-correction, the proportion of good outcomes increased to 89.4 %, and poor outcomes decreased to 0.9 %. Poor outcomes were most commonly due to ocular co-morbidities (54.5 %) and refractive error (36.4 %). Older age and pre-operative blindness were strongly associated with borderline or poor visual outcomes. The most common surgical complication was posterior capsule tear (without vitreous loss). In a rural African environment, using standard IOL power plus SICS can lead to a high proportion of good outcomes and a low frequency of surgical complications. A comparative study is required to determine if any additional benefit in visual outcomes can be gained by the addition of biometry.

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Section: Discussionmentioning

confidence: 97%

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

Sherwin

Dean

Schaefers³

et al. 2012

Int Ophthalmol

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“…Cost is a major barrier to uptake of CSS in resource-limited economies, including the WA subregion. [13][14][15][16][17] Social marketing of CSS most likely would boost uptake of CSS and raise CSR. This involves creating demand for CSS by getting cataract patients informed about where to get quality, accessible and affordable CSS.…”

Section: Discussionmentioning

confidence: 99%

Trainee ophthalmologists′ opinions on ways to improve cataract surgical rate

2009

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Objective: To know the opinions of trainee ophthalmologists on ways to improve cataract surgical rate (CSR) with a view to having insight into actions that should be of high priority for achieving this improvement. Methods: A survey of 27 trainee ophthalmologists using structured self-administered questionnaire. Results: Most trainees had a positive view about actions towards raising CSR: Structured ophthalmic training-25 (92.6%), monthly cataract camps by eye departments in teaching hospitals-21 (77.8%), rural allowance for ophthalmologists-26 (96.3%) and welfare package for indigent cataract patients-21 (77.8%). Other actions included local production of cataract consumables-22 (81.5%), duty-free importation of ophthalmic materials-23 (85.2%), employment of ophthalmologists in the services of the state governments-24 (88.9%) and local governments-20 (74.1%), effective primary eye care-25 (92.6%) and marketing of cataract surgical services-23 (85.2%). However, only 16 (59.3%) trainees wanted fi rst ladies (wives of the president, governors and local government chairmen) to adopt cataract elimination as pet projects, and 24 (88.9%) opposed the introduction of cataract surgeons. Conclusion: Most trainees had positive perceptions about most actions that can raise CSR. However, top-priority actions to improve CSR were attractive rural allowance, structured training, resource availability, cost reduction and marketing of cataract surgical services. Multiple actions might be necessary to raise CSR.Keywords: Cataract surgical rate, opinion, priority actions, trainees RésuméObjectif: Pour connaître l'avis du stagiaire ophtalmologistes sur les moyens d'améliorer la cataracte Taux chirurgicale (CSR) avec une vue d'avoir un aperçu des actions qui Il convient de haute priorité. Méthodes: A enquête de 27 stagiaire structurés ophtalmologistes à l'aide de self-administered questionnaire. Résultats: La plupart des stagiaires avaient vue positif des actions vers la RSE: Structuré en ophtalmologie formation camp de la cataracte (92.6%), 25 fois par mois par les ministères de le oeil dans l'enseignement hôpitaux 21 (77.8%), rural l'allocation aux ophtalmologistes 26 (96.3%) et bien-être package pour les patients de cataracte indigentes 21 (77.8%). D'autres incluent local production de la cataracte consommables 22 (81.5%), franchise importation d'ophtalmique matériaux 23 (85.2%), l'emploi de l'ophtalmologiste dans les services d'état 24 (88.9%) et le gouvernement local (74.1%), 20 effi cace principal Eye Care 25 (92.6%), et 23 (85.2%), services de marketing de la cataracte chirurgicale. Toutefois, seuls 16 (59.3%) stagiaires voulaient première cataracte Mesdames à adopter élimination comme projets pour animaux familiers et 24 (88.9%) s'est opposé à l'introduction de la cataracte chirurgiens. Conclusion: Plupart stagiaires eu perception positive de la plupart des actions qui peuvent déclencher des entreprises. Toutefois, actions de priorité pour améliorer la RSE seront allocation rurale attrayante, structurée formation, de ...

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“…3 A major proportion of total blindness in India (81%) is constituted by cataract blinds. Yorston 4 has suggested that four barriers in limiting access to cataract surgery worldwide: Lack of knowledge, uncertainty over the quality of available services, transportation problems, and concerns over the cost of surgery. The present study was carried out to assess the knowledge, attitude and practices regarding cataract surgery.…”

Section: Introductionmentioning

confidence: 99%

Awareness and Attitude Regarding Cataract Surgery Among Senile Cataract Cases Attending Camps

2017

IJCRR

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Context: Study conducted in district of North Karnataka where majority of the population are illiterate and have poor access to treatment of cataract. People have different concepts regarding cataract Aims:The present study is an attempt to know the knowledge, attitude and practices regarding cataract surgery Settings and Design: All the camp cases screened during the period Dec-May 2012 from 6 neighboring villages for 6 months were included in the study. The data was collected by interview technique Methods and Material: A Cross-sectional study was carried over a period of 6 months. The results were analysed using proportion and chi-square test. Statistical analysis used:The results were analysed using proportion and chi-square test. Results:In the present study, 81% were illiterates and 50% were unemployed. Majority of them (67%) were females. The knowledge about cataract related to, 'at what age it occurs' and how it occurs was found statistically significant with relation to education. Regarding reasons for not getting surgery done, 64(21.3%) cases cited lack of escort as the reason, 148(49.3%) cases managed with existing eyesight, 49(16.3%) cases cited economic reasons. The socioeconomic status versus preference of surgery with or without lens found to be significant (p<0.001). Conclusions:There are lot of misconceptions regarding cataract and its surgery among the public. We need to explore their myths regarding cataract surgery and bridge the gap between their knowledge and the actual causes and thus prevent cataract blindness.

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High-volume surgery in developing countries

Cited by 65 publications

References 27 publications

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

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

Trainee ophthalmologists′ opinions on ways to improve cataract surgical rate

Awareness and Attitude Regarding Cataract Surgery Among Senile Cataract Cases Attending Camps

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