Complications of Couching and Visual Outcome after IOL Implantation - a Study of 60 Patients in Sudan

ABSTRACT

Aims: to describe visual outcome and complications of traditional cataract surgery (couching) which is still practiced in some regions in West Darfur; Sudan. Material and Methods: This case series studied the use of Scleral-fixated IOL in the management of patients who underwent traditional cataract surgery (couching) in West Darfur; between July; 2006 and June; 2007. Results: The study included 60 patients; of which 36 were males and 24 were females. The mean age of patients was 70 years (range 55-90 years). Fifty seven patients had poor vision in one eye; and only three patients had poor vision in both eyes. Complications of couching included secondary glaucoma and optic nerve atrophy (38); endophthalmitis (22); Majority of patients (60) ended up with no perception of light (NPL) vision. In 9 patients sclera fixated IOL and in 4 patients ACIOL implantation procedures were done. Best corrected vision postoperatively ranged between 6/9 and 6/18 in both groups. Conclusion: Couching results in poor visual outcome and blinding complications in most of the patients. Hence; traditional healers performing couching should be banned by the government; not only by setting legislations against them; but also by organizing wide campaigns of heath education and mobile cataract surgery facilities (eye camps) that target the areas of action