Relationship between ocular surface disease and patient’s satisfaction among cataract surgical patients in Nigeria

Abstract

To determine the effect of clinical and cytological features of ocular surface disease on patient's satisfaction following small incision cataract surgery at a tertiary eye care centre. This is a prospective observational study of 70 consecutive consenting patients who underwent manual small incision cataract surgery(MSICS) at a tertiary eye care centre. All participants underwent ocular surface profile assessment using Schirmer I test (ST1), tear film break-up time (TBUT), conjunctival impression cytology (CIC) and ocular surface disease index (OSDI) at pre-operative visit, 1-week and 4-week post-operative visit. Patient's satisfaction with surgical outcome was evaluated at 6-week post-operative visit using a rating scale of 1 to 10. Data were analysed using IBM Statistical Package for the Social Sciences (SPSS) version 20.0 (IBM Corp., Armonk, NY USA). The mean age was 68 ± 9.4years with a male/female ratio of 1:1.1. The mean OSDI score decreased significantly (p < 0.001) from 33.1 ± 8.4 pre-operatively to 20.8 ± 7.4 four weeks after surgery. The TBUT was 12 ± 4.1s pre-operatively, but significantly reduced to 11.2 ± 3.9s (p < 0.001) at 4-week post-operative period. At 6 weeks, patients with normal CIC reduced from 53 (75.8%) pre-operatively to 8 (11.4%) (p < 0.001, z = -7.24). Fifty percent of patients with severe post-operative ocular surface disease reported dissatisfaction with their surgical outcome (p = 0.024). Manual small incision cataract surgery can significantly impair the ocular surface health profile of patients. The presence of ocular surface disease in patients pre-operatively can negatively impact their level of satisfaction with surgical outcome.