Eye disease detection a stumbling block in Eastern Europe

PRAGUE, Czech Republic — Conditions vary for cataract and vitreoretinal surgery in Eastern Europe, but a main obstacle for surgeons is detecting disease and properly identifying patients requiring surgery, a large survey has found.

Researchers here with Charles University queried all 458 eye departments in the region of Central and Eastern Europe; the response rate was almost 100%.

The survey found that most cataract removal was via extracapsular surgery. Intracapsular extractions were frequently performed in Bosnia and Herzegovina, Belarus, Bulgaria and Romania. Phacoemulsification was uncommon in 1998, except in the Czech Republic (86%), Estonia (50%), Slovakia (38%) and Hungary (16%). IOLs were implanted in more than 90% of cataract patients in the Czech Republic, Estonia, Hungary, Latvia, Lithuania and Slovakia. The main obstacles to surgery, according to the survey responses, were state budget limitations, insufficient supply of consumables, underuse of operating facilities and poor detection of patients requiring surgery.

In the same regions, the number and method of retinal detachment (RD) surgery varied widely The number of RDs treated by extraocular surgery was 82 or fewer per 1 million inhabitants. The number treated by pars plana vitrectomy was 40 or fewer in all countries except Hungary, where 88 pars plana vitrectomies were performed per million inhabitants. Survey respondents said underserved regions require more surgeons trained in surgical and laser retinal detachment, improvement in screening for diabetic eye complications and retinopathy of prematurity and more technical equipment.

The study is published in two parts in the August issue of British Journal of Ophthalmology.