Impact of Cataract Surgical Services in Ogun State, Nigeria

Abstract

Background: Cataract remains the principal cause of blindness globally at 51%. The cataract surgical rate (CSR) in developed countries is about 4000 to 6000 while in most part of Africa and other developing countries it is 400 - 500. Cataract backlog and low cataract surgical rate is a constant feature in Nigeria as in other parts of Africa and Asia. Objective: to determine the impact of cataract surgical services in Ogun state of Nigeria. Methods: This was a cross-sectional study whereby the operation registers for the period of one year (1st January to 31st December 2014) at the Eye Foundation Centre (EFC), St Mary’s Catholic Eye Hospital (SMCEH) Ago-Iwoye, Babcock University Eye Clinic and all the state hospitals in Ogun state were reviewed. The numbers of operable cataracts (eye with <6/24 due to cataract) in the outreach and clinic registers were noted. The number of eyes operated for age-related cataracts were determined. This research did not consult patients. The name of the surgeon per cataract surgery was noted and number of surgeons per clinic or hospital compiled. Information on Ogun state population was obtained. Cataract backlog and cataract surgical rate in the state were assessed. Results: A total of 8660 operable cataracts were identified and 5410 eyes were done during this period leaving a backlog of 3250 eyes (in this study). Cataract surgical rate for Ogun state for the period was 1098 operations per million per year. The main providers of cataract surgical services in Ogun state are Eye Foundation Centre 3099 eyes (57.2%) and St Mary’s Catholic Eye Hospital 1951 (36.0%), totalling 5050 eyes (93.2%). Others did 360 eyes (6.8%). There are 18 surgeons in the state but 11 participated in the study. Therefore an average of 491 cataract operations is performed by an ophthalmic surgeon per year in Ogun state. Conclusion: Cataract surgeries of 5410 performed annually in the state is more than the incidence of cataract blindness in the state which is estimated at 4924. CSR of 1098 is more than the universally accepted cataract blindness incidence of 1000 per million populations per year for developing countries. Therefore, if these figures are surpassed in the coming years with more improved cataract services delivery, the backlog will be drastically reduced.