Cataract surgery in Yemen resent and future [Archives:2005/855/Health]

Cataract Surgery is usually required to restore full sight to individuals afflicted by cataract, a loss of transparency in the eye's lens. The surgeon cuts into the cornea and snips off a piece of the iris, the round membrane that covers the lens and gives the eye its individual color. After this procedure, called an iridectomy, the natural lens is removed with a small pair of forceps and replaced by a new plastic lens. A fine suture is then used to close the incision in the cornea.

According to the available data about cataract surgery in Yemen, the cataract surgical rate in 1995 was 670 per 1,000,000 population. This rate became 1,000 cataract surgeries per 1,000,000 population in 1999. An ophthalmic situation analysis in 2003 refers to 31,258 cataract surgeries that were done, and reaching a rate of 1600 per 1,000,000 population. However this analysis considers just new cases without considering the backlog of cataract cases.

Intraocular lens implantation in cataract surgery in Yemen is 71.6% .The highest rate of this surgery was found in Dhamar, Al-Dhala, Sana'a, and Aden. The lowest rate was found in Hajja, Shabwa, Al-Mahweet and Lahj.

Ministry of health, local and international non governmental organizations (NGOs), try to decrease this rate to reach 2500 or 3000 cataract cases in the coming five years. Therefore the last ophthalmic situation analysis referred to human, infrastructural reasons which caused such situations. The analysis exposed that there are deficiencies or sometimes absence of ophthalmic doctors and nurses in some governorates like Mareb, Al-Jawf, Al -Mahara. There is one ophthalmologist for 96,000 patients, but this number differs between different governorates.

The analysis mentioned that most eye units (162 eye units) are localized in Sana'a, Aden and Taiz. 86% of cataract surgeries are performed in the following five governorates: Sana'a (25%) Taiz (21%), Hadramout (17%) Aden ( 12%) and Hodeidah (11%).

Most of this surgeries are formed in private sector eye units. 23% of cataract surgeries are performed in public sector eye units, whereas 68% are performed in private sector eye units and 9% are performed in eye camps.

Based on these results the ophthalmic situation analysis strongly recommend many procedures such as:

– Establishing a national evidence based strategy for prevention of blindness and prepare effective plans to apply this strategy.

– Performing Multiple Rapid Assessment for Cataract Coverage Services (RACCS).

– Developing ophthalmic human recourses by improving surgical training especially in cataract surgeries and intraocular lens implantations mainly in the governorates that require such services, since the population of these governorates represent 49% of the total population in Yemen.

– Establishing eye units in those governorates with no or deficient eye units.

– Providing necessary equipments for the existing eye units.

– Ensuring cataract surgery quality control via monitoring outcomes of cataract surgeries

– Establishing a data base for primary eye health, preferably to be part of the national health data base.
——
[archive-e:855-v:13-y:2005-d:2005-06-30-p:health]