Outcomes of Cataract Surgeries Performed in Makeshift Operating Rooms in Rural Camps, Compared to Hospital-based Surgeries in Nepal

ABSTRACT

Purpose

This study was undertaken to evaluate the complication rates and visual outcomes of outreach cataract surgeries done in makeshift operating rooms.

Method

In this retrospective study, surgical outcomes of consecutive Manual Small Incision Cataract Surgeries (MSICS) done in 11 rural camps in Nepal were compared with the results of consecutive hospital surgeries (MSICS and phacoemulsification) done by the same surgeon. Surgeries were done from September 2018 to March 2020.

Results

Out of 1034 study population in each group, a significantly higher number (p < .001) of camp patients (27%, n = 279) were either blind or had severe visual impairment when compared to hospital patients (18.6%, n = 192). Around 88.9% (n = 919) of cases operated in camps and 85.7% (n = 886) in the hospital achieved uncorrected visual acuity (VA) of 6/18 or better on the first postoperative day. Poor outcome (VA<6/60) was seen in 3.7% (n = 38) of cases in camps and 3.9% (n = 40) in the hospital. The difference in visual outcomes was not significant (p = .162) when the results were controlled for other associated variables. There was no significant difference (p = .126) between complication rates in camps (1.9%, n = 20) and hospital surgeries (3.5%, n = 36) when preoperative conditions were statistically controlled. No cases of endophthalmitis were reported.

Conclusions

Makeshift operating rooms can be used for cataract surgeries in rural areas where no standard operating rooms are available. If appropriate patient selection criteria and standard surgical protocols are followed, good surgical outcomes can be achieved in camps by an experienced surgical team.

KEYWORDS:

• Cataract
• eye camps
• postoperative visual outcome
• MSICS
• cataract blindness

Acknowledgments

We would like to acknowledge Mr Ramesh Bhatta and Mr Narendra Bista from the Outreach Department of Geta Eye Hospital for their important contribution to data collection for this study.

Disclosure statement

There is no external financial support for the study and none of the authors have any proprietary interests or conflicts of interest related to this submission.