Purpose:
Cataracts are the leading cause of treatable blindness in rural Thailand, where access to treatment remains a major obstacle for those with visually significant cataracts. The World Health Organization (WHO) identified mobile surgical clinics as a solution, but evaluation of this model of care delivery is still needed.
Methods:
This study retrospectively reviews outcomes of cataract surgeries performed by the Ban Phaeo Mobile Eye Clinic in Thailand from October 2008 to March 2011. Demographic data, visual acuity (VA) before and at 4 weeks after surgery, surgery method, type of intraocular lens (IOL) implanted, and complications were recorded from patient charts for 7088 eyes (7088 patients). Visual outcome was compared by surgery method, phacoemulsification or extracapsular cataract extraction (ECCE), and IOL type, rigid polymethylmethacrylate or foldable acrylic.
Results:
Preoperatively, 3.6% of eyes had VA ≥20/70. Four weeks postoperatively, 85.5% of eyes had VA ≥20/70. Phacoemulsification was performed in 89.7% of eyes and 87.3% of these eyes saw ≥20/70 at four weeks compared to 70.8% of eyes that underwent ECCE. Foldable lenses were placed in 25.0% of eyes undergoing phacoemulsification. Forty eyes were left aphakic. Reported intraocular complications included zonular dehiscence (40 eyes), retained lens fragment (2 eyes), wound leakage (1 eye), and posterior capsule tear (1 eye).
Conclusions:
Four-week post-operative visual outcomes at the Ban Phaeo Mobile Eye Clinic meet the WHO quality target and are comparable to those of an urban hospital in Bangkok. This finding suggests that the mobile eye clinic is an effective method for providing quality cataract surgery to rural Thailand
Keywords: treatment outcomes of cataract surgery • visual acuity • cataract