World view
Outcomes of extracapsular surgery in eye camps of eastern Nepal
J K Shresthaa, Y M Pradhanb, T Snellingenc
a BP Koirala Lions
Centre for Ophthalmic Studies, Kathmandu, Nepal, b Lions Eye Care Centre, Kathmandu, Nepal, c Institute of Clinical and
Community Medicine, University of Tromsø, 9037,Tromsø, Norway
Correspondence to: Torkel Snellingen torkel.snellingen{at}ism.uit.no
Accepted for publication 16 February 2001
BACKGROUND
Extracapsular
cataract (ECCE) surgery is becoming increasingly popular in surgical
eye camps of developing countries. This study assesses the outcome of
166 eyes at 6 weeks and 14 and 32 months after ECCE with and without
implantation of intraocular lens in refugee camps of eastern Nepal.
METHODAll patients
operated on in seven refugee camps during the 3 years before the
assessment were included in the study population. Visual acuity,
examination of anterior segment and posterior segments, and grading of
capsular opacification using a standardised grading system were performed.
RESULTSOf 166 eyes
examined, of which 49.4% were aphakic, 58% of eyes had very poor
functional vision (WHO severe visual impairmentVA <6/60). After
refraction and best correction 19% still had very poor vision. The
aphakic eyes had both significantly poorer functional and best
corrected vision than the pseudophakic eyes. In patients with intact
posterior capsule clinically significant posterior capsular
opacification was observed in over 10% of eyes at 14 months and
30% at 32 months.
CONCLUSIONIt was
found that ECCE surgery in eye camps in this setting gave unacceptable
outcomes because of a high rate of capsular rupture and posterior
capsular opacification. Careful consideration should be given to the
quality of the surgical set up and available resources and
possibilities of postoperative follow up when ECCE is introduced in eye camps.
© 2001 by British Journal of Ophthalmology
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