Prevalence of cataract surgery and postoperative visual outcome in rural central India: Central India Eye and Medical Study

Abstract

To determine the prevalence of cataract surgery and the postoperative visual outcomes in rural central India. Villages in rural central India. Cohort study. The population-based Central India Eye and Medical Study examined the prevalence of surgical pseudophakia/aphakia, the postoperative visual acuity, and the reasons for decreased postoperative vision in subjects aged 30+ in rural central India. Visual impairment was defined as (1) presenting visual acuity worse than 6/18 or (2) corrected distance visual acuity (CDVA) worse than 6/18. Of the 9392 eyes (99.7%) of 4711 subjects with available data on the lens status, 318 eyes (3.4%) (234 patients, 129 women) had had cataract surgery (5.0% ± 0.3%). Cataract surgery was significantly associated with age (P<.001), female sex (P = .008), shorter axial length (P<.001), and diabetes mellitus (P<.001). The prevalence of postoperative presenting visual impairment was 63% (201/318 eyes) and of postoperative CDVA impairment, 36% (117/318 eyes). The major cause of the former was incorrect intraocular lens (IOL) power (42%); the major causes of the latter were posterior capsule opacification (24%), surgical complications (21%), age-related macular degeneration (10.3%), other macular disorders (4.3%), corneal opacities (3.4%), and glaucoma (2.0%). Surgical complications were significantly more common in the aphakic group than in the pseudophakic group (46.4% versus 2.0%; P<.001). Approximately 5% of the central India population aged 30 years or older had had cataract surgery. Postoperative visual impairment was present in 2 of 3 eyes. The major reasons were incorrect IOL power and surgical complications. Improved IOL power calculations and improved surgical techniques may markedly improve postoperative outcome. No author has a financial or proprietary interest in any material or method mentioned.