Manoj Sharma1,2, Sushant Wagley3, Rosie Dawkins1,2, Marcelino Correia1, Sameer Dabral1,6, Nitin Verma2,4

Purpose: There is currently a global debate about whether cataract surgery should be performed on an ‘outreach’ basis. Important factors in this debate include quality and safety of the surgery.

This study from Timor-Leste aims to compare cataract surgery performed at the National Eye Centre (NEC) with that performed on outreach visits. The NEC is located in Dili, the capital city, and serves the population of Dili as well as being a referral centre. For those who cannot access the capital, the NEC conducts outreach surgical visits throughout Timor-Leste on a rotating basis.

Method: Data was prospectively collected for cataract patients treated at the NEC and on outreach visits over the year 2014. Demographic information, surgery type, complications and pre / post visual acuity were collected.

Results: A total of 409 cataract surgeries were performed at the NEC and 402 on outreach. The most common cataract surgery was manual small incision cataract surgery: 93.90% at the NEC, and 100% on outreach.

No significant difference in intra-operative complications was found between NEC (12.94%) and outreach (13.21%) (p=0.91). Post-operative average best corrected visual acuity at last follow-up at NEC (6/12.9) was slightly better than on outreach (6/18) (p<0.001). Average time for final follow up was not significantly different: outreach (36 days) and NEC (41 days) (p=0.18).

Conclusion: Whilst there was a small difference in visual acuity outcome between surgery performed at the NEC and outreach, patient demand for outreach surgery remains high. It is important that ongoing monitoring and evaluation continues.