Outcomes Of High Volume Cataract Surgeries In A Tertiary Rural Center In Central India

India has signed the World Health Organization's resolution on Vision 2020: The Right to Sight, which has led to an increase in the number of cataract surgeries performed in India. While this is expected to lead to a decrease in the prevalence of cataract blindness, the absolute number of people affected by this condition is projected to increase from 7.75 million in 2001 to 8.25 million in 2020 due to a significant increase in India's population. Taking into account the existing prevalence and expected incidence of cataract blindness between 2001 and 2020, as well as the visual outcomes after cataract surgery, it is unlikely that India will be able to eliminate cataract blindness by 2020.

This is a retrospective study conducted over a period of 1.5 years from January 1, 2022 to June 30, 2023. The study population comprised of 8510 patients who were screened at community-based outreach camps organized by the Ophthalmology department of a tertiary care hospital in rural central India.

As part of the outreach program, junior residents accompanied by optometrists conducted community-based outreach camps for ocular/vision defects. During the screening, a total of 8510 patients were referred. A pre-operative testing was conducted, which included measuring the best-corrected visual acuity (BCVA) using Snellen's and E-charts.  Additionally, a detailed posterior segment and retinal examination was performed using direct/indirect ophthalmoscopy.. A post-operative examination was conducted by junior residents, junior staff, and then consultants following the OCTET protocol. The identified complications were classified into three categories. In total, three groups of surgeons performed 9028 surgeries on 8510 patients.

Out of the 9028 eyes underwent cataract extraction with IOL implantation, Small incision cataract surgery (SICS) was the commonest method (67%) used. The most common first post-operative day complication was striate keratitis (37%), corneal edema (28%), anduveitis (6%). A post operative vision in the range of 6/6-6/18 was achieved in 91% of the study population.

The results unequivocally showcase the attainment of superior surgical quality, characterized by a notably low incidence of intra-operative complications and consistently favorable visual outcomes post-surgery. These findings are particularly significant as they underscore the feasibility of achieving excellent results even in resource-constrained settings typically associated with rural healthcare facilities