1. Outcomes of cataract surgery performed by non-physician cataract surgeons in remote North Cameroon.
- Author
-
Fortané M, Bensaid P, Resnikoff S, Seini K, Landreau N, Paugam JM, Nagot N, Mura T, Serrand C, Villain M, and Daien V
- Subjects
- Aged, Cameroon, Clinical Competence, Cross-Sectional Studies, Delivery of Health Care organization & administration, Female, Humans, Intraoperative Complications, Male, Middle Aged, Postoperative Complications, Prospective Studies, Risk Factors, Visual Acuity, Cataract Extraction methods, Health Personnel standards, Ophthalmology organization & administration
- Abstract
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., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2019
- Full Text
- View/download PDF