Reduction of cataract blindness in rural areas of Cameroon

In this retrospective study, medical records of 47 consecutive patients (94 eyes) who underwent simultaneous bilaterale small-incision cataract surgery between januar 2010 and December 2015 in outreach surgical camps in rural Cameroon were reviwed. At the 4 week follow-up, 84,04% of the eyes showed increased visual acuity of one line or more. No cases of post operative endophtalmitis were recorded. Under the strict observation of endophtalmitis prophylaxis, simultaneous bilaterale small-incision cataract surgery is an option to reduce the cataract blindness backlog in rural areas of developing countries

Cataract surgery with intraocular lens implantation in children aged 5-15 in local anaesthesia: visual outcomes and complications

The aim of this study was to report feasibility, the visual outcomes and complications of pediatric cataract surgery with primary intraocular lens implantation in children aged 5 to15 years in local anesthesia. This retrospective interventional case series included 62 eyes from 50 children who underwent pediatrc cataract surgery with primary intraocular lens implantation at the Mana eye Clinic Nkongsamba between 2006 and 2015 Main outcome measures were: best-corrected post operative visual acuity, and intraoperative and postoperative complications. Mean age at surgery was 10.18 ± 3.21 years. Mean follow up length was 15.75 ± 3.36 weeks. Etiology included: 10 congenital cataracs (16.12%). 35 developmental cataracts (56.45%) and 17 traumatic cataracts (27.41%). The mean preoperative BCVA was logMAR 1.19 ± 0.33. (range 0.6-2.3). After cycloplegia refraction 2 weeks after surgery, the mean postoperative BCVA was log MAR 0.58 ± 0.88 ( range 0.5-1.8). The mean implanted IOL power was 22.01 ±3.16 D. IOL was succefuly implanted in 54 eyes (87.07%). Eight eyes (9.67%) were left aphakic. Increase in BCVA of 4 logMAR lines and above was recorded in 27 patients (43.55%). Intraoperative complications included: 4 posterior capsule holes with vitrous lost, 3 lenses subluxation and 1 case of iris dialyse. Late postoperative complications included: posterior capsular opacity which occurred in 16 patients, 3 posterior synechia, 2 retinal detachment. Peribulbar anaesthesia can be considered as a viable option in selected patients presenting developmental cataract undergoing cataract surgery in developing countries. Effort should be made to improve the early identification of congenital cataract and its early surgical intervention and prompt optical rehabilitation to prevent amblyopia.Pan African Medical Journal 2016; 2

Reduction of cataract blindness in rural areas of Cameroon

In this retrospective study, medical records of 47 consecutive patients (94 eyes) who underwent simultaneous bilaterale small-incision cataract surgery between januar 2010 and December 2015 in outreach surgical camps in rural Cameroon were reviwed. At the 4 week follow-up, 84,04% of the eyes showed increased visual acuity of one line or more. No cases of post operative endophtalmitis were recorded. Under the strict observation of endophtalmitis prophylaxis, simultaneous bilaterale small-incision cataract surgery is an option to reduce the cataract blindness backlog in rural areas of developing countries

Reduction of cataract blindness in rural areas of Cameroon

In this retrospective study, medical records of 47 consecutive patients (94 eyes) who underwent simultaneous bilaterale small-incision cataract surgery between januar 2010 and December 2015 in outreach surgical camps in rural Cameroon were reviwed. At the 4 week follow-up, 84,04% of the eyes showed increased visual acuity of one line or more. No cases of post operative endophtalmitis were recorded. Under the strict observation of endophtalmitis prophylaxis, simultaneous bilaterale small-incision cataract surgery is an option to reduce the cataract blindness backlog in rural areas of developing countries

Indications for Surgical Removal of the Eye in Rural Areas in Cameroon

Objective To determine the main clinical indications for surgical removal of the eye in rural areas in Cameroon. Design Retrospective non-comparative case series. Participants A total of 253 patients presenting to the Manna eye clinic Nkongsamba who underwent destructive eye surgery (DES) between January 2006 and December 2010 were reviewed. Main Outcome Measure Age, gender, occupation, prior medication, visual acuity, operation indications, and type of operation. Results There were 58.10% (n = 147) men and 41.90% (n = 106) women. Median age was 29 years (interquartile range: 14–69 years); age ranged from 10 to 88 years. A total of 67.19% (n = 170) of participants were farmers and lived in rural zones. In all, 79.05% (n = 200) confessed to have trying a medication before the presentation. Surgical indications included infective causes (perforated corneal ulcer 33.20% (n = 84) and endophthalmitis 18.20% (n = 46)), trauma 17.40% (n = 44), painful blind eyes 11.50% (n = 29), malignancy 10.70% (n = 27), and others 9.10% (n = 23). Conclusion The most common causes of DES in this series could be avoided. Therefore, preventive measures including extensive health education of the public and traditional healers on the risks linked to the use of traditional medicines in ophthalmology and the late presentation of eye disease, quality control of the campaigns that offer free cataract operations in the country

Uveal coloboma: about 3 cases at the University Teaching Hospital, Yaounde, Cameroon

Uveal coloboma is a rare eye malformation caused by failure of the optic fissure to close during the fifth to seventh weeks of foetal life. The risk of retinal detachment increases with age in colobomatous eyes. Preventive measures such as early detection of the retinal break , prophylactic laser photocoagulation along the coloboma margin, confer a significant benefit in reducing this risk of retinal detachment. Difficulties linked to the diagnosis and management of uveal colobomas in developing countries setting are presented in this study.Pan African Medical Journal 2016; 2

Modified Small Incision Cataract Surgery and Intraocular Lens Implantation in HIV Patients

Aim To describe a surgical technique suitable for cataract surgery in regions with a high prevalence of HIV infection. Methods We reviewed the medical records of 20 consecutive AIDS patients with cataract who underwent modified small-incision cataract surgery (mSICS) with posterior chamber lens implantation. Classic extracapsular cataract extraction (ECCE) was compared to mSICS. The number of potentially risky steps for contamination during surgery and duration of surgery were analyzed. A risky step was defined as any time when the surgeon had to use a sharp instrument. Student's paired t -test was carried out to compare continuous variables, and P -values <0.05 were considered statistically significant. Results Twenty patients were included in the study, 13 males (65%) and seven females (35%). The mean age was 46.3 ± 13.6 years (range 22–70 years). The number of potentially risky steps for contamination was significantly higher in the classical ECCE than in mSICS ( P < 0.001). The mean duration of cataract surgery with mSICS was significantly shorter as well ( P < 0.001). Conclusion Conversion to mSICS is essential in order to reduce accidental injuries during cataract surgery in sub-Saharan countries. Sharp instruments should be passed through a neutral zone to ensure that the surgeon and nurse do not touch the same instrument at the same time

Aphakia Correction by Injection of Foldable Intra Ocular Lens in the Anterior Chamber

We assessed the outcomes of the use of anterior chamber foldable lens for unilateral aphakia correction at the University Teaching Hospital of Yaounde. In this retrospective, non-comparative, consecutive case series study, we reviewed the records of patients who underwent an operation for aphakia correction by the means of injection of an angular supported foldable lens between January 2009 and December 2011 in the University Teaching Hospital Yaounde. Student's paired t -test was carried out to compare preoperative and postoperative visual acuity (VA) and intraocular pressure (TOP). P -values less than 0.05 were considered statistically significant. Twenty-one patients were included in the study; twelve were male (57.1%) and nine were female (42.9%). The mean age was 55.38 ± 17.67 years (range 9–75 years). The mean follow-up duration was 5.95 ± 3.14 months (range 2–12 months). The mean logMAR visual acuity was 1.26 ± 0.46 pre-operatively and 0.78 ± 0.57 post-operatively ( P = 0.003). The change in intraocular pressure was not statistically significant. Complications included intraocular hypertension (over 21 mmHg) in 3 patients (14.3%) and macular edema, pupillar ovalization, and retinal detachment in one patient each. The results indicate that injection of an angular support foldable lens in the anterior chamber is a useful technique for the correction of aphakia in eyes without capsular support. More extended follow-up, however, and a larger series of patients are needed to ascertain the effectiveness and safety of this procedure

Prevalence of Trachoma in the Far North Region of Cameroon: Results of a Survey in 27 Health Districts

<div><p>Background</p><p>Cameroon is known to be endemic with trachoma. To appreciate the burden of the disease and facilitate the national planning of trachoma control in the integrated control program for the neglected tropical diseases, an epidemiological mapping of trachoma was conducted in the Far North region in 2010–11.</p><p>Methodology</p><p>A cross-sectional, cluster random sampling survey was carried out. The survey focused on two target populations: children aged 1 to 9 years for the prevalence of active trachoma and those aged 15 and over for the prevalence of trichiasis (TT). The sample frame was an exhaustive list of villages and neighborhoods of Health Districts (HDs). The World Health Organization simplified trachoma grading system was used for the recognition and registration of cases of trachoma.</p><p>Principal Findings</p><p>48,844 children aged 1 to 9 years and 41,533 people aged 15 and over were examined. In children aged 1–9 years, the overall prevalence of trachomatous inflammation–follicular (TF) was 11.2% (95% confidence intervals (CI): 11.0–11.5%). More girls were affected than boys (p = 0.003). Thirteen (13) of 27 HDs in the region showed TF prevalence of ≥10%. The overall TT prevalence was 1.0% (95% CI: 0.9–1.1%). There were estimated 17193 (95% CI: 12576–25860) TT cases in the region. The prevalence of blindness was 0.04% (95% CI: 0.03–0.07%) and visual impairment was 0.09% (95% CI: 0.07–0.13%).</p><p>Conclusions/Significance</p><p>The survey confirmed that trachoma is a public health problem in the Far North region with 13 HDs qualified for district-level mass drug administration with azithromycin. It provided a foundation for the national program to plan and implement the SAFE strategy in the region. Effort must be made to find resources to provide the surgical operations to the 17193 TT cases and prevent them from becoming blind.</p></div