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• W228379818 abstract "Efforts to tackle cataract blindness in India have been going on in earnest for the last three decades. The revolutionary idea of holding surgical eye camps in makeshift hospitals started in the late 1960s and was extremely popular until the early 1980s. These frequently used measures for bringing an eye care delivery system to the village level created awareness and interest in the target population. More importantly, the participation of the community leaders and quick access to a familiar location played an important part in ensuring the success of these camps. In the early 1980s, Aravind Eye Hospital began changing this strategy by conducting screening eye camps to identify patients with cataract who could then be brought to the base hospital. Instead of a single large surgery camp, multiple smaller screening camps at a more grassroots level were conducted, with reduced infrastructure requirements. Surgeons were more comfortable operating in a fixed, familiar environment, and this resulted in better surgical quality and more cost effectiveness. A traditional intracapsular cataract extraction (ICCE) was performed and aphakic spectacles were provided during discharge. Brian & Taylor (1) have pointed to the effectiveness of the Aravind system. The late 1980s saw the intraocular lense (IOL) becoming more popular in the affluent population of India. However, its widespread use was limited by cost constraints of the IOL and other consumables and by lack of adequately trained personnel. Around this time, the setting up of IOL manufacturing facilities like Aurolab in Madurai, India, and the Fred Hollows Foundation in Nepal and Eritrea helped produce high quality intraocular lenses at a fraction of the cost, thus making these devices affordable to the general population. In the early 1990s, patients attending the free section of the Aravind Eye Hospital were offered a choice of free ICCE surgery or IOL surgery for which they would have to pay an equivalent of US$ 10. Information about the felt advantages of the IOL spread rapidly, and patients came to the hospital on their own asking for it. Apart from the advantage of patients sharing a significant part of their surgical costs, this process also reduced the cost and energy of case-finding, which could then be channelled into more productive activities. A retrospective analysis was made for the years 1992-94, to determine the rate of acceptance and affordability of IOL among the rural population of Tamil Nadu. The study estimated that the acceptance rate increased at an average of almost 70-100% as compared to a 17-20% increase in the total number of cataract operations performed per year (2). Introduction of large-scale extracapsular cataract extraction with IOL implantation (ECCE/PC-IOL) sparked off a debate about the safety and efficacy of this new procedure as compared to the conventional ICCE. To answer these queries, the Madurai Intraocular Lens Study randomized 3400 cataract patients to receive either an ICCE or an ECCE with PC-IOL. After a follow-up period of one year, the study concluded that although both operative procedures were safe and effective for cataract patients with bilateral impairment, ECCE/PC-IOL was superior to ICCE in terms of both visual acuity restoration and safety (3). Moreover, in this developing country setting, ICCE and ECCE/PC-IOL were associated with substantial benefits in improved everyday vision function and patients who received ECCE/PC-IOL reported greater benefits and fewer problems with vision than did patients who received ICCE-AG (4). …" @default.
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• W228379818 date "2001-01-01" @default.
• W228379818 modified "2023-09-23" @default.
• W228379818 title "Cataract blindness--the Indian experience." @default.
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