A major cause for botched cataract operations is infections in the operation theatre, surgical devices and fluids used for surgery, according to senior ophthalmologists. This was seen again at Hanamkonda where cataract surgeries have left at least seven with affected vision.
A senior ophthalmologist in government hospital said, “The source of infection is from fluids and devices. Bacteria in the fluids can’t be seen with the naked eye but if the products are procured from a standardised company that have quality control checks the contaminated products are removed from the stock.”
Senior doctors stated that the government had entered into a memorandum of understanding with private hospitals in districts for carrying out cataract surgeries. A senior doctor said, “Infection control is an ongoing and in-built process which has to be followed. The checks on this system have to be strong with regular monitoring from the microbiology department.”
Apart from the doctors, the paramedical staff, nurses and ward boys who clean the devices have to be counselled on hygiene practices.
Dr P. Rashmi, senior microbiologist, said, “Cataract is now a 15 to 20-minute surgery but the devices come in contact with body fluids. It is very important that after being used for one patient, the devices are cleaned immediately and then used for others.”
Cleaning is mostly done with water and detergent is used when there is blood, pus and protein. “In the case of eye instruments it is challenging as there are very small lumens and due to the delicate tips of the instruments there are chances of easily breaking and damaging in case of improper handling,” Dr Rashmi said.
The most important stage is decontamination where the chemicals are used to inactivate, destroy blood borne pathogens where they are no longer capable of transmitting infections, she added.