Your SlideShare is downloading. ×
0
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Patients' preoperative expectation for the outcome of cataract surgery
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

Patients' preoperative expectation for the outcome of cataract surgery

1,374

Published on

Published in: Health & Medicine
1 Comment
0 Likes
Statistics
Notes
  • it is good research
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • Be the first to like this

No Downloads
Views
Total Views
1,374
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
39
Comments
1
Likes
0
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. Patient PreoPerative exPectation for the outcome of cataract surgery and the actual PostoPerative exPerience. in judoauthors- Zelalem addisu - berhan solomon Presented @ OSE in 2008
  • 2. Outline of the study report Introduction Literature review significance of the study Objectives Methodology Result and Discussion Conclusion and recommendations
  • 3. Introduction cataract is the leading cause of blindness in the world. an estimated of 25 million people were blind due to cataract i.e. 50% or more of the global burden of blindness. Annually, at least 25 million eyes develop visual acuity <6/60 due to cataract. around 1% of Africans are blind
  • 4.  around 7.1 of the worlds 38 million blind people live in sub-Saharan Africa Around 60% of Africas blind are women Around 50% of blindness in sub-Saharan Africa is due to cataract The number of people blind from cataract in the world is increasing by approximately 1 million per year and the number of ‘operable’ cataract eyes with a visual acuity of less than 6/60 is increasing by 4–5 million per year. In NBS prevalence of BL and LV was 1.6 and 3.7% [50% and 41 %]
  • 5.  Globally, the need for cataract operations is at least 30 million per year, but only around 10 million cataract operations are performed annually For this reason intervention against cataract blindness has received priority attention in Vision 2020:
  • 6.  Global causes of blindness as a percentage of total blindness in 2002 cataract 47.8% Source: WHO 04.138
  • 7. Outcome of cataract surgery is: the change in functional disability as a result of cataract operation usually expressed as visual acuity Purpose of monitoring cataract surgical outcome: Encourage eye surgeons to monitor their own results over time. Identify causes of poor outcome •Selection •Surgery •Spectacles •Sequelae�Address causes to improve future outcome
  • 8. Outcome depends on:�skills and knowledge of eye surgeon�surgical technique used�surgical facilities and environment�post-operative care�optical correction provided�patient-related risk factors, like ocular co- morbidity (glaucoma, age-related macula degeneration
  • 9.  Patient satisfaction is an increasingly important objective for health services with satisfied patients reporting greater compliance, well-being, and treatment outcomes with satisfied patients both remaining with and recommending their provider ,and that a satisfied patient is the best defense against malpractice lawsuits. patient satisfaction with surgery is an important outcome measure to include in the assessment of surgical outcomes.
  • 10.  Monitoring outcomes could , therefore, be applied in a clinical setting,where the visua l outcome of cataract surgery(post-operative visual acuity) is primarily measured. In addition, studies based on activities of daily living(ADL), patient well being, quality of life and patient satisfaction may be instituted as a routine or, more commonly, on randomly selected post-operative patient groups.
  • 11. LiteratureReview
  • 12.  In USA to assess the functional expectations and postoperative outcomes revealed very high and were unrelated to their demographic or ocular characteristics. The preoperative VF-12, score ,however, was positively correlated with expected postoperative VF-12 score. Only 61% of patients achieved or surpassed their expected level of postoperative functioning.
  • 13.  In Australia to assess expectations and outcomes in cataract surgery showed that the median v/a was 6/18, with a mean (SD) preoperative VF-14 score of 84.7 (14.8) and postoperative VF-14 score of 89.8 (16.4). The most unrealistic expectations involved driving at night, reading small print, and doing fine handiwork.
  • 14.  In British Columbia to assess VF post cataract surgery –of 47 people 28 (59.6%) had a perfect score postoperatively, 13 (27.6%) had a score of 90 or better, 5 (10.6%) had a score of 87 to 90, and 1 (2.1%) had a score of 67.Among the 200 people with a preoperative VFA score of 90 to 99, postoperatively the VFA score improved for 146 (73.0%), remained the same for 43 (21.5%) and worsened for 11 (5.5%).
  • 15.  In Indonesia to evaluate cataract surgical outcomes reported a total of 443 patients were operated and at one month after surgery, 76.08% was seen > 6/18. 2.48% < 3/60Intra & post-operative cxns were seen in 10.84% of all cases, mainly due to vitreous loss (66.67%). Intra-operative complications, systemic diseases present before the operation, and associated eye diseases were significant risk factors for poor outcome.
  • 16.  The results of hospital based prospective studies of cataract surgery in developing countries have usually reported good outcomes. In the Madurai intraocular lens study 1yr after ECCE + PC IOL , 0.6% of patients had a BCVA of < 6/60, and 98.1% had a BCVA of 6/18 or better. In a study from Kenya, 1.5% of eyes had a visual acuity of < 6/60 postoperatively, and 94.3% were 6/18 or better after ECCE and PC-IOL. These studies demonstrate that good outcomes can be obtained in the settings of developing countries. This has led to calls for the quality of cataract surgery to receive at least as much attention as the quantity of surgery.
  • 17.  At Kikuyu Eye Unit, to assess the visual outcome of patient undergoing cataract surgery and the result were: BCVA of 6/18 or better was obtained in 94.3% of eyes and an uncorrected vision of 6/18 or better in 78.2% of eyes. Six eyes (1.5%) had BCVA of < 6/60
  • 18.  At Menelik II Hospital revealed that out of the 214-study population, 174 (81.3%) were followed up to the 8th week and also completed the entire interview and examination. The uncorrected VA of the 174 patients was 6/18 or better in 74 (42.5%), while 100(57.5%) patients had low vision (<6/18). However, the final corrected post-operative visual acuity (VA) was 6/18 or better in 109 (63.0%) of the patients, and in 65(37%) patients it was found to be low (<6/18).
  • 19.  Study done in Jimma zone showed that out of 617pts operated, 77 eyes (18.4%) had final visual acuity (V/A) of >6/18; 388 eyes (92.6%) had V/A of >6/60 and 395 eyes (94.3%) had V/A > 3/60.
  • 20. Significance of the study Calculates the visual outcome and assesses the quality of cataract surgery encouraging eye surgeons to monitor their own results, over time, in itself will lead to better outcomes of cataract surgery. Provide base line data for the eye unit to design appropriate strategies in order to provide the highest level of satisfaction and improve results of cataract surgery as improved outcome will motivate more patients to come forward for surgery.
  • 21. OBJECTIVESGENERAL OBJECTIVIES To describe the relationship between patients preoperative expectations regarding the outcome of cataract surgery and actual postoperative experience. To evaluate post operative visual outcome of cataract surgery
  • 22. SPECIFIC OBJECTIVES To assess patients preoperative expectations for postoperative outcomes and actual postoperative experience To evaluate post operative outcome of cataract surgery at first day postoperative and at 4 weeks after the operation To identify the cause of poor outcome.
  • 23. Methods and Materials
  • 24.  Study area and period. Ham 16/1999- Hed 10/00 Study Design Population  Source Population  Study Population Sample size PROCEDURE AND MEASURES - Structured questionnaire - Preop assessment VA , slit lamp bio microscopy, & dilated funduscopy. Keratometry and A-scan biometry
  • 25.  VF were measured using a 15-item visual function assessment with final score ranging from 0 (no visual ability) to 100 (no visual disability). Patients were then asked to rate their expected postoperative functional outcome for each of the 15 items on the VF-15 scale. The visual status was classified using the World Health Organization (WHO) category of Visual Impairment and Blindness. Data collections were conducted Validity and reliability Data analysis Ethical consideration Limitation of the study
  • 26. RESULTS &DISCUSSION
  • 27.  200 patients were approached. Of these, 179 (89.5%) were followed up to the 5th week follow up.Table 1.patient characterstics, Jimma University, ophthalmology department, 2007. Characteristics preoperative 5 th wks Post operative No. of patients 200 179 Age mean (SD) 58.7(14.6) No of women (%) 60 (40 %) VF-15 score, mean (SD) 54.19 (34.1) 94.1 (15.9) Overall satisfaction Very much improved 132(73.7%)
  • 28. Table 2.preoperative visual acuity of patients, Jimma University, Ophthalmology Department, 2007. V/A No % 6/24-6/60 1 0.5 <6/60-3/60 9 4.5 <3/60-LP 190 95.0 Total 200 100
  • 29. Fig.1 .cataract type (N=200), Jimma University, ophthalmologydepartment, 2007.
  • 30. Table 4.Surgeon that did the surgery &type of IOL inserted, Jimma University, Ophthalmology Department, 2007. Surgeon PC IOL AC IOL aphakic TotalOphthalmologist 139 4 0 143Resident /trainee/ 12 0 0 12Cataract Surgeon /trainer/ 42 1 2 45 Total 193 5 2 200
  • 31. Table 5. Intraoperative complications in operated eye ,Jimma University, Ophthalmology Department, 2007 . Intraoperative complication No % None 181 90.5Capsular rupture with vitreous loss 8 4.0Iris damage(inadverteal PI,iridodialysis 4 2.0Retrobulbar hemorrhage 4 2.0Capsular rupture without vitreous loss 2 1.0Zonular dehiscence 1 .5Total 200 100.0 NB at Kikuyu OF 388 PCR 27 (7.0) ,Z 2(0.5) ,V 16(4.1) at Kaduna PCR10 eyes (5.7%), v 3% NZ PCR 4.45 % FINLAND 5.4%. Aravind 1.7% of 898 eyes 10% in Ghana and 11.4% in Sierra Leone.
  • 32. Table 6. Immediate postoperative surgical events of cataract surgery , Jimma University, OphthalmologyDepartment, 2007. Immediate postoperative Total No. of Patients(%) complicationStriate keratopathy 143 ( 71.5)A/c reaction 82 (41.0 )A/c hemorrhaged 9 (4.5 )retained lens matter 8 (4.0 ) Wound leak 1 (0.5 )SK & retained lens matter 2 (1.0 )A/C shallow 2 (1.0 )Kaduna 78 (44.6%) Sk , cortical/AC remnant 14 (8%),1 eye (0.6%) endophthalmitis.New Zealand increase IOP
  • 33. Table 7. Postoperative visual acuity of patients (after 4wks), Jimma University, Ophthalmology department, 2007. Post operative V/A without correction with pin hole No % No % Good >6/18 102 57.0 126 70.4 Borderline <6/18-6/60 55 30.7 39 21.8 Poor <6/60 22 12.3 14 7.8 Total 179 100 179 100 In Nepal – uncorrected 47.9% of cases - corrected 77.4% of cases. at Kikuyu 73.1% had uncorrected 2 m. In Menelik Without correction 74(42.5%) With pin hole 110(63.2%) (1999) 174
  • 34.  Best corrected vision after 1 year in clinical trials: LAHAN ARAVINDVisual Acuity ICCE + ICCE + ICCE + ECCE + PC-IOL specs AC-IOL specs6/6 - 6/18 93.2 89.9 95.5 96.6 < 6/18 - 6/60 4.6 7.5 2.9 1.1< 6/60 2.2 2.6 1.6 2.3 n= 914 906 1401 1474 follow-up 91% 85% WHO guideline for evaluating the outcome of cataract surgery Post-operative Available correction Best correction visual acuityGood 6/6–6/18 >80% (70.4%) >90%Borderline <6/18–6/60 <15% (21.8%) <5%Poor <6/60 <5% (7.8%) <5%
  • 35. Table 8. Postoperative complications following cataractsurgery in 179 pts. at Jimma UniversityOphthalmology Department.Post operative complications No % No (%) Me-II 1999None 135 75.4Missed shaped pupil 21 11.7PCO 9 5.0 9 (5.2%)Cortical remanants 3 1.7 16(9.2%)IOL decenteration 2 1.1 10(5.7%)Bullus keratopathy/Corneal opacity/ 2 1.1 3(1.7%)Uvieitis 2 1.1 13(7.5%)Postoperative glaucoma 1 .6 2(1.1%) Wound gap 1 .6 2(1.1%) Vitreous opacity 1 .6 RD 1 .6Pupillary fibrinous material, Vit.in A/C & Iridocorneal touch 1 .6 5(0.3%) Total 179 100.0
  • 36. Table 9. Causes of poor outcome (best corrected acuity <6/60) in 200 pts seen at 2 month follow up   Factors No Pre-existing ocular comorbidity 7(50%) Central corneal opacity 1 Pseudoexfolation and Glaucoma 2 Pseudoexfolation and ARMD 2 Others 3Surgical events 3(21.4%) PC tear 2 Iris damage(inadverteal PI,iridodialysis 1Post-surgical conditions 4(28.6%) PCO 3 RD 1 Total 14
  • 37. Table 10. Mean of pt. Expectation and outcome for visual function index (VF-15) items, Jimma University, ophthalmology department, 2007. VF-15 Item Expectation Outcome Mean (SD) Mean (SD) P-value1. Performing manual tasks? 87.6(21.4) 93.1(17.93) 0.122. Going out by your self? 94.5(13.1) 94.5(17.02) < 0.0013. Reading small print? 91.7(14.89) 91.5(22.65) 0.0264. Reading large print such as posters, numbers on a Telephone? 97.8(8.09) 96.1(15.54) 0.75. Recognizing people? 96.3(10.55) 94.3(17.13) < 0.0016. Doing fine hand works like sewing, knitting or wood working? 89.6(18.29) 83.1(30.00) < 0.0017. Cooking, dressing or other self-care activities? 95.4(11.77) 93.4(18.79) 0.078. Participating in social activities? 95.9(10.86) 93.0(20.18) 0.0019. Going to shops/Markets? 94.9(13.56) 92.2(21.89) < 0.00110. Working just like you did before? 94(13.31) 93.0(19.11) < 0.02111. Choosing clothes to wear? 98(8.44) 98.2(9.92) < 0.00112. Taking a bath by yourself? 98(8.44) 98.2(9.92) < 0.00113. Getting dressed by yourself? 98.4(7.95) 98.4(9.77) < 0.00114. Visiting your friends? 96.9(10.00) 93.7(19.08) 0.1815. Watching Television? 94.7(13.95) 98.0(8.66) 0.17
  • 38.  In Sydney Private Hospital, Sydney, of 121pts 80 patients (66%) failing to equal or exceed their expectations at 1-month follow-up.
  • 39. Table 11. Sperman rank correlation with patient satisfaction for visual function Index (VF-15) items, JimmaUniversity, Ophthalmology department 2007Correlation with satisfaction VF-15 Item Preoperative post operative Expectation outcome1. Performing manual tasks? NS 0.842. Going out by your self? NS 0.883. Reading small print? NS 0.534. Reading large print such as posters, numbers on a Telephone? NS 0.885. Recognizing people? 0.26(0.002) 0.886. Doing fine hand works like sewing, knitting or wood working? 0.26(0.002) 0.637. Cooking, dressing or other self-care activities? NS 0.89
  • 40. 8. Participating in social activities? 0.16(0.048) 0.929. Going to shops/Markets? NS 0.9210. Working just like you did before? NS 0.8211. Choosing clothes to wear? NS 0.3712. Taking a bath by yourself? NS 0.3713. Getting dressed by yourself? NS 0.3714. Visiting your friends? NS 0.7615. Watching Television? NS 0.70Abbreviations: NS, not significant;P values (outcome) <0.001
  • 41. Table 12.Sperman correlation with patient satisfaction for composite measures, Jimma University, ophthalmology department, 2007. Measure Correlation p-value With satisfactionExpected VF -15 score improvement 0.004 NSActual VF -15 score improvement 0.19 NSActual post operative VF -15 score 0.38 .010NB. Expected VF -15 score improvement 0.21 0.02 Actual VF -15 score improvement 0.11 NS Actual post operative VF -15 score 0.32 .004
  • 42. CONCLUSION Expectations regarding visual functioning after cataract surgery were very high, and in most cases such expectations are fulfilled. The visual outcome of cataract surgery performed during the sample period was satisfied the patients by the results achieved and very encouraging to consider it in the future. With adequate surgical skills, ECCE with PC IOL implantation offers good visual rehabilitation even with training conditions. The need for measuring outcomes, preferably over a wider spectrum than the mere visual outcome, is a critical element in measuring and tracking our achievements towards the goal of eliminating avoidable blindness by 2020.
  • 43. RECOMMONDATIONS Prospective standardized monitoring of cataract surgical outcomes with regular analysis of the causes of poor outcome is an important tool, in which the ophthalmic surgical teams can use to improve the results of their cataract surgery. Surgeons have to emphasize the importance of controlling their patients’ expectations. (B/c controlling patient expectations may be more effective than improving patients’ postoperative outcome in terms of maximizing patient satisfaction).
  • 44. Reference1. Bull World Health Organ 1995; 73: 115-21.2. ELLWEIN LB & KUPFER C - Strategic issues in preventing cataract blindness in developing countries. Bul World Health Org 1995; 73:681-690.3. PCON super site Microsoft internet co management results in ‘excellent’ patient outcomes Yorston D, Foster A. Audit of extracapsular cataract extraction and posterior chamber lens implantation as a routine treatment for age related cataract in east Africa Br J Ophthalmol. 999;83:897-901.5. Monitoring cataract surgical outcome, Text for presentation on monitoring cataract surgical outcome, Community eye health CD 2007.6. Mangione CM, Lee PP, Gutierrez PR, et al. Development of the 25-item National Eye Institute Visual Function Questionnaire. Arch Ophthalmol. 2001;119:1050-1058.7. Scott A, Sjjnjmith RD. Keeping the customer satisfied: issues in the interpretation and use of patient satisfaction surveys. Int J Qual Health Care.
  • 45. 8. Epstein AM. The outcomes movement: will it get us where we want to go? N Engl J Med. 1990;323:266-270.9. Cleary PD, McNeil BJ. Patient satisfaction as an indicator of quality of care. Inquiry.1988;25:25-36.10. Padberg RM, Padberg LF. Strengthening the effectiveness of patient education: applied principles of adult education. Oncol Nurs Forum. 1990;17:65-69.11. Williams B. Patient satisfaction: a valid concept? Soc Sci Med. 1994;38:509-516.12. Yucelt U. An investigation of causes of patient satisfaction/dissatisfaction with physician services. Health Mark Q. 1994;12:11-28.13. Ware JE, Davies AR. Behavioral consequences of consumer dissatisfaction with medical care. Eval Program Plann. 1983;6:291-297.14. Espallargues M, Alonso J. Effectiveness of cataract surgery in Barcelona, Spain site results of an international study. Barcelona I-PORT investigators. International Patient Outcomes Research Team. J Clin Epidemiol 1998;51:843–52.
  • 46. 15.Steinberg EP, Tielsch JM, Schein OD, et al. National study of cataract Surgery outcomes. Variation in 4-month postoperative outcomes as reflected in multiple outcome measures. Ophthalmology 1994;101:1131–40.16. MacCormick AD, Collecutt WG, Parry BR. Prioritizing patients for elective surgery: a systematic review. ANZ J Surg 2003;73:633–42.17. LeBlanc RP. Evaluating elective surgery. CMAJ 2003;168:397–400.18. Rubin HR, Gandek B, Rogers WH, Kosinski M, McHorney CA, Ware JE. Patients ratings of outpatient visits in different practice settings: results from the Medical Outcomes Study. JAMA. 1993; 270:835-840.19. Rubin HR. Can patients evaluate the quality of hospital care? Med Care Rev; 1990;47:267-326.20. Zeithaml VA, Parasuraman A, Berry LL. Delivering Quality Service: Balancing Customer Perceptions and Expectations. New York, NY:T Free Press; 1990.21. Messner RL, Lewis SJ. Increasing Patient Satisfaction: A Guide for Nurses. New York,22. Carr-Hill RA. The measurement of patient satisfaction. J Public Health Med 1992;14:236-249. NY: Springer; 1996.
  • 47. 23. Thompson AG, Sunol R. Expectations as determinants of patient Satisfaction concepts, theory and evidence. Int J Qual Health Care. 1995;7:127-141.24. Flood AB, Lorence DP, Ding J, McPherson K, Black NA. The role of expectations in patients reports of post-operative outcomes and improvement following therapy. Med Care. 1993; 31:1043-1056.25. Scott A, Smith RD. Keeping the customer satisfied: issues in the interpretation and use of patient satisfaction surveys. Int J Qual Health Care. 1994;6:353-359.26. Epstein AM. The outcomes movement: will it get us where we want to go? N Engl J Med. 1990; 323:266-270.27. Community eye health journal 2002; 15(44): 51-5328. Aharony L, Strasser S. Patient satisfaction: what we know about and what we still need to explore. Med Care Rev 1993;50:49–79.29. American Academy of Ophthalmology. Basic and Clinical Sciences Course. Section 11 (Lens and Cataract).160.30. Limburg HbAc, Foster A, Murthy GVS. Monitoring visual outcome of cataract surgery in India. Bull World Health Org 1999; 77 (6):455-60.
  • 48. 31.Duaen clinical ophthalmology CD 200532. Tielsch JM, Steinberg EP, Cassard SD, Schein OD, Javitt JC, Legro MW, Bass EB, Sharkey P. Preoperative functional expectations and postoperative outcomes among patients undergoing first eye cataract surgery. Arch Ophthalmol 1995 Oct; 113(10):1312-833. Chet K. Pager, BMed (Hons), DipEd, MA, Expectations and Outcomes in Cataract Surgery, Arch Ophthalmol. 2004;122:1788-1792.34. Ms Linda Santamaria Dr Marcel Favilla, Southern Health Quality Surgical Audit Ophthalmology Unit, Monash University, 200535. Ken Bassett, Kukuh Noertjojo, Praveen Nirmalan Paul Courtright, Duncan Anderson, visual function assessment and cataract surgery in British Columbia CAN J OPHTHALMOL—VOL. 40, NO. 1, 200536. Mayang Rini, Evaluation of cataract surgical outcomes in Cicendo Eye Hospital, Bandung, West Java, Indonesia , Community Eye Health J 2007;20(61): 7-1537. Reeta Gurung, Cataract surgical outcome and gender specific barriers to cataract services in Tilganga Eye Centre and its outreach microsurgical eye clinics in Nepal Community Eye Health J 2007;20(61): 7-15
  • 49. 38. Dandona L, Dandona R, Naduvilath, et al. Population-based assessment of the outcome of cataract surgery in an urban population in southern India. Am J Ophthalmol 1999; 127:650–8.39. Limburg H, Kumar R. Follow-up study of blindness attributed to cataract in Karnataka State, India. Ophthalmic Epidemiol 1998; 5:211–23.40. Zhao J, Sui R, Jia L, et al. Visual acuity and quality of life outcomes in patients with cataract in Shunyi County, China. Am J Ophthalmol 1998;126:515–23.41.Yorston D. Are intraocular lenses the solution to cataract blindness inAfrica? Br J Ophthalmol 1998;82:469–71.42. Singh AJ, Garner P, Floyd K. Cost-effectiveness of public-funded options for cataract surgery in Mysore, India. Lancet 2000;355:180–4.43. McCarty CA, Nanjan MB, Taylor HR. Operated and unoperated cataract in Australia. Clin Exp Ophthalmol 2000;28:77–82.44. Desai P, Minassian DC, Reidy A. National cataract surgery survey 1997–8: a report of the results of the clinical outcomes. Br J Ophthalmol 1999;83:1336–40.
  • 50. 45. Prajna NV, Chandrakanth KS, Kim R, et al. The Madurai intraocular lens study II: Clinical outcomes. Am J Ophthalmol 1998;125:14–25.46. Yorston D, Foster A. Audit of extracapsular cataract extraction and posterior chamber lens implantation as a routine treatment for age related cataract in east Africa. Br J Ophthalmol 1999;83:897–901.47. Johnson GJ. Improving outcome of cataract surgery in developing countries. Lancet 2000; 355:158–9.48. Limburg H, Foster A, Vaidyanathan K, et al. Monitoring visual outcome of cataract surgery in India. Bull World Health Organ 1999;77:455–6049. Courtright P,Kanjaloti S Barriers to acceptance of cataract surgery among patients presenting to district hospitals in rural malawi . Trop Geogr Med 1995; 47:18-1850. David Yorston, Allen Foster.Audit of extracapsular cataract extraction and posterior chamber lens implantation as a routine treatment for age related cataract in east Africa Br J Ophthalmol 1999;83:897–90151. D Yorston, S Gichuhi, M Wood, A Foster, Does prospective monitoring improve cataract surgery outcomes in Africa?,Br J Ophthalmol 2002;86:543–7
  • 51. 52. Dr Uma Pradhan, Dr Shrirang Deshpande, Dr P S Grewal, and Dr Museret Awave. Intercontinental Medicare Project in Ethiopia, Community Eye Health.2003;16(47):42-43.53. Tesfaye Haileselassie, Yared Asefa, Samson Bayu, Abebe Bejiga.Outcome of extra-capsular cataract extraction with posterior chamber intraocular lens implantation performed at a cataract surgical campaign Ethiop. J. Health Dev. 2002;16(1):77- 8354. Zerihun N Visual outcome of the first 500 cataract extractions done in the field; Jimma,Ethiopia. Int Ophthalmol. 2001;24(5):291-555. Egbert PR, Buchanan M.Results of extracapsular cataract surgery and intraocular lens inplantation in Gana. Arch Ophthalmol 1991 ;109 :1764- 1768 [Abstract]56. Cook NJ. Evaluation of high volume extracapsular cataract cataract extraction extraction with posterior lens implantation in sierra leone.West Africa Br J Ophthalmology 1996 :80 :698-701[Abstract/Free Full Text ]57. Mahmoud B Alhassan, Fatima Kyari, Ibrahim B Achi, Chinenyem P
  • 52. 58. Lumme P, Laatikainen LT .Risk factors for intraoperative and early postoperative complications in extracapsular cataract surgery. Eur J ophthalmol 1994;4:151-158[Medline]59. Natchiar G Robin AL.Nalgirkar AR,et al. posterior capsule tears during extracapsular cataract surgery in India. Arch Ophthalmol1993;1993 111:706- 708[Abstract]60. Welsh NH. Extracapsular cataract extraction with and without intra-ocular lenses in black patients.S AfrMed J 1992;81:357–60.61. Apple DJ, Solomon KD, Tetz MR, et al. Posterior capsule opacification. Surv Ophthalmol 1992;37:73–116.62. Argento C, Nunez E,Wainsztein R. Incidence of postoperative posterior capsular opacification with types of senile cataracts. J Cataract Refract Surg 1992;18:586–8.63. Isenberg SJ, Apt L, Yoshimori R, et al.Outpatient topical use of povidone- iodine in preparing the eye for surgery.Ophthalmology 1989;98:1769–75.64. Ruit S, Robin AL, Pokhrel RP, Sharma A, DeFellar J. Extracapsular

×