Cataract surgery

Dr B B O Mmbaga CEHEFO
Executive Secretary, PO Box 1323, Dodoma, Tanzania

Dear Editor

There is still a place for intracapsular cataract extraction (ICCE), especially in remote areas of developing countries. The main reasons are known to all who have practised in developing countries or who have experience travelling in remote areas.

John Sandford-Smith (J Comm Eye Health 2000; 13: 62) mentioned that in northern Nigeria they still practise couching rather than ICCE. That is the method they can afford. It is not unusual to find well-trained personnel in those areas but they lack essential instruments. Even those patients who have ICCE surgery lack spectacles which may not be available or be available but expensive.

I agree that IOL implant surgery has excellent results compared to the previous technique. The major problem is the unavailability of the equipment, although it may be easy to train the existing personnel who are readily available.

The DU-AL Corporation* still has much to contribute, as their equipment could be carried to the remotest areas without difficulty. I have used their cryoextractors for ICCE ever since I qualified from ICEH, London, in 1986. Post-operative results are very good.

If we want to promote IOL implant surgery in full capacity let's follow the recommendations of Dr David Yorston in his article in this Journal (J Comm Eye Health 2000; 13: 51-52).

You, as Editor, have the means of evaluating what is written and recommended in most of our Community Eye Health Journals. Please give ICCE time -- it will phase out as soon as we reach our goals of supporting the Districts and Regional Eye Workers with essential instruments.

*DU-AL Corporation now acquired by Restored Sight Projects Ltd. Singleton Court, Wonastow Road Monmouth, UK