Journal d'ophtalmologie clinique et expérimentale
Libre accès
ISSN: 2155-9570
ISSN: 2155-9570
Magali Fortané, Serge Resnikoff, Nathan Congdon, Philippe Bensaïd, Kali Seini, Oumar Boukar, Aminou Bouba, Max Villain and Vincent Daien
Purpose: To assess outcomes and reasons for poor results after cataract surgery by non-physician surgeons (NPCS) in North Cameroon using a novel app.
Design: Prospective cohort study.
Participants: Consecutive patients undergoing surgery for age-related cataract between December 2016 and August 2017 at two non-governmental organization (NGO) hospitals (Lagdo and Kousseri) in northern Cameroon.
Methods: The Better Operative Outcome Software Tool (BOOST) app was used to collect data on visual acuity (VA) before and one day after surgery. Reasons for poor visual outcomes were recorded for 20 consecutive patients returning >6 weeks after surgery with VA<6/60.
Main outcome measures: Proportion of patients with good (VA ≥ 6/18), borderline (VA 6/60–6/18), and poor (VA<6/60) results, and cause of poor results: refractive problems, surgical complications or presence of ocular comorbidities.
Results: In total, 148 patients (148 eyes) in Lagdo and 91 patients (91 eyes) in Kousseri were evaluated. Mean (Standard deviation [SD]) age was 62.1 (8.0) years (54.1% male) in Lagdo and 65.7 (11.1) years (56% male) in Kousseri. Most patients (63.4% in Lagdo, 64.9% in Kousseri) were blind in the surgical eye pre-operatively. Good, borderline and poor surgical outcomes were present on Day 1 in 6.8%, 62.1%, and 31.1% in Lagdo (3rd percentile among BOOST users) and 2.2%, 65.9% and 31.9% in Kousseri (2nd percentile). Main reasons for poor surgical outcomes were ocular comorbidities in Lagdo (19 among 21 patients) and refractive errors in Kousseri (8 among 13 patients).
Conclusions: BOOST placed surgical results into context, and identified main causes of poor outcomes in each center.