Low-cost high-volume extracapsular cataract extraction with posterior chamber intraocular lens implantation in Nepal
Section snippets
Materials and methods
The results of high-volume cataract surgery performed at both an eye hospital (Tilganga Eye Centre) and a remote eye camp setting (Chaughada) in Nepal are presented. All patients in both surgical venues received treatment following the same protocol and surgical technique. The technique was developed through the combined efforts of Dr. Sanduk Ruit of the Tilganga Eye Centre in conjunction with Dr. Fred Hollows and the Medical Directorate of the Fred Hollows Foundation of Australia. The
Results
The best preoperative visual acuities for the 62 consecutive patients from the Tilganga Eye Centre, with an average age of 63.4 years, were measured using both Snellen Letter Acuity and Illiterate E Charts. All of the patients returned for a follow-up at 2 months after surgery. Results from the Tilganga Eye Centre are listed in Table 1. There were no major surgical complications in this study group, but after surgery it was documented that there was one case each of macular scarring from
Discussion
The effectiveness of a simple technique for performing low-cost, high-volume cataract surgery in the developing world is shown. In addition to the 62 consecutive cases from this study, 6826 surgeries with IOL implantation have been performed at the Tilganga Eye Centre in the 2 years from January 1996 to December 1997 using the same method. Of this group, only two patients (0.029%) developed infectious endophthalmitis. The technique has also been used in 26 eye camps in Nepal and Tibet from 1992
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Dr. Tabin has no financial interest in the Fred Hollows Foundation of Sydney, Australia, or the Fred Hollows Intraocular Lens Factory in Nepal. All travel to and from Nepal is done on a voluntary basis, with Dr. Tabin paying all of his own expenses. Dr. Ruit, Dr. Paudyal, and Dr. Gurung are full-time employees of the Tilganga Eye Centre. The Tilganga Eye Centre runs the Fred Hollows Intraocular Lens Laboratories in Nepal and has received support from the Fred Hollows Foundation. (The Fred Hollows Foundation is a community-based, nongovernment organization. The foundation was formally launched in Sydney in 1992 with the aim of raising funds to continue the work of Professor Fred Hollows and his quest to reduce the huge backlog of cataract blindness and provide equality of access to healthcare to the developing world.)