Abstract

In 2019 the German Commission for the Prevention of Blindness (DKVB) held an eye camp in the Tanzanian town of Sumbawanga. For patients with mature cataracts and the ability to see light cateracts were treated by manual small incision cataract surgery (MSICS). For the first time in this camp the quality of the results of the cataract operations was measured. The quality of the cataract operations is presented and the results were assessed in the context of the guidelines of the World Health Organization (WHO). Those patients who had acataract operation in the first week were examined during the second week with respect to the parameters vision, refraction, split lamp microscopic findings, results and complications after surgery. The results were retrospectively evaluated and compared with the guidelines of the WHO. A total of 42postoperative patients from the eye camp could be examined within 5-9days after cataract sugery. The following parameters were found: median postoperative visual acuity 0.26, spherical equivalent -2.82 dpt, astigmatism -2.2 dpt, axis 113°. Visual acuity >0.3 in 14.2% (WHO 80%), vision 0.1-0.3 in 62% (WHO 15%), vision <0.1 in 23.8% (WHO 5%). Prolonged healing time and intraocular irritation in 29% of the cases. Although the vision improved, the results are sobering when taken in the context of the WHO guidelines. The postoperative refraction showed amyopic shift and an high level of astigmatism. The reasons are manifold: ocular comorbidities, limited diagnostic and therapeutic possibilities in anonclinical setting. Other factors are the kind of training of the staff in the camp, the difficult circumstances and advanced findings. Consideration of the results of this study is imperative to be able to measure the quality of the work and to create the potential to make future improvements.

Highlights

  • In 2019 the German Commission for the Prevention of Blindness (DKVB) held an eye camp in the Tanzanian town of Sumbawanga

  • For patients with mature cataracts and the ability to see light cateracts were treated by manual small incision cataract surgery (MSICS)

  • The quality of the cataract operations is presented and the results were assessed in the context of the guidelines of the World Health Organization (WHO)

Read more

Summary

Der Ophthalmologe

Die World Health Organization (WHO) schätzt, dass weltweit ca. 18 Mio. Menschen an einer (beidseitigen) Katarakt erblindet sind („blinding cataract“). Die augenchirurgische Versorgung wird dort seit knapp 10 Jahren von einem einzelnen Kataraktchirurgen (Assistent Medical Officer [AMO], nicht universitärer staatlich anerkannter Ausbildungsberuf) für die gesamte Rukwa-Region mit etwa 1,5 Mio. Menschen sichergestellt. Um die Versorgung zu verbessern, hat das Deutsche Komitee zur Verhütung von Blindheit (DKVB) seit 2017 Augencamps eingerichtet: Zweimal jährlich fliegt ein Team aus mehreren Ärzten und medizinischem Fachpersonal nach Sumbawanga, um in einem jeweils 2-wöchigen Einsatz Patienten zu untersuchen und zu operieren. Dennoch scheint es nach dem nunmehr vierten Camp in Sumbawanga angemessen, sich mit der Qualität der geleisteten Arbeit auseinanderzusetzen, zumal die Weltgesundheitsorganisation (WHO) sehr klare Vorgaben für die Ergebnisqualität in der Kataraktchirurgie formuliert [20]. Diese Tatsache hat dazu geführt, dass in den betroffenen Ländern – auch in Tansania – eine erhöhte Aufmerksamkeit für die Bedeutung der Qualität in der Kataraktchirurgie im öffentlichen Gesundheitswesen entstanden ist [1, 22]. Susan Lewallen hat bereits vor Jahren beschriebenen, dass es gut durchdachter, qualitativ hochwertiger und langfristig geplanter Programme bedarf, um die Cataract-surgical-Rate zu steigern [11, 22]

Material und Methoden
Pigment in Vorderkammer
Einhaltung ethischer Richtlinien
Findings
Literatur
Full Text
Paper version not known

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call

Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.