Small-incision manual extracapsular cataract surgery in Ghana, West Africa.
OBJECTIVE
To evaluate the results of small-incision manual extracapsular cataract extraction surgery (ECCE) in a district hospital in West Africa.


METHODS
Margret Marquart Catholic Hospital, Ghana, West Africa.


METHODS
This prospective study consisted of 200 eyes of 193 patients who had small-incision manual ECCE between January 1999 and May 2000. For comparison, the charts of 32 patients (32 eyes) operated on between July and December 1998 using a limbal incision (control group) were retrospectively analyzed. Outcome measures included intraoperative and postoperative complications, postoperative visual acuity, and refractive astigmatism.


RESULTS
In the small-incision ECCE group, self-sealing wounds were achieved in 129 eyes (64.5%). Vitreous loss occurred in approximately 3% of eyes in both the small-incision and control groups. The final visual acuities were similar between the 2 groups, with more than 90% of eyes in both groups achieving a final best corrected visual acuity of at least 20/60. Eyes in the small-incision group had faster visual recovery (P <.001), a lower incidence of fibrinous iritis (P =.02), and were more likely to have round pupils (P <.001) than eyes in the control group. The main complication of small-incision surgery was moderate corneal edema, which persisted until at least the 1-week visit in 14 eyes (7%). At the most recent visit, 1 eye in the small-incision group (0.5%) had bullous keratopathy.


CONCLUSIONS
In a district hospital in West Africa, small-incision manual ECCE surgery yielded faster visual rehabilitation and had a lower incidence of fibrinous iritis than standard ECCE surgery.
Guzek
James Paul
JP
Loma Linda University, Loma Linda, California, USA.
Ching
Andrea
A
D000368:Aged; D002387:Cataract Extraction / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D003316:Corneal Diseases / Q000209:etiology; D004487:Edema / Q000209:etiology; D005260:Female; D005869:Ghana; D006801:Humans; D015994:Incidence; D007500:Iritis / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011680:Pupil; D012189:Retrospective Studies; D012424:Rural Population; D013997:Time Factors; D014792:Visual Acuity