VISUAL OUTCOME OF CATARACT SURGERY IN A FIELD HOSPITAL OF SUB- SAHARAN AFRICA

Abstract

Objective: The aim of the study was to document the visual outcome of cataract surgery in the difficult setting of the field hospital and compare it with international standards.
Study Design: A quasi-experimental study.
Place and Duration of Study: Level II hospital United Nation mission, Sudan. Feb 2006 to Nov 2006
Materials and Methods: All the patients undergoing cataract surgery in our hospital were included in the study. The patients had complete general physical, systemic and ophthalmic examination before surgery. Most of the patients underwent phacoemulsification, or extra-capsular cataract extraction (ECCE) with posterior capsular intraocular lens (IOL) implantation. The patients were followed up after 1 day, 7 days, 6 weeks, and 3 months of surgery. The preoperative and postoperative visual acuity was compared.
Results: A total of 163 eyes in 145 patients were operated by one experienced Phaco surgeon and only those who completed 6 weeks follow up were included in the study (141 eyes in 136 patients). The average age of the patients at operation was 57 years (age ranged from 10-78 years). There were 88 (64.71%) females and 48 (35.29%) males. Most of the patients had senile cataracts. The majority of the patients had marked improvement in the vision at six weeks follow up. Preoperatively 112 of eyes (79.43%) had poor vision (best corrected acuity <3/60) compared to only 2 (1.41%) eyes postoperatively. A corrected vision of 6/18 or better was achieved in 124 (87.94%) eyes. An uncorrected vision of 6/18 or better was obtained in 102 eyes (72.34%) at their last follow up visit. Six patients (4.2%) had a poor visual outcome (best corrected vision less than 6/60).
Conclusion: Cataract extraction with IOL implantation gives good visual results even in the field hospital settings provided it is performed by experienced surgeon with good team support.