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通过社区外展项目在基层医院对部落人群连续两天进行双侧白内障手术的安全性、有效性和成本效益:印度西北部阿拉瓦利山的前瞻性研究

Safety, efficacy and cost-effectiveness of consecutive bilateral cataract surgery on two successive days in tribes at base hospital through community outreach program: A prospective study of Aravali Mountain, North West India.

作者信息

Mohan Amit, Kaur Navjot, Bhatanagar Vishal C

机构信息

Department of Community Ophthalmology, Global Hospital Institute of Ophthalmology, Abu Road, Sirohi, Rajasthan, India.

出版信息

Indian J Ophthalmol. 2017 Dec;65(12):1477-1482. doi: 10.4103/ijo.IJO_641_17.

Abstract

PURPOSE

The aim of the study was to evaluate the safety and efficacy of consecutive bilateral cataract surgery (CBCS) on two successive days in a single hospital visit.

METHODS

Prospective study was conducted on 565 patients of various tribes of hilly area of West Rajasthan who had come to our hospital through community outreach programmed (CORP) between January 2015 and March 2016. Patients with significant bilateral cataract without any other ocular morbidity were advised bilateral manual small incision cataract surgery on two consecutive days. Intraoperative and postoperative complications were evaluated, and follow-up was done at 1 week, 1 month, and 3 months.

RESULTS

Out of 565 patients, 519 underwent both eye surgeries. Second eye surgery was deferred for a later date in 46 cases. Because of intraoperative and postoperative complications in the first eye, 31 had delayed surgeries while 15 patients refused to undergo another eye surgery either because of postoperative day 1 poor vision in the operated eye due to retinal pathologies (n = 8) or unwillingness (n = 7). The second eye surgery was performed for 519 patients, out of whom six had intra or postoperative complications. At 1 month follow-up, four patients had unilateral cystoid macular edema and three had prolonged postoperative inflammation. At 3 months, all patients were satisfied and had no complications. None of the patients had sight-threatening complications such as endophthalmitis, corneal decompensation, or vitreoretinal complications.

CONCLUSION

CBCS may be considered safe and cost-effective for patients living in remote locations, dependent on CORP.

摘要

目的

本研究的目的是评估在单次医院就诊中连续两天进行双侧白内障手术(CBCS)的安全性和有效性。

方法

对2015年1月至2016年3月期间通过社区外展项目(CORP)来到我院的西拉贾斯坦邦山区不同部落的565例患者进行了前瞻性研究。建议患有显著双侧白内障且无任何其他眼部疾病的患者连续两天进行双侧手动小切口白内障手术。评估术中及术后并发症,并在1周、1个月和3个月进行随访。

结果

565例患者中,519例接受了双眼手术。46例患者的第二眼手术推迟到以后进行。由于第一眼的术中及术后并发症,31例患者手术延迟,15例患者因术后第1天手术眼视力差(视网膜病变,n = 8)或不愿意(n = 7)而拒绝进行另一只眼的手术。519例患者进行了第二眼手术,其中6例出现术中或术后并发症。在1个月的随访中,4例患者出现单侧黄斑囊样水肿,3例患者术后炎症持续时间延长。在3个月时,所有患者均满意且无并发症。没有患者出现威胁视力的并发症,如眼内炎、角膜失代偿或玻璃体视网膜并发症。

结论

对于依赖CORP的偏远地区患者,CBCS可能被认为是安全且具有成本效益的。

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