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Outcomes of cataract surgery performed by non-physician cataract surgeons in remote North Cameroon
  1. Magali Fortané1,
  2. Philippe Bensaid2,
  3. Serge Resnikoff3,4,
  4. Kali Seini5,
  5. Nathalie Landreau6,
  6. Jean-Michel Paugam2,
  7. Nicolas Nagot7,
  8. Thibault Mura7,8,
  9. Chris Serrand7,
  10. Max Villain1,
  11. Vincent Daien1,8,9
  1. 1 Department of Ophthalmology, Gui De Chauliac Hospital, Montpellier, France
  2. 2 Ophtalmo Sans Frontières, Luçon, France
  3. 3 Brien Holden Vision Institute, University of New South Wales, Sydney, Australia
  4. 4 Organisation Pour la prévention de la Cécité (OPC), Paris, France
  5. 5 Ophtalmo Sans Frontières, Lagdo, Cameroon
  6. 6 Ophtalmo Sans Frontières, Garoua, Cameroon
  7. 7 Department of Medical Information, La Colombière Hospital, Montpellier, France
  8. 8 INSERM (Institut National de la Santé Et de la Recherche Médicale), Montpellier, France
  9. 9 The Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, Australia
  1. Correspondence to Professor Vincent Daien, Department of Ophthalmology, Gui de Chauliac Hospital, Montpellier 34295, France; vincent.daien{at}


Objective To report the outcomes of cataract surgery performed by non-physician cataract surgeons due to lack of ophthalmologists in remote areas of North Cameroon.

Design Prospective cohort study.

Setting The main centre of the non-governmental organisation Ophtalmo Sans Frontières in Lagdo.

Participants and interventions Age-related cataract surgery performed between 28 November 2016 and 17 May 2017.

Main outcomes measures The main outcome measure was presenting visual acuity (PVA) 1–4 weeks after surgery, classified according to the WHO as good (PVA ≥6/18), borderline (PVA 6/60–6/18) and poor (PVA <6/60). The WHO definition of blindness (visual acuity <3/60) and severe visual acuity (visual acuity 3/60–6/60) was used to assess the proportion of patients with a change in WHO category.

Results We included 474 eyes of 474 patients; the mean (SD) age was 63.9 (15) years (42.2% female). At 1–4 weeks after surgery, the surgical outcome was good for 170 patients (41.1%), borderline for 213 (51.5%) and poor for 31 (7.5%). In all, 224 patients (47.2%) had blindness or severe visual impairment before cataract surgery and 22 (5.3%) at 1–4 weeks after surgery. Poor visual outcome was associated with older age (p=0.018), preoperative blindness or severe impairment (p=0.012) and surgical complications (p=0.019).

Conclusion Blindness and severe visual impairment were significantly decreased in the early postoperative period. Poor outcomes were associated with older age, low preoperative binocular visual acuity and intraoperative complications. Non-physician cataract surgeons may compensate for the lack of ophthalmologists in remote areas of low-income and middle-income countries.

  • cataract surgery
  • non-physician cataract surgeon
  • prevention of blindness
  • vision 2020

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  • Contributors Conception or design of the work: PB, VD. Acquisition of data: KS, NL, J-MP. Analysis or interpretation of data: NN, TM, CS. Drafting the work or revising it critically for important intellectual content: MF, VD. Final approval of the version published: MF, PB, SR, KS, NL, J-MP, NN, TM, CS, MV, VD.

  • Funding MF had a travel grant from the Thea Foundation. The project was also supported by the NGO ‘Ophtalmo Sans Frontières’.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval The Ethics Committee of North and Extreme North Cameroon approved this study on 13 November 2016, and the study was conducted in accordance with the tenets of the Declaration of Helsinki.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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