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British Journal of Ophthalmology 2005;89:1079-1083; doi:10.1136/bjo.2004.063479
Copyright © 2005 by the BMJ Publishing Group Ltd.

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WORLD VIEW

Outcomes of high volume cataract surgeries in a developing country

R Venkatesh1, R Muralikrishnan2, Linda Civerchia Balent3, S Karthik Prakash2, N Venkatesh Prajna1

1 Aravind Eye Hospital, 1 Anna Nagar, Madurai-625 020 Tamil Nadu, India
2 Lions Aravind Institute of Community Ophthalmology, 72, Kuruvikaran Salai, Gandhi Nagar, Madurai-625 020 Tamil Nadu, India
3 Eye Care and Surgery Center of Fort Lauderdale, 1110 SE 4th Street, Ft Lauderdale, FL 33301, USA

Correspondence to:
Correspondence to:
Linda Civerchia Balent
MD, Eye Care and Surgery Center of Fort Lauderdale, 1110 SE 4th Street, Ft Lauderdale, FL 33301, USA; dralvan{at}msn.com


ABSTRACT
Aim: To analyse the outcome of high volume cataract surgery in a developing country, community based, high volume eye hospital.

Methods: In a non-comparative interventional case series, the authors reviewed the surgical outcomes of 593 patients with cataract operated upon by three high volume surgeons on six randomly selected days. There were 318 female (54%) and 275 male (46%) patients. Their mean age was 59.57 (SD 10.13) years. The majority of the patients underwent manual small incision cataract surgery (manual SICS). Extracapsular cataract extraction with posterior chamber intraocular lens (ECCE-PCIOL) and intracapsular cataract extraction (ICCE) were also done on a few patients as clinically indicated.

Results: Best corrected visual acuity of >=6/18 was achieved in 94% of the 520 patients who could be followed up on the 40th postoperative day (88% follow up rate). Intraoperative and immediate postoperative complications as defined by OCTET occurred in 11 (1.9%) and 75 (12.6%) patients, respectively. Average surgical time of 3.75 minutes per case (16–18 cases per hour) was achieved. Statistically significant risk factors for outcomes were found to be age >60, sex, and surgeon.

Conclusion: High volume surgery using appropriate techniques and standardised protocols does not compromise quality of outcomes.


Abbreviations: BCVA, best corrected visual acuity; deff, design effects; ECCE, extracapsular cataract extraction; ICCE, intracapsular cataract extraction; OCTET, Oxford Cataract Treatment Evaluation Team; PCIOL, posterior chamber intraocular lens; PL, perception of light; SICS, small incision cataract surgery; UCVA, uncorrected visual acuity

Keywords: cataract surgery; developing country


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