EXTRACAPSULAR CATARACT-SURGERY IN VIETNAM - A 1 YEAR FOLLOW-UP-STUDY

Purpose: Unoperated cataract is the leading cause of blindness in the developing world. Many developing countries now use extracapsular cata ract extraction (ECCE) with intra-ocular lens insertion (IOL) in their cataract blindness-prevention programmes. To date, little research ha s been directed al visual outcomes and complication rates of ECCE/IOL surgery in developing countries. Methods: We conducted a follow-up stu dy 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 E CCE with insertion of a three-piece posterior chamber IOL. All eyes we re also assessed for the presence and severity of posterior capsule op acification (PCO) using a newly developed grading system. Results: Ove rall, 110 eyes (75%) had uncorrected visual acuities greater than or e qual to 6/24 and 107 eyes (74%) had best spherically corrected visual acuities greater than or equal to 6/18. Some degree of PCO was found i n 40% of eyes, but was graded as visually significant in only 4% of ey es. No major sight-threatening complications were noted. A portable ne odymium:yttrium aluminium garnet (Nd:YAG) laser was used to perform ca psulotomies on all eyes with visually significant PCO, There were no l aser complications noted. Conclusions: At approximately 1 year after E CCE/IOL the visual outcomes for subjects in this cohort were favourabl e and complication rates were low. Posterior chamber opacification was not a major cause of vision impairment in this cohort. Portable Nd:YA G lasers may provide an effective solution to the problem of visually significant PCO occurring in developing countries as a late complicati on of extracapsular surgery. These findings support an increasing role for ECCE/PCIOL surgery by trained local eye surgeons in developing co untries.