Journal of Clinical and Experimental Ophthalmology
Open Access

Abstract

Outcome of the Manual Small Incision Cataract Surgery at the Base Hospital and Improved Surgical Eye Camps in Nepal: A Prospective Observational Comparative Study

Ramesh Chandra Bhatta, Sannapaneni Krishnaiah, Bidya Prasad Pant and Yuddha Dhoj Sapkota

A prospective observational comparative case study on the outcome of manual small incision cataract surgery (SICS) at the base hospital and improved surgical eye camps in FarWestern region in Nepal was conducted during June and November 2010. A total of 445 cataract patients aged above or equal to 40 years without coexisting ocular pathologies were recruited and operated with SICS. Patients were examined on the first day of surgery and followed up after one week and again after 4 to 6 weeks. The uncorrected and best corrected visual acuity (VA) with pinhole was recorded on day one and after one week. Refraction and kerotometry was done at 4 to 6 weeks follow up. Comparison of the uncorrected and best corrected postoperative visual acuity at base hospital with surgical eye camps was done at 4 to 6 weeks. Of the 221 cases operated at base hospital 189 (85.5%; 95% Confidence Interval (CI): 80.9 - 90.2) and of the 224 cases operated at camps 202 (90.2%; 95% CI: 86.3 - 94.1) were available at the follow up period of 4 to 6 weeks. The VA improved significantly at one week and 4 to 6 weeks follow up in both the groups. A comparative analysis of two surgical set-ups showed no significant difference of uncorrected (p = 0.400) and best corrected (p = 0.580) VA in the operated eye at 4 to 6 weeks follow up time respectively. The surgical complications were low in both the settings; 8 out of 221 (3.6%; 95% CI: 1.2 - 6.1) at base hospital and 3 out of 224 (1.3%; 95% CI: 0.0 - 2.8) in camps and did not differ significantly (p = 0.580). Cataract surgery at surgical eye camps with improved settings offers safe and noticeably good outcome, equivalent to that of the hospital set-up if the appropriate surgical protocol is maintained and surgery is performed by an experienced ophthalmic surgeon in the western region in Nepal.