ABSTRACT

Purpose

This study was undertaken to evaluate the complication rates and visual outcomes of outreach cataract surgeries done in makeshift operating rooms.

Method

In this retrospective study, surgical outcomes of consecutive Manual Small Incision Cataract Surgeries (MSICS) done in 11 rural camps in Nepal were compared with the results of consecutive hospital surgeries (MSICS and phacoemulsification) done by the same surgeon. Surgeries were done from September 2018 to March 2020.

Results

Out of 1034 study population in each group, a significantly higher number (p < .001) of camp patients (27%, n = 279) were either blind or had severe visual impairment when compared to hospital patients (18.6%, n = 192). Around 88.9% (n = 919) of cases operated in camps and 85.7% (n = 886) in the hospital achieved uncorrected visual acuity (VA) of 6/18 or better on the first postoperative day. Poor outcome (VA<6/60) was seen in 3.7% (n = 38) of cases in camps and 3.9% (n = 40) in the hospital. The difference in visual outcomes was not significant (p = .162) when the results were controlled for other associated variables. There was no significant difference (p = .126) between complication rates in camps (1.9%, n = 20) and hospital surgeries (3.5%, n = 36) when preoperative conditions were statistically controlled. No cases of endophthalmitis were reported.

Conclusions

Makeshift operating rooms can be used for cataract surgeries in rural areas where no standard operating rooms are available. If appropriate patient selection criteria and standard surgical protocols are followed, good surgical outcomes can be achieved in camps by an experienced surgical team.

中文翻译：

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与尼泊尔的医院手术相比，在农村营地的临时手术室进行的白内障手术的结果

摘要

目的

本研究旨在评估在临时手术室进行的外展白内障手术的并发症发生率和视觉结果。

方法

在这项回顾性研究中，将在尼泊尔 11 个农村营地进行的连续手动小切口白内障手术 (MSCS) 的手术结果与同一外科医生连续进行的医院手术（MSCICS 和超声乳化术）的结果进行了比较。手术于 2018 年 9 月至 2020 年 3 月进行。

结果

在每组的 1034 名研究人群中，与住院患者（18.6%，n = 192）。大约 88.9% (n = 919) 在营地接受手术的病例和 85.7% (n = 886) 在医院接受手术的病例在术后第一天达到了 6/18 或更高的裸眼视力 (VA)。营地中 3.7% (n = 38) 的病例和医院中 3.9% (n = 40) 的病例出现不良结局 (VA<6/60)。当控制其他相关变量的结果时，视觉结果的差异不显着 ( p = .162)。无显着差异（p= .126) 在术前条件得到统计控制的情况下，营地 (1.9%, n = 20) 和医院手术 (3.5%, n = 36) 的并发症发生率之间。没有报告眼内炎病例。

结论

在没有标准手术室的农村地区，可以使用临时手术室进行白内障手术。如果遵循适当的患者选择标准和标准手术方案，经验丰富的手术团队可以在营地实现良好的手术效果。