Intraocular Lens Implantation Surgery In Onitsha, Nigeria

Abstract

Objective: to evaluate the outcome of cataract extraction with intraocular lens implantation surgery at the Guinness Eye Centre, Onitsha, Nigeria. Design: Retrospective cases series. Main outcome Measures: Visual acuity; post-operative complications. Materials and Methods: Consecutive patients who had cataract extraction with intraocular lens implant between January 2001 at the Guinness Eye Centre, Onitsha and follow up for at least 2 months post-surgery were studied. Information on age, sex, ocular and systemic co-morbidities; type of cataract; pre- and post-operative visual acuity and surgical complications were analyzed. Results: 30 patients (41eyes) were studied; mean age – 66.1 years (range – 10-90 years); M:F = 1:1. Eleven patients (36.7%) had bilateral surgery. Follow up was 5-18 months. 35 eyes (85.4%) had senile cataract; traumatic cataract and couched eyes, 2 eyes each; post-uveitic cataract and secondary lens implant, 1 eye each. Systemic co-morbidities were diabetes melitus and hypertension, 6 patients each; cardiovascular disease (2 patients); arthritis and bronchitis (1 patient each). Pre-operative acuity in all eyes was 6/18; 46.1% had corrected acuity >6/18; 16.9% had acuity >6/9. At the last visit, 43.6% and presenting acuity >6/18 or better, 75.4% had corrected acuity >6/18; 29.1% had corrected acuity >6/9. Optimal post-operative acuity occurred in 2-5 months; means – 3.5 months. Surgical complications were recurrent uveitis, 20 eyes (48.8%) astigmatism, 14 eyes (34.1%); high intraocular pressure, 3 eyes (7.3%); posterior capsule opacity, 3 eyes (7.3%) posterior castle tear, 2 eyes (4.9%). Poor post-operative acuity were due to posterior capsule opacity and macular scar, 3 eyes each; leukoma, 2 eyes; diabetic retinopathy, 1 eye. Conclusion: In spite of lacking some facilities for ocular microsurgery, cataract surgery with IOL implantation is safe and ensures better visual rehabilitation in Nigerians. Use of A-mode ultrasound scan, keratometer, YAG laser and newer lens designs will improve our results. But ophthalmic surgeons should promptly attend to such vision threatening complications as post-operative uveitis. KEY WORDS: Cataract; intraocular lens; visual acuity; surgical complications. [Nig. J. Ophthalmology Vol.10(1): 5-9]