MOBILIZING A MOBILE SURGICAL TEAM AT THE DISTRICT LEVEL, A COST EFFECTIVE STRATEGY FOR CATARACT SURGERY IN MALISOCIAL REHABILITATION, VISUAL FUNCTIONNING AND QUALITY OF LIFE OUTCOMES

Objectives:-To compare, in the region of Mopti region (Mali), the impact of a cataract surgery practised in a regional hospital (strategy 1 or fixed strategy) with a surgery close to the patients at the district level (strategy 2 or advanced strategy) on patient reported quality of life and visual functioning as well as on social rehabilitation. Methods:-Two samples of 100 and 199 people operated on for cataract in the fixed and advanced strategies respectively, were included in this study and were submitted at questioned on perceived vision and quality of life (IOTAQOL). Results:-Social conditions improved dramatically in both strategies, Most of men were able again to sustain their families (86,0% and 93,9% in strategies 1 and 2 respectively) and women to participate in housekeeping (87,8% and 88,2% respectively). The gains in QOL scores were high and equivalent in both strategies. These scores were strongly linked with the presence of an intraocular lens, with the ability to work and to fulfil his/her family duty. The gains in Perceived vision scores were equals in both strategies and strongly linked with postoperative visual acuity and with the presence of an intraocular lens. Conclusion:-Cataract surgery allows a dramatic socioeconomic reinsertion and a quality of life improvement whatever the strategy adopted.