Eye healthcare services in eastern Europe: Part 1. Cataract surgery

Area of Science:

• Ophthalmology
• Public Health
• Health Services Research

Background:

• Cataract remains a leading cause of blindness globally.
• Effective cataract surgical services are crucial for vision restoration.
• Eastern European countries faced unique challenges in healthcare provision in 1998.

Purpose of the Study:

• To assess the status of cataract surgical services in 12 Eastern European nations in 1998.
• To identify specific needs and barriers hindering cataract surgery and contributing to blindness in the region.

Main Methods:

• A comprehensive survey was distributed to all inpatient eye departments across the 12 countries.
• Data collection involved a standardized questionnaire, with results centralized and processed in Prague.
• A 100% response rate was achieved, with minor exceptions in Bulgaria and Romania.

Main Results:

• Cataract surgery rates per million inhabitants varied significantly, with the Czech Republic (4210) and Hungary (3530) reporting the highest rates.
• Extracapsular technique was predominant, while intracapsular extractions were common in certain nations (e.g., Federation of Bosnia and Herzegovina, Belarus).
• Phacoemulsification was rarely used, except in the Czech Republic (86%) and Estonia (50%). Intraocular lens (IOL) implantation exceeded 90% in several countries.

Conclusions:

• Significant disparities exist in cataract surgery provision across Eastern Europe.
• Major obstacles to increasing cataract surgical services include state budget constraints, inadequate supplies, underutilized operating facilities, and insufficient patient identification for surgery.