Die Ophthalmologie · 2025
[Cataract surgery in sub-Saharan Africa-Possibilities and limits].
Аннотация на английскомСтатьяНазвание и аннотация: Перевод в очереди
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Irle Stephan, Irle Hanne, Paes Rohil, Noë Piet
Аннотация
BACKGROUND: The importance of cataract surgery for the treatment of visual impairment and blindness is as uncontroversial as the cost-effectiveness of the procedure. In terms of quality, there are almost no published case series of cataract operations in sub-Saharan Africa that meet the World Health Organization (WHO) guidelines for postoperative visual acuity.
OBJECTIVE: The results after cataract surgery at a publicly accessible tertiary care eye clinic in Rwanda are presented and compared with standardized results from an eye clinic in Germany (AKW).
METHODS: Data from 100 consecutive eyes (manual small incision cataract surgery, MSICS-Rwanda, Phaco-Rwanda, Phaco-AKW) were retrospectively evaluated. The results were compared with each other and with WHO guidelines.
RESULTS: The number of patients with significantly reduced preoperative visual acuity (visual acuity > 1.3 logMAR) was highest in the MSICS group (MSICS 92%, Phaco-Rwanda 13%, Phaco-AKW 1%). Uncorrected postoperative visual acuity was similar in the Phako-Rwanda and Phako-AKW groups (0.22/0.21 logMAR) and better than MSICS Rwanda (0.33 logMAR). The best corrected postoperative visual acuity was significantly better in the Phako-Rwanda group (0.07 logMAR) than in the two comparison groups Phako-AKW (0.1 logMAR) and MSICS Rwanda (0.15 logMAR). The results of all three groups fulfilled the WHO criteria for postoperative visual acuity.
CONCLUSION: Despite poor initial visual acuity, high quality results can be achieved in cataract surgery in a clinical setting in sub-Saharan Africa that are within WHO expectations. A coexistence of MSICS technique and phaco seems reasonable to avoid complications and achieve the best possible results.
OBJECTIVE: The results after cataract surgery at a publicly accessible tertiary care eye clinic in Rwanda are presented and compared with standardized results from an eye clinic in Germany (AKW).
METHODS: Data from 100 consecutive eyes (manual small incision cataract surgery, MSICS-Rwanda, Phaco-Rwanda, Phaco-AKW) were retrospectively evaluated. The results were compared with each other and with WHO guidelines.
RESULTS: The number of patients with significantly reduced preoperative visual acuity (visual acuity > 1.3 logMAR) was highest in the MSICS group (MSICS 92%, Phaco-Rwanda 13%, Phaco-AKW 1%). Uncorrected postoperative visual acuity was similar in the Phako-Rwanda and Phako-AKW groups (0.22/0.21 logMAR) and better than MSICS Rwanda (0.33 logMAR). The best corrected postoperative visual acuity was significantly better in the Phako-Rwanda group (0.07 logMAR) than in the two comparison groups Phako-AKW (0.1 logMAR) and MSICS Rwanda (0.15 logMAR). The results of all three groups fulfilled the WHO criteria for postoperative visual acuity.
CONCLUSION: Despite poor initial visual acuity, high quality results can be achieved in cataract surgery in a clinical setting in sub-Saharan Africa that are within WHO expectations. A coexistence of MSICS technique and phaco seems reasonable to avoid complications and achieve the best possible results.