iapb 9 th general assembly hicc hyderabad 19 september 2012 long term visual outcome after cataract...

IAPB 9th General AssemblyHICC Hyderabad

19 September 2012

Long term visual outcome after cataract surgery in a district community eye care centre in rural Nepal

Sunu Dulal MD MSc (ICEH)

Nepal Netra Jyoti Sangh

Introduction

• >80% of the blind people live in rural community of the developing countries.

• Resources for the eye care service delivery remains at the cities.

• There are barriers for the people living in the community to come to the hospital

• Surgical Eye camps are still the most effective way to provide eye care services to the people in country like Nepal

Methodology

• Stratified cluster sampling, 24 clusters • After a random start, 50 individuals aged 50+ were

enumerated and examined sequentially. All those who had undergone cataract surgery for longer than a year and consented for the study were included for the study.

• VA were recorded. Those with VA of <6/18 were dilated and examined by ophthalmologist to find cause for poor vision. 1,200 individuals aged 50 years and above were enumerated and 144 eyes were included for the study

Findings

Visual Acuity Presenting VA BCVA

6/6-6/18 Good 95 (66.0%) 116 (80.6%)

<6/18-6/60 Borderline 18 (12.5%) 13 (9.0%)

<6/60 Poor 31 (21.5%) 15 (10.4%)

Causes of Poor visual outcome:Pre existing ocular disease (Selection): 10 (66.7%) Surgical Complication (Surgery): 3 (20%)Long term complication (Sequelae): 2 (13.3%)

Conclusions

• Eye camps are still one of the effective way to provide surgical services in remote places

• Case selection very important• Experienced surgeon, strict adherence to the

surgical protocols and periodic follow up are the major contributing factors for the success of the eye camps

Thank You

Before Surgery After Surgery