Outcome of an outreach microsurgical project in rural Nepal.

PURPOSE

This study is aimed at evaluation of the outcome of an outreach program conducted in the remote Himalayan part of Nepal. Conclusions will be used to improve blindness prevention projects in this country.

METHODS

A temporary outreach microsurgical clinic was established in Diktel, Nepal. All patients who reported to the clinic were examined. Cases requiring surgical treatment, mostly cataracts, were operated on. Minor ocular diseases were treated on the spot, while the complicated ones were diagnosed, given initial treatment and referred to the nearest eye hospital.

RESULTS

Examination was performed on 1296 patients; 84 subjects underwent manual small incision cataract surgery with intraocular lens implantation. Intraoperative complications included 1 posterior capsule rupture (1.2%). Six weeks following the treatment 98.6% of the operated patients achieved corrected distance visual acuity of 0.3 or better. Out of all 1296 examined individuals, 224 (17.3%) presented visual impairment; 634 (24.5%) of the total number of eyes presented visual acuity of <0.3. In 90.2% of eyes the determinant of loss of sight was avoidable.

CONCLUSION

High percentage of avoidable blindness, with the majority caused by cataract and refractive errors alone, indicate that appropriate programs focused on these diseases should be implemented. High volume cataract surgery in a camp setting with the application of appropriate surgical techniques and standardized protocols of disinfection and sterilization do not have to compromise on the quality of the outcome.