Review of cataract intervention in Maharashtra State.

Abstract

Blindness due to cataracts presents an enormous problem, not only in terms of human suffering, but also in terms of economic loss and social burden. In the absence of proven measures of primary prevention, secondary prevention in the form of surgical intervention is, currently, the remedy to the problem of blindness due to cataracts. There are various therapeutic approaches in cataract extraction. However, the conventional ICCE/SPECT and the newer ECCE/IOL are the popular approaches presently adopted on a mass scale. Maharashtra is consistently achieving the quantitative targets for cataract surgery given by the Government of India. However, the qualitative aspects of cataract surgery, the desired outcome of which is sight restoration in those blinded by cataracts, has hitherto not been monitored and assessed. The Kolhapur Circle was selected for this purpose. With the improvement of Ophthalmic Surgeons and PMOAS, the sample of cataract patients operated on in the year 1992-93 was followed. Two blocks from each of three districts in the circle were selected at random. The respondents were patients from these six blocks who had cataract surgery in the year 1992-93. 50% of the operations took place in the mobile camps while 20% took place in government fixed facilities and 30% in the private sector. Micro-analysis of the quantitative performance of cataract surgery in the Kolhapur Circle revealed that the circle is continuously delivering the intended benefits, i.e. relieving human suffering due to blindness from cataracts. The overall success rate of cataract surgery was 86% (Postoperative VA > 6/60). It seems that the investment made in cataract intervention is highly productive.