Phacoemulsification? The solution to the cataract problem in the Caribbean - abstract

ABSTRACT

The outcomes of the first 28 phacoemulsification (PE) cataract procedures done by one of the authors (DS) were compared with those achieved in 100 extracapsular cataract extractions (ECCE). A greater complication rate was encountered during PE, 28.5 percent vitreous loss, compared to ECCE with 1 percent vitreous loss. The visual outcome was however comparable with 96 percent of the PE group achieving 20/40 or better and 86 percent of the ECCE group achieving the same. Prompt handling of complications is essential. A cost analysis for PE was also done indicating that PE cost at least US$50 more per eye than ECCE. The investment in training, equipment and disposables as well as a low cataract surgery rate may mitigate against the provision of the new technology in the smaller territories. For those planning to embark on phaco surgery, a comprehensive training programme is recommended culminating with supervised hands-on experience. Time outside the routine operating schedule should be devoted to training as operating time is long during the learning curve. A phaco machine inthe hands of an itinerant Ophthalmology Resident is certainly not the answer to the prayer of the Caribbean cataract patient (AU)