The cataract situation in Suriname: an effective intervention programme to increase the cataract surgical rate in a developing country

Aims To provide an overview of cataract data in Suriname and to describe and evaluate a programme to control cataract blindness in a developing country. Design Evaluation of hospital data and findings from a population-based cross-sectional survey. Methods The implementation of a new cataract surgical intervention programme was described and retrospectively evaluated by analysing the number of cataract operations and other related indicators at the Suriname Eye Centre (SEC) in the period 2006-2014. Findings of the recent Rapid Assessment of Avoidable Blindness (2013-2014) survey were used to evaluate the national cataract situation in Suriname in people aged >= 50 years (n=2998), including prevalence of cataract blindness, outcome and cataract surgical rate (CSR). Results Since the implementation of a new cataract intervention programme, the number of cataract operations at the SEC has increased from 1150 in 2006 to 4538 in 2014, leading to an estimated national CSR of 9103 per one million inhabitants. The prevalence of bilateral cataract blindness in Suriname was 0.8% (95% CI 0.2% to 1.3%) in individuals aged >= 50 years. The proportion of eyes with a postoperative visual acuity <6/ 60 (poor outcome) was lowest in eyes operated at the SEC (8.5%) and highest in surgeries performed by foreign humanitarian ophthalmic missions. Conclusions The cataract situation in Suriname is well under control since the implementation of the new intervention programme. Important factors contributing to this success were the introduction of phacoemulsification, intensive training, and improvement in the affordability and accessibility of cataract surgery. The proportion of poor outcomes was still > 5%.