Extracapsular cataract surgery in Vietnam: a 1 year follow-up study.
OBJECTIVE
Unoperated cataract is the leading cause of blindness in the developing world. Many developing countries now use extracapsular cataract extraction (ECCE) with intra-ocular lens insertion (IOL) in their cataract blindness-prevention programmes. To date, little research has been directed at visual outcomes and complication rates of ECCE/IOL surgery in developing countries.


METHODS
We conducted a follow-up study of 155 eyes approximately 12 months after ECCE/IOL surgery by eight local eye surgeons in Central Vietnam. We report the findings for the 144 eyes (93%) successfully reviewed. All subjects underwent manual ECCE with insertion of a three-piece posterior chamber IOL. All eyes were also assessed for the presence and severity of posterior capsule opacification (PCO) using a newly developed grading system.


RESULTS
Overall, 110 eyes (75%) had uncorrected visual acuities > or = 6/24 and 107 eyes (74%) had best spherically corrected visual acuities > or = 6/18. Some degree of PCO was found in 40% of eyes, but was graded as visually significant in only 4% of eyes. No major sight-threatening complications were noted. A portable neodymium:yttrium aluminium garnet (Nd:YAG) laser was used to perform capsulotomies on all eyes with visually significant PCO. There were no laser complications noted.


CONCLUSIONS
At approximately 1 year after ECCE/IOL, the visual outcomes for subjects in this cohort were favourable and complication rates were low. Posterior chamber opacification was not a major cause of vision impairment in this cohort. Portable Nd:YAG lasers may provide an effective solution to the problem of visually significant PCO occurring in developing countries as a late complication of extracapsular surgery. These findings support an increasing role for ECCE/PCIOL surgery by trained local eye surgeons in developing countries.
Tobin
S
S
Centre for Public Health, The University of New South Wales, Sydney, Australia. sntobin@ozemail.com.au
Nguyen
Q D
QD
Phàm
B
B
La Nauze
J
J
Gillies
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D002386:Cataract / Q000209:etiology / Q000473:pathology; D002387:Cataract Extraction / Q000009:adverse effects / Q000379:methods*; D003906:Developing Countries; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy; D007903:Lens Capsule, Crystalline / Q000473:pathology / Q000601:surgery; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome; D014744:Vietnam; D014792:Visual Acuity