Br J Ophthalmol 1999;83:343-346 ( March )
Evaluation of visual outcome of cataract surgery in an Indian eye
camp
Harpreet Kapoor,a
Arin Chatterjee,a
Richard Daniel,a
Allen Fosterb
a Christian
Medical College and Hospital, Ludhiana, Punjab, India, b Institute
of Ophthalmology, London
Correspondence to: Allen Foster, International Centre for Eye Health, Institute of
Ophthalmology, 11-43 Bath Street, London EC1V 9EL.
Accepted for publication 30 September 1998
AIM
To evaluate the
results of cataract surgery performed in a rural Indian eye camp.
METHODThe pre-
and postoperative visual acuities and surgical complications were
recorded prospectively in 6383 eyes undergoing cataract extraction for
age related cataract in rural eye camps held in northern India in
1993-4. The best visual acuity and cause of poor outcome were recorded
on 3908 eyes seen at 6 weeks' follow up.
RESULTSOf 6383 operated eyes 94.8% had a visual acuity of less than 3/60
preoperatively, and 41% of the procedures were performed on patients
who were bilaterally blind (less than 3/60 better eye). At discharge
with standard aphakic spherical spectacles, 11.3% of eyes had an
acuity of less than 6/60 (poor outcome), and 25.9% had an acuity of
6/18 or better. At 6 weeks' follow up 3908 eyes were examined
(61.2%), of which, with best correction, 4.3% had poor outcome
(acuity of less than 6/60) and 79.9% obtained 6/18 or better.
Pre-existing eye pathology was responsible for poor outcome in 3.0% of
eyes and surgical complications in 1.3% of eyes, of which corneal
decompensation was the major cause (0.5%). In 237 eyes which received
an intraocular lens implantation (IOL) in the camp, the visual acuity
at discharge was 6/18 or better in 44.5% of eyes improving to 87.9%
in the 157 eyes which were seen at 6 weeks' follow up. Poor outcome
(less than 6/60) was seen in 5.7% of the eyes with an IOL at discharge
improving to 1.9% at follow up.
CONCLUSIONThis
evaluation suggests that it is possible to obtain acceptable results
from cataract extraction with experienced ophthalmologists in well
conducted Indian eye camps. Better correction of aphakia at discharge
from the camp would improve the immediate visual results, which is
important as a significant number of patients do not return for follow
up. The use of posterior chamber IOLs in the eye camp by experienced
ophthalmologists, appeared to give satisfactory results, although
further evaluation with a larger series of cases and more surgeons is
required before it can be recommended.
Keywords:
visual outcome;
cataract
surgery;
India;
eye camps
© 1999 by British Journal of Ophthalmology
