Survey of Clinical Practice of Eye Surgeons and Trainees in Tanzania
Name: Samantha Xing
School: Vagelos College of Physicians and Surgeons, Class of 2026
Mentor: Lisa Park, MD
Abstract
Research Question: What is the surgical practice and interest in learning phacoemulsification among Tanzanian eye surgeons?
Background: Cataracts represent the principal cause of blindness and visual impairment in Sub-Saharan Africa1. As of 2016, there were 55 ophthalmologists and 81 assistant medical officers in ophthalmology (AMO-O) in Tanzania2. Phacoemulsification and manual surgery are both safe and effective for cataract patients, with phacoemulsification leading to better visual outcomes3.
Methods: Self-administered questionnaires were distributed at the 2023 TOS 4th Eye Health Workers Congress. Data on demographics, surgical practice, and interest in learning phacoemulsification and barriers were collected. Descriptive statistics were computed using Microsoft Excel.
Results: Out of the 19 eye surgeons (16 ophthalmologists and 3 AMO-Os), most were male (74%) and were between 30-39 years old (47%). On average, they had 8 years of practice experience, with all AMO-Os having >20 years. Most practiced in urban settings (68%), and some held medical school positions (32%). All respondents performed manual surgery, at an average rate of 209 surgeries per year. 100% implant PMMA lenses and 32% also implant foldable lenses. 5 have learned phacoemulsification in the past but only 4 are currently performing. All 12 eye surgeons who have not learned phacoemulsification expressed an interest in learning it. Barriers to learning phacoemulsification surgery included lack of insurance coverage, limited access to and costs of machines and materials, and high training expenses.
Conclusions: There is a strong desire among Tanzanian eye surgeons to learn phacoemulsification. Targeted training programs addressing cost, insurance and resource constraints can enhance the adoption of phacoemulsification.
References:
1. A B, Wh D, Jc S. Blindness and visual impairment due to age-related cataract in sub-Saharan Africa: a systematic review of recent population-based studies. Br J Ophthalmol. 2013;97(10). doi:10.1136/bjophthalmol-2013-303135
2.Mwakyusa N, Gosbert K, Bernadetha S, et al. Eye Health System Assessment: Mainland Tanzania. Published online May 2017. Accessed July 31, 2023. https://research.sightsavers.org/wp-content/uploads/2018/05/Eye-health-s...
3. Zhang J yu, Feng Y fan, Cai J qiu. Phacoemulsification versus manual small-incision cataract surgery for age-related cataract: meta-analysis of randomized controlled trials. Clin Experiment Ophthalmol. 2013;41(4):379-386. doi:10.1111/j.1442-9071.2012.02868.x