Risk factors affecting cataract surgery outcome: The Malaysian cataract surgery registry (original) (raw)
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Clinical Ophthalmology
Background: Cataract is the leading cause of blindness and the second leading cause of visual impairment worldwide, accounting for 51% and 33% of all cases, respectively, in low-and medium-income countries bearing a disproportionately high burden. Hence, this study aimed to assess the visual outcome of age-related cataract surgery and identify factors associated with patients' postoperative visual outcomes in Jimma University Medical Center, Southwest Ethiopia. Methods: An institution-based cross-sectional study design was conducted among 386 cataract surgery patients from January 1, 2016, to December 30, 2017. The study participants were selected using a systematic random sampling technique. Data were collected by reviewing the selected patients' medical records using a pre-tested checklist, entered into EpiData version 3.1, and exported to SPSS 20 for analysis. Proportions, summary statistics, and tables were used for presentations of the findings. Binary logistic regression was carried out to identify independent predictors of visual outcome. Findings were presented with adjusted odds ratios and their 95% confidence interval. A p-value <0.05 was used to declare a statistically significant association. Results: About 231 individuals (59.8%) had poor visual results following cataract surgery. Furthermore, age >70 (AOR = 3.64; 95% CI [1.35-9.82]), preoperative ocular co-morbidities (AOR = 2.34; [1.32-4.15]), incision-based cataract surgery (AOR = 7.11; [3.16-16.02]), compared phacoemulsification operated by resident surgeons (AOR = 2.19; [1.23-3.89]), presence of intraoperative complication (AOR = 3.41; [1.47-7.92]), lens remnant (AOR = 2.91; [1.11-4.92]), ocular inflammation (OR = 2.56; [1.34-4.92]), and striate keratopathy/corneal edema (AOR = 1.91; [1.07-3.44]) were significantly associated with poor visual outcome. Conclusion: The visual outcome following cataract surgery fall below WHO recommendation. In this study, age, ocular comorbidities, surgical method, surgeon status, intraoperative complication, SK, and ocular inflammation associated with postoperative Uveitis and anterior chamber reaction were associated with a poor visual outcome.
Visual outcome after cataract surgery in a tertiary eye hospital of Chittagong district, Bangladesh
2019
To evaluate the visual outcome in patients who have had their cataract surgery in a tertiary hospital of Chittagong district in Bangladesh. This is a clinic-based study of consecutive cataract-operated patients who had age-related cataract with vision less than <6/60 before surgery. A total of 228 patients who visited the hospital and met the eligibility criteria were included in the study. The mean age of the patients was 62.46± 10.14 years and 134 (58.8%) were female. A total of 456 surgeries were performed on 228 patients. The most common procedure was small incision cataract surgery (SICS) with intraocular lens (IOL) implantation, operated in 422(92.5%) eyes. Among cataract-operated eyes, 290 (64%) had presenting vision >6/18 and <6/60 were found in 11 (2.4%) eyes. In most of the cases, visual acuity has improved after best correction as the percentages with the best correction were 402(88%) and 7(1.55%) respectively. Analysis of multiple logistic regression shows that patient's older age (OR 9.101; 95% CI 3.331, 24.869), gender female (OR 2.374 CI 1.403, 4.017), literacy (OR 1.660; CI 1.009, 2.733) and SICS surgery technique (OR 3.540; CI1.298, 9.659) were significantly associated with poor visual outcome. Overall, this study demonstrates that cataract surgery can restore good visual acuity. However, the visual outcome needs to be improved to meet the WHO standard, and more attention should be directed towards monitoring of outcomes and correction of refractive error after cataract surgery.
Pakistan Journal of Medical Sciences
Objectives: To observe and analyze the visual outcomes of cataract surgery of ten years at a tertiary eye care hospital, Karachi. Methods: An observational study with retrospective data search was conducted in Al Ibrahim Eye Hospital (AIEH), Karachi. Data of all adults (above 16 years) who underwent cataract surgery from 2010-2019 was retrieved from HIMS. Presence of opacity in the lens was labelled as cataract. Surgery was advised when patient’s BCVA was found to be 6/18. Visual assessments of the patients were done on day 01, one week and six weeks postoperatively. Postoperatively, 6/6 – 6/12 was considered as good, 6/18 as mild visual impairment, < 6/18 to 6/60 as moderate visual impairment and < 6/60 as severe visual impairment. Results: A total of 1,027,840 patients visited AIEH with different eye diseases. Among 1027840 individuals, cataract was identified in 88443 (8.6%). Surgery was advised to 58371 and performed in 38616. Records of operated cases (38616) were retriev...
Introduction: An uneventful cataract surgery with intraocular lens implant is capable of providing normal vision. Good visual outcome increases patient's satisfaction and quality of life. Aim is to evaluate the postoperative complications and visual outcomes after manual small incision cataract surgery at a teaching hospital. Materials and Methods: This is a clinic-based and hospital based study of consecutive cataract-operated patients who had age-related cataract with vision less than <6/60 before surgery. A total of 140 patients who visited the hospital and met the eligibility criteria were included in the study. In this study 140 patients who underwent uneventful SICS with PCIOL implant were followed up. Patients having pre-existing ocular disease were excluded. IOL power was accurately estimated. Visual acuity, anterior segment and fundus findings were recorded at each postoperative visit upto 6 weeks and in some cases upto 3months. We followed the visual outcome standards set by WHO. Results: 66 males and 74 females in the age group of 45 to 75 and above were selected. On 1st post operative day 38.57% patients had quiet eyes. In 61.43% patients, decreased vision and complications observed on 1st post operative day and upto 1st week were: Striate keratopathy and corneal edema, anterior uveitis with pupillary membrane, residual lens matter, macular edema, endophthalmitis, intraocular hemorrhage with secondary glaucoma and IOL related causes. On the 6th postoperative week during spectacles prescription, 61.42% had uncorrected Astigmatism, 6.42% consecutive myopia/ hypermetropia and 8.57% had posterior capsular opacity. At 3 months follow up, 91.42% had good outcome, 3.57% patients had borderline outcome. 5% poor visual outcome was seen in patients with Bullous keratopathy, endophthalmitis, vitreous hemorrhage and longstanding macular edema. Conclusion: Our hospital based study reports 5% patients with poor visual outcome 3 months after uneventful cataract surgery
Clinical Optometry, 2017
Background: Globally, cataract is the leading cause of blindness which accounts for 51% of 39 million blind people. The visual rehabilitation is made through sight-restoring surgery. The patients' postoperative visual satisfaction, vision related quality of life, ability to function in daily activities and their overall productivity mainly depend on the visual outcome. However, there are limited data on the visual outcome and its associated factors in the study area. Therefore, this study intended to evaluate the postoperative level of visual acuity to provide a baseline information regarding visual outcome and design a standardized protocol to maximize it. Methods and materials: A hospital-based cross-sectional study was conducted at the Gondar University Hospital Tertiary Eye Care and Training Center on 223 patients who underwent cataract surgery, selected using simple random technique from April to June 2015. Results: This study consisted of 218 patients or eyes that underwent cataract surgery. The median age of the participants was 65 years with an interquartile range of 20 years. Of 218 cataract-operated visually impaired eyes (<6/60), 26.6% of them achieved good visual acuity (≥6/18), 28.9% of them had borderline acuity (<6/18-6/60), and the remaining of 44.5% were remained as poor visual acuity (<6/60). It has been observed that the postoperative visual acuity had an association with postoperative follow up time duration (P=0.035). Conclusion: In this study, the visual outcome of cataract surgery was significantly low as compared to World Health Organization's recommendations, and it has been recognized that there is significant progression of visual acuity in different consecutive weeks.
Eye (London, England), 2015
AimsTo describe the outcomes of cataract surgery in the United Kingdom.MethodsAnonymised data on 180 114 eyes from 127 685 patients undergoing cataract surgery between August 2006 and November 2010 were collected prospectively from 28 sites. Outcome measures included intraoperative and postoperative complication rates, and preoperative and postoperative visual acuities.ResultsMedian age at first eye surgery was 77.1 years, 36.9% cases had ocular co-pathology and 41.0% patients underwent cataract surgery on both eyes. Preoperative visual acuity was 0.30 logMAR or better in 32.0% first eyes and 47.7% second eyes. Postoperative best-measured visual acuity was 0.00 and 0.30 logMAR or better in 50.8 and 94.6% eyes without ocular co-pathology, and 32.5 and 79.9% in eyes with co-pathology. For eyes without co-pathology, postoperative uncorrected distance visual acuity was 0.00 and 0.30 logMAR or better in 27.3 and 80.9% eyes. Posterior capsule rupture or vitreous loss or both occurred in 1...
British Journal of Ophthalmology, 2007
Aim: To evaluate the outcomes of cataract surgery in Pakistan. Methods: Cross-sectional, nationally representative sample of 16 507 adults (aged >30 years). Each underwent interview, logarithm of the minimum angle of resolution visual acuity (VA), autorefraction, examination of optic disc. Those with ,6/12 VA on presentation underwent best-corrected VA and dilated biomicroscopic ocular examination. Results: 1317 subjects (633 men) had undergone surgery in one or both eyes. Of the 1788 operated eyes, 1099 (61%) had undergone intracapsular cataract extraction (ICCE) and 607 (34%) extracapsular surgery with an intraocular lens (ECCE+IOL). Presenting VA: 275 (15.4%) eyes: 6/12 or better; 253 (14.1) ,6/12 >6/18; 632 (35.3%) 6/18 to 6/60; 85 (4.8%): 6/60 to 3/60; 528 (29.5%): ,3/60. With ''best'' refractive correction, these values were: respectively. Of the 1498 eyes with VA (6/12 on presentation, 352 (23.5%) were the result of coincident disease, 800 (53.4%) refractive error and 320 (21.4%) operative complications. Eye camp surgery (OR 1.72, p = 0.002), ICCE (OR 3.78; p,0.001), rural residence (OR 1.36, p = 0.01), female gender (OR 1.55, p,0.001) and illiteracy (OR 2.44, p,0.001) were associated with VA of ,6/18. More recent ICCE surgeries were associated with a poorer outcome. The ratio of ECCE+IOL:ICCE in the last 3 years was 1.2:1, compared with 1:3.3 >4 years before the survey. Conclusion: Almost a third of cataract operations result in a presenting VA of ,6/60, which could be halved by appropriate refractive correction. This study highlights the need for an improvement in quality of surgery with a more balanced distribution of services.
Cataract surgery complications as a cause of visual impairment in a population aged 50 and over
Cadernos de Saúde Pública, 2008
Cataract surgery complications as a cause of visual impairment in a population aged 50 and over Complicações de facectomias como causa de baixa visual em uma população com 50 ou mais anos de idade Abstract The purpose of this study was to measure the extent to which complications relating to cataract surgery are a cause of visual impairment in a population aged 50 and over from the city of Campinas, São Paulo State, Brazil. An assessment of cataract surgery services was conducted using random cluster sampling, with the sample composed of 60 clusters of 40 people aged 50 years or older. Of the selected sample of 2,400 subjects, 92.67% were examined. Of these 2,224 examined subjects, 75 (3.37%) presented bilateral visual impairment and 164 unilateral, while a total of 314 (7.06%) eyes presented visual impairment. 352 eyes had undergone cataract surgery. The causes of visual impairment after surgery were concurrent eye disease (56%), surgical complications (28.8%) and refractive errors (15.2%). Cataract surgery complications represented the 5th most important cause of visual impairment. The other main causes were cataract, posterior segment disorders, diabetic retinopathy and glaucoma. These results suggest cataract surgery complications are a major cause of visual impairment in this population. Their prevention and treatment must be part of public health care policies.
The Malaysian Cataract Surgery Registry
Asia-Pacific Journal of Ophthalmology, 2014
Purpose: To present the cataract surgery practice pattern among the ophthalmic surgeons in hospitals managed by the Ministry of Health (MOH) in Malaysia. Design: Secondary data analysis on Malaysian Cataract Surgery Registry (CSR). Methods: The Malaysian CSR collected data on cataract surgeries done at all the ophthalmology departments in MOH from year 2002 to 2004 (paper-based) and 2007 to 2011 (web-based). Data collected include type of admission, surgical techniques, type of anesthesia, and intraocular lens (IOL). Descriptive and inferential analysis was performed. Results: Of the 185,388 cataract surgeries done over 8 years, 171,482 (91.5%) were captured in CSR. There was a steep rise in phacoemulsification cataract surgery from 39.7% in 2002 to 78.0% in 2011 with a corresponding fall in extracapsular cataract extraction from 54.0% to 17.3% in the respective years. This explained the surge in the use of foldable IOL from 26.5% in 2002 to 88.3% in 2011. The proportion of cataract surgery with IOL implantation was 97.5% in 2012 and 98.2% in 2011. The proportion of day-care cataract surgery was low, with 39.3% in 2002 to 52.3% in 2011. Vitreoretinal surgery was the commonest type of combined surgery performed. Conclusions: Although phacoemulsification was performed in two thirds of the patients who presented to MOH hospitals in Malaysia, extracapsular cataract extraction was still being performed because of a significant proportion of cataract that were brunescent and limited access to phacoemulsification machines and consumables. There is a need to increase day-care cataract surgery as it will eventually save cost.