Outcomes Of Cataract Surgery Research Articles

Real-world outcomes of cataract surgeries using a new type of enhanced monofocal toric intraocular lens.

In this single-center study, 62 eyes of 41 patients with regular astigmatism, who received cataract surgery with TECNIS Eyhance Toric II intraocular lens (IOL) insertion between January 1, 2022, and June 30, 2023, were retrospectively investigated. At 3months postoperatively, there were significant improvements in the mean logMAR uncorrected distance visual acuity (VA) (from 0.64 ± 0.42 to 0.11 ± 0.13, p < 0.001) and logMAR corrected distance VA (from 0.28 ± 0.30 to 0.03 ± 0.06, p < 0.001). An 81.9% reduction in astigmatism (from 1.66 ± 0.49D corneal cylinder preoperatively to - 0.30 ± 0.39D refractive cylinder at 3months postoperatively, p < 0.001) was observed. In the vector analysis, the average of difference vector was 0.27 ± 0.35D, and the average correction index was 1.09 ± 0.22, revealing a minimal overcorrection. Mean IOL misalignment at 3months postoperatively was 0.68 ± 4.17°, and average absolute misalignment was 3.41 ± 2.44°. Defocus curves showed < 0.2 logMAR range between - 0.85 and 1.27 diopters, and distance-corrected near and intermediate VA were 0.38 ± 0.14 and 0.17 ± 0.13, respectively. These results indicate that the new enhanced monofocal toric IOL is a safe and effective treatment for astigmatic eyes with cataract.

Challenges and outcomes of cataract surgery after vitrectomy.

This review examines the challenges and outcomes of cataract surgery after pars plana vitrectomy (PPV), focusing on surgical techniques, timing, and complication management. Cataract formation remains the primary complication post-PPV, affecting approximately 80-100% of patients within two years. Nuclear sclerotic cataracts are most common, occurring in 60-100% of patients over 50, followed by posterior subcapsular cataracts (4-34%), which primarily affect younger and diabetic patients. PPV disrupts the normal oxygen gradient in the vitreous, resulting in a more uniform oxygen distribution and accelerating cataract formation.Post-PPV eyes present unique surgical challenges due to anatomical alterations, including zonular instability and capsular changes characterized by increased fragility, the potential for tears, and altered elasticity. Newer intraocular lens power calculations show promise, but unexpected refractive outcomes may occur. The choice between combined phacovitrectomy and sequential surgeries remains debated, with patient-specific factors guiding the approach. Visual outcomes vary depending on preexisting vitreoretinal pathologies and baseline vision before PPV. Further randomized controlled trials are needed to establish treatment guidelines and improve predictive models. Post-PPV cataract surgery presents unique challenges, including anatomical alterations and an increased risk of capsular complications. These necessitate careful consideration of the surgical approach and highlight the need for further research to optimize outcomes and establish treatment guidelines.

Client’s pre-operative expectations and outcome of cataract surgery at the Jos University Teaching Hospital, Jos, Plateau State, Nigeria

Objectives: A cataract is an opacity of the natural crystalline lens that causes vision loss. It is the most common cause of blindness worldwide, accounting for 39% of the 42 million blind people in the world. The optimum outcome from a cataract surgery can be achieved if post-operative subjective outcomes meet pre-operative expectations. It is expressed in different ways including patient satisfaction. This study evaluated clients’ pre-operative expectations and the outcome of cataract surgery at Jos University Teaching Hospital. Materials and Methods: A quasi-experimental, prospective hospital-based study that consecutively recruited 109 participants aged 18 years and above for 6 months. Data regarding the sociodemographic characteristics, pre-operative visual function, and expected post-operative outcome were collected preoperatively, and the subjective outcome and level of patient satisfaction were also assessed 6 weeks after surgery using a visual function index questionnaire. Data were analysed using the Statistical Package for the Social Sciences’ version 23. Frequencies and percentages were determined for categorical variables; mean and standard deviation, median, and interquartile range were calculated for continuous variables. Correlation was used to measure the relationship between overall satisfaction and expected or achieved visual function. A significant level was determined at P &lt; 0.05. Results: A total of 109 participants were seen in this study, of which 60 (55%) were males. The mean age of participants in the study was 64.5 ± 11.1 years. The median (interquartile range) expected and actual post-operative outcome scores were 100 (80–100) and 98 (75–100), respectively. The majority of the participants, 86 (78.9%), were satisfied with the outcome of cataract surgery, and the predictors of satisfaction were insertion of posterior chamber intraocular lens, absence of complications, and absence of ocular comorbidities. We found a significant strong positive correlation between subjective outcome and satisfaction (r = 0.538, P ≤ 0.0001). Conclusion: The majority of the clients were satisfied with the outcome of their surgeries which meets the high expected outcomes from the clients pre-operative. Adequate counselling, training, and retraining of surgeons are key to improving and maintaining satisfaction with the outcome of cataract surgery.

Visual and Surgical Outcomes of Outreach Cataract Surgeries in Ilam District of Nepal: An Observational Study

Introduction: Cataracts are the leading cause of preventable blindness worldwide. Although cataract blindness is reversible, its service coverage remains poor, particularly in rural and hilly areas of Nepal. The study aimed to evaluate visual outcomes of outreach cataract surgeries and associated intraoperative and post-operative complications. Methods: This cross-sectional study was conducted at a district of Eastern Nepal after ethical clearance was taken from the Institutional Review Committee (Reference number: 88). Total 131 subjects had cataract surgeries at the surgical camp, and their pre-operative, one-day and one-month post-operative visual acuities were compared, and intraoperative and post-operative surgical complications were recorded. Visual acuity ≥ 6/12 was considered normal. Data was collected in excel and analyzed in SPSS. Results: The mean age of participants was 71.8±9.51 years, with 70 (53.43%) male. A total of 156 eyes from 131 subjects underwent cataract surgeries and among them 25 (19.08%) cases underwent bilateral cataract surgeries. At the day one of surgery, visual acuity improved to normal in 137 (87.82%) of cases, while after one-month, visual acuity improved to normal in 150 (96.15%) of cases with best-corrected glasses. There were 4 (2.56%) intraoperative complications, which included surgery-induced subluxated bag, premature entry, iris trauma, and posterior capsule rent. Conclusions: The visual and surgical outcomes of cataract surgeries performed at an outreach surgical camp were excellent with minimal surgical complications.

Long-Term Outcomes of Cataract Surgery: Analysis of Visual Acuity and Intraocular Pressure in a Tertiary Care Center

Abstract: Posterior capsule opacity (PCO) is a common complication following cataract surgery, caused by the proliferation of residual lens epithelial cells. This study aimed to evaluate the long-term effects of Nd:YAG laser capsulotomy on intraocular pressure (IOP) and visual acuity in PCO patients. This was a retrospective descriptive study. Samples were 24 patients diagnosed with PCO who underwent Nd:YAG laser capsulotomy at Prof. Dr. R. D. Kandou Hospital, Manado, from January 1, 2022, to January 1, 2024. The study recorded pre- and post-procedure IOP and best-corrected visual acuity (BCVA) data. Descriptive analysis, including paired t-tests, was used to assess changes in IOP and BCVA over an average follow-up period of 19.2 months. The results showed a statistically significant improvement in BCVA (p=0.000), with mean values improving from 0.72 to 0.27 LogMAR. A significant reduction in IOP was also observed (p=0.015), with long-term IOP remaining stable. A weak correlation was found between follow-up duration and IOP variation (p=0.02). In conclusion, Nd:YAG laser capsulotomy significantly improves visual acuity and stabilizes intraocular pressure in the long term for PCO patients, suggesting its effectiveness in managing post-cataract surgery complications. Keywords: posterior capsule opacity; Nd:YAG laser capsulotomy; intraocular pressure; visual acuity; cataract surgery Methods: A retrospective descriptive study was conducted on 24 patients diagnosed with PCO who underwent Nd capsulotomy at RSUP Prof Dr. R. D. Kandou Central Hospital, Manado, from January 1, 2022, to January 1, 2024. The study recorded pre- and post-procedure IOP and Best-Corrected Visual Acuity (BCVA) data. Descriptive analysis, including paired t-tests, was used to assess changes in IOP and BCVA over an average follow-up period of 19.2 months. Results: The study revealed a statistically significant improvement in BCVA (p = 0.000), with mean values improving from 0.72 to 0.27 LogMAR. A significant reduction in IOP was also observed (p = 0.015), with long-term IOP remaining stable. A weak correlation was found between follow-up duration and IOP variation (p = 0.02). Conclusion: Nd capsulotomy significantly improves visual acuity and stabilizes IOP in the long term for PCO patients, suggesting its effectiveness in managing post-cataract surgery complications.

How do intraocular lens materials influence the outcome of cataract surgery?

This review summarizes the evidence on the effect of intraocular lens (IOL) material on the outcomes of cataract surgery, as well as on the surgical procedure itself. Differences in capsular biocompatibility between IOL materials lead to variations in capsular stability and posterior capsule opacification (PCO), while differences in uveal biocompatibility affect postoperative inflammatory response. Refractive outcomes are affected by both incision size and the rotational stability of toric IOLs. Small incision sizes favour hydrophilic IOLs. Rotational stability of hydrophobic and hydrophilic IOLs were comparable in recent studies. Visual outcomes are affected by chromatic aberrations, dysphotopsia, lens opacifications and PCO. Hydrophilic IOLs are associated with reduced chromatic dispersion. Hydrophobic IOL opacifications are caused by sub-surface glistenings, while hydrophilic IOL opacifications are due to surface calcifications. Some surgeries, including pars plana vitrectomy and lamellar corneal transplants, were shown to increase the risk of IOL calcifications, although the mechanism is still unknown. Hydrophilic IOLs have greater ease of manipulation, greater resistance to IOL damage, and higher uveal biocompatibility. Hydrophobic IOLs show better PCO prevention than hydrophilic IOLs, and should be preferred in highly myopic eyes where Nd:YAG capsulotomy might increase the risk of retinal detachment.

Evaluation of postoperative outcomes after cataract surgery in patients with Juvenile Idiopathic Arthritis-Associated Uveitis.

To evaluate the postoperative outcomes of cataract surgery and intraocular lens (IOL) implantation on visual outcomes and complications in pediatric patients with Juvenile Idiopathic Arthritis-Associated Uveitis. This study included 25 patients (30 eyes) with uveitis and cataracts who underwent cataract surgery. The study was conducted as a retrospective study. Patients were divided into two groups based on their preoperative treatment: those who received immunomodulatory therapy (IMT) along with systemic corticosteroids and those who received IMT in combination with a biologic therapy. Best corrected visual acuity (BCVA), intraocular pressure (IOP), central macular thickness (CMT), macular volume (MV), and postoperative complications were assessed at various time points up to 12 months. All surgeries were performed by a single surgeon. Significant improvement in BCVA were observed postoperatively in both study groups, with approximately 80% of eyes showing improvement. Mean BCVA improved from 0.89 ± 0.63 to 0.37 ± 0.33 in group 1and from 0.82 ± 0.68 to 0.35 ± 0.31 in group 2 after 12 months. Postoperatively, there was a decrease in mean IOP, with no significant variance observed between the two groups. Complications were observed in 73% of cases, including posterior capsular opacification (PCO), secondary glaucoma, and macular edema (ME), but did not significantly differ between groups. Cataract surgery in children with uveitis associated with JIA presents significant challenges due to the risk of postoperative complications, even with adequate preoperative and postoperative care. The similar improvement in BCVA observed in both groups suggests that different systemic therapies were sufficient for satisfactory control of inflammation before and after surgery.

Comparison of Visual Acuity Outcomes of Phacoemulsification and Small Incision Cataract Surgery

Background. The visual outcomes of phacoemulsification (Phaco) and manual small incision cataract surgery (MSICS) have been extensively studied, with research indicating that both methods are highly effective in restoring vision. Purpose. This study was aimed at comparing the visual acuity outcomes of the two surgical techniques. Methods. A total of 90 participants were scheduled for cataract surgery at Adetula Opticals &amp; Eye Clinic, Oshodi-Isolo, Lagos State, Nigeria, from June to August 2023. The participants were divided into two groups of 45, a group was scheduled for Phaco (0.92 ± 0.65; 6/60-6/36) and SICS (1.32 ± 0.81; 3/60) logMAR. Visual acuities (VAs) were measured pre- and postoperatively. Results. The difference in mean VA pre-op of -0.40 (95% confidence interval (CI): -0.096, -0.71) between the two techniques was statistically significant (p = 0.000). There was no significant difference in the logMAR VAs between the techniques post-operatively (p = 0.06), although the visual outcome with the two methods showed the tendency of a better VA (0.11± 0.17 [6/9 - 6/6]) as opposed to that of the other two techniques (0.22 ± 0.32; [6/12 - 6/9]). Conclusion. Both techniques have been refined to a point where they provide comparable long-term visual outcomes, making the choice of method dependent on specific patient needs, surgeon expertise, and available resources.

Unexpected encounter with an intracameral cilium postcataract surgery

Abstract Background: Cataract surgery, a routine and highly successful ophthalmic intervention, is not immune to unexpected challenges. While complications are infrequent, their diverse nature necessitates a thorough understanding to ensure optimal patient outcomes. Case Report: This presentation focuses on a 55-year-old female who underwent routine phacoemulsification with intraocular lens placement. Despite uneventful initial postoperative assessments, a horizontally oriented intraocular cilium was discovered on the 1st day. Prompt removal was undertaken, leading to an uneventful recovery. The case is distinguished by video evidence ruling out the presence of cilium at the surgery’s conclusion, prompting exploration into the mechanisms of delayed entry. Discussion: Delving into the intricacies of intraocular cilium postcataract surgery, this discussion emphasizes the rarity of such occurrences and explores the spectrum of ocular responses documented in the literature. Patient-specific factors, wound integrity, and the role of postoperative eye rubbing are scrutinized. The importance of patient education, vigilant postoperative monitoring, and timely interventions to mitigate complications are highlighted. The case prompts a reconsideration of preventive strategies and underscores the adaptability required in managing unexpected challenges. Conclusion: In conclusion, this case of intraocular cilium following routine cataract surgery contributes a unique perspective to the understanding of postoperative complications. The absence of cilium at the surgery’s conclusion challenges assumptions, urging a reevaluation of preventive measures. Beyond this specific case, the discussion emphasizes the broader implications for patient care and surgical practice. The adaptive approach to unforeseen challenges, coupled with comprehensive patient education, emerges as pivotal for optimal outcomes in cataract surgery.

Clinical Performance of an Extended Range of Vision Intraocular Lens After LASIK.

To evaluate the clinical and patient-reported outcomes (PROMs) of cataract surgery with implantation of a wavefront-shaping extended depth of focus (EDOF) intraocular lens (IOL) in eyes with previous laser in situ keratomileusis (LASIK) for myopia correction. This prospective observational study enrolled 50 eyes with previous LASIK from 25 patients (age: 46 to 70 years) who underwent cataract surgery with implantation of the AcrySof IQ Vivity IOL (Alcon Laboratories, Inc). Visual and refractive outcomes were evaluated during a 3-month follow-up. PROMs were evaluated with the Intraocular Lens Satisfaction (IOLSAT; Alcon Vision, LLC) (general satisfaction), Catquest-9SF (difficulty in doing vision-related activities), and Questionnaire for Visual Disturbances (QUVID; Alcon Vision, LLC) (photic phenomena) questionnaires. Mean 3-month postoperative binocular uncorrected distance, intermediate, and near visual acuities were 0.02 ± 0.11, -0.02 ± 0.09, and 0.14 ± 0.13 logarithm of the minimum angle of resolution (logMAR), respectively. Mean binocular distance-corrected intermediate and near visual acuities were 0.05 ± 0.11 and 0.32 ± 0.14 logMAR, respectively. All eyes had a postoperative spherical equivalent within ±0.75 diopters (D). The mean defocus curve showed visual acuity values better than 0.20 logMAR for defocus levels from +0.50 to -1.50 D. Most patients (92.0%) confirmed that they had no vision-related difficulties limiting their normal daily life. Perception of starbursts, halos, glare, hazy vision, blurry vision, and double vision was referred by 24%, 24%, 28%, 28%, 8%, and 4% of patients, respectively. Most of symptoms were described as mild and not or a little bothersome. The wavefront-shaping EDOF IOL evaluated provides efficacious distance, intermediate, and near visual restoration in eyes with previous LASIK, with minimal photic phenomena associated. [J Refract Surg. 2024;40(10):e742-e753.].

The Clareon Vs AcrySof PanOptix Trifocal IOL: A Comparative Study of Patient Satisfaction and Visual Performance.

To evaluate patient-reported outcomes of cataract surgery using the Clareon Panoptix and Panoptix Toric trifocal lenses and to compare these to the data collected previously for the AcrySof Panoptix and Panoptix Toric. Prospective, open-label, multicenter analysis of satisfaction, spectacle independence, presence of unwanted side effects, and best-corrected visual acuity among patients undergoing cataract surgery who had been implanted at least 1 month previously with the Clareon PanOptix or PanOptix Toric trifocal IOL bilaterally. Results were compared to outcomes measured two years ago from a similar study with the AcrySof version of the same lens. No significant differences in patient satisfaction rates were reported between the two cohorts. Spectacle independence was similar with 88% of Clareon Panoptix and 83% of AcrySof Panoptix patients having no need for any corrective lenses. Quality of vision was not statistically different with 7% of Clareon vs 15% of AcrySof patients reporting "very much" or more of glare/halo severity. Significantly more AcrySof (66%) than Clareon (42%) patients achieved a spherical equivalent outcome within 0.25 D of target. Best corrected distance visual acuity differences were not statistically significant, and no safety concerns were reported. The Clareon PanOptix trifocal lens provides similar satisfaction and spectacle independence and has a similar side effect profile and BCVA outcome to the identical lens made of the predecessor AcrySof lens.

Comparative Analysis of Refractive Outcomes Using Optical and Ultrasound Biometry in Phacoemulsification Cataract Surgery

Background: Accurate biometry is critical for optimal visual outcomes in cataract surgery. Both optical and ultrasound biometry are widely used, but their comparative effectiveness remains under evaluation.Objective: To compare the refractive outcomes of optical and ultrasound biometry in patients undergoing elective phacoemulsification cataract surgery.Methods: This prospective cohort study included 352 patients aged 30-60 years undergoing elective phacoemulsification with in-the-bag IOL implantation. Patients were randomly assigned to either optical biometry using the Zeiss IOL Master 700 or ultrasound biometry with Axis Nano contact A-mode echography. Visual acuity and spherical equivalent were measured at baseline and 4 weeks post-operatively. Data were analyzed using SPSS version 25, with independent t-tests comparing outcomes between groups.Results: The mean post-operative visual acuity was 0.83 ± 0.22, with a mean spherical equivalent of -0.88 ± 0.16. No significant difference was found between the ultrasound (-0.89 ± 0.17) and optical biometry (-0.87 ± 0.16) groups (p=0.152, 95% CI -0.06 to 0.01).Conclusion: Both optical and ultrasound biometry provide comparable refractive outcomes in cataract surgery, with no significant difference in post-operative spherical equivalent.

Visual outcome of cataract surgery by phacoemulsification in diabetic versus non-diabetic patients: A comparative study

This study aims to evaluate and compare the results of phacoemulsification cataract surgery performed on diabetic patients with those of non-diabetic patients. The primary objective was to compare the visual outcome of phacoemulsification cataract surgery in diabetic patients and non-diabetic patients, and the secondary objective was todetermine the final visual outcome following phacoemulsification cataract surgery in diabetics and non-diabetics.A comparative study of the overall 300 eyes of the patients, in which 150 eyes were diabetic and 150 eyes were non-diabetic, underwent phacoemulsification cataract surgery with posterior chamber intra ocular lens implantation. Age, sex, follow-up, preoperative and postoperative best corrected visual acuity and post-operative complications were evaluated. Out of the 300 eyes of the patients, 150 eyes were diabetic and 150 eyes were non-diabetics. Phacoemulsification with posterior chamber intra ocular lens implantation was done in all patients. Follow up duration was 6 weeks. Postoperatively, 6 weeks after surgery, 31.7% of patients had BCVA of 6/9 or better in diabetic group while 36.3% of patients had BCVA of 6/9 or better in non-diabetic group. The difference in BCVA between two groups at postoperative 6 weeks was found to be statistically significant p value of &amp;#60;0.001. Post-operative complications included wound leak, striate keratopathy, folds in descemets membrane, corneal haze or edema, iritis, posterior capsular rent, cystoid macular edema, iridodialysis. The incidence was higher in the diabetic group as compared to non-diabetics. Overall, the final visual outcome was better in non-diabetic group as compared to diabetic group. Diabetics are more likely to develop intra operative and postoperative complications. Thus, special care should be used both throughout the surgical procedure and the post-operative period.

Cataract and Diabetes: a review of the literature.

Cataracts can cause visual impairment in diabetic patients. Diabetes mellitus (DM) affects different parts of the eye and causes many complications and problems before, during and after intraocular surgeries. In this review, we will discuss the effects of diabetes on different aspects of cataract surgery and review the current management of diabetic cataracts. Careful preoperative examination of the patient's ocular surface, cornea, iris and posterior segment, as well as the use of advanced phacoemulsification techniques, new intraocular lenses (IOLs) and the appropriate use of auxiliary medications such as non-steroidal anti-inflammatory drugs (NSAIDs) and anti-vascular endothelial growth factors (VEGFs) have improved the outcomes of cataract surgery in diabetic patients.

Outcome of Phacoemulsification Cataract Surgery in Complicated Cataract Due to Uveitis

Background: Surgical removal of cataractous lens is the only of treatment of cataract irrespective of etiology. Phacoemulsification is a modern cataract surgery in which the eyes internal lens is emulsified with an ultrasonic hand-piece and aspirated from the eye. Complicated cataract due to anterior uveitis has difference in morphology and outcome from that of age-related cataract variety. Aim of the study: The purpose of this study was to evaluate the outcome of phacoemulsification in complicated cataract due to uveitis. Methods: This prospective observational cross-sectional study conducted in cataract clinic of National Institute of Ophthalmology &amp; Hospital, Dhaka, Bangladesh, from September 2018 to March 2019. Sample was selected by purposive sampling technique. Total 50 patients suffering from complicated cataract due to uveitis were included according to selection criteria. Data were gathered from the informant and recorded in a structured case report format. Clinical examination and relevant investigation were done meticulously. All acquired data was entered into a Microsoft Excel Work Sheet and analyzed using descriptive statistics in SPSS 24.0. Results: In this study, the maximum number of patients 18(36.0%) were 51-60 years age group, mean age of the patient was 52.7±6.37 years. Male to female ratio was 1:1.17. Postoperative best corrected visual acuity (BCVA) was better progressively and reached significance difference (P&lt;0.05). Astigmatism was measured in different follow up time. There was significant difference (p&lt; 0.05) present in all post-operative days. In time wise comparison revealed, there was also significant difference in between 1st postoperative day and 30th postoperative day but no significance was present between 30th postoperative day and 180th postoperative day (P= 0.161). In this study postoperative complications included posterior capsule opacification (55.5%), posterior synechiae (11.1%), cystoid macular edema (22.2%) &amp; glaucoma (11.1%). Conclusion: Present study concluded that phacoemulsification is safer for the uveitic cataract as less inflammation is induced than that by a manual extracapsular cataract extraction. In order to optimize the postoperative outcome of uveitic cataract surgery, it is necessary to be meticulous and thorough.

Comparative Analysis of Refractive Outcomes Following Cataract Surgery Using IOL Master 500 and IOL Master 700 Biometry Devices: A Retrospective Analysis.

Background: This study aims to compare the refractive outcomes of cataract surgery using two different biometry devices, the IOL Master 500 and IOL Master 700, and to investigate the influence of patient-related factors on these outcomes. Methods: In this retrospective study, we analyzed data from 2994 eyes that underwent cataract surgery. Multiple linear regression analyses were performed to examine the impact of the biometry device (IOL Master 500 or IOL Master 700), patient age, time elapsed between biometry and surgery, gender, and insurance status, as well as biometric parameters (anterior chamber depth, axial length, and corneal curvature), on postoperative refractive outcomes, specifically the deviation from target refraction. Results: The choice of the IOL Master device did not result in a statistically significant difference between the two devices (p = 0.205). Age (p = 0.006) and gender (p = 0.001) were identified as significant predictors of refractive outcomes, with older patients and males experiencing slightly more hyperopic outcomes compared to younger patients and females, respectively. The time elapsed between biometry and surgery and insurance status did not significantly influence the refractive outcomes. Conclusions: Our study, supported by a large cohort and a diverse group of patients representing typical anatomical variants seen in cataract surgery, supports the thesis that the IOL Master 500 and IOL Master 700 can be regarded as equivalent and effective for biometry in cataract surgery. The differences between the devices were negligible. Therefore, switching between the devices is safe for bilateral patients.

Poor visual outcome and associated factors among patients underwent cataract surgery at Debre Markos and Felege Hiwot comprehensive specialized hospitals, Northwest Ethiopia, 2023

ObjectiveThis study aimed to determine the proportion of poor visual outcome and associated factors among adult patients who underwent cataract surgery at Debre Markos and Felege Hiwot Comprehensive Specialized Hospitals in northwestern Ethiopia in 2023.MethodsA hospital based cross-sectional study was conducted on 418 adult patients who had undergone cataract surgery from June 07 to August 07, 2023. Patients were recruited using systematic random sampling with an interval of 2. A pre-tested semi-structured questionnaire, medical record review, and ophthalmologic examination were used to collect data. The collected data was entered into Epi-info version 7 and exported to SPSS version 25 software for analysis. Binary logistic regression was used to determine the factors associated with poor visual outcomes of cataract surgery. Variables with a p-value of less than 0.05 in the multivariable binary logistic regression were considered statistically significant.ResultsA total of 408 study participants with a median age of 65 years and a response rate of 97.6% took part. The proportion of poor visual outcomes of cataract surgery from 4 weeks to one year was 25.7% (95%CI: 21.6%, 30.3%). Factors responsible for poor visual outcomes of cataract surgery were intraocular lens implantation without a posterior chamber (AOR = 2.91, 95%CI:1.46,5.80), per-existing central corneal opacity (AOR = 3.83, 95%CI:1.52,9.69), pseudoexfoliation (AOR = 3.91,95%CI:1.39,11.88), age-related macular degeneration(AOR = 3.75, 95%CI:1.22, 11.88), glaucoma (AOR = 3.11, 95%CI:1.06,9.17) and striate keratopathy(AOR = 3.4, 95%CI: 1.11, 10.88).ConclusionIn this study, the proportion of poor visual outcomes of cataract surgery is higher than the World Health Organization recommendation. The study found that implantation of an intraocular lens without a posterior chamber, pre-existing central corneal opacity, pre-existing age-related macular degeneration, pre-existing glaucoma, pseudoexfoliation, and striate keratopathy were significantly associated with poor visual outcomes of cataract surgery. We recommend that ophthalmologists and cataract surgeons prioritize the reduction of surgical complications and pre-existing ocular co-morbidities to enhance post-operative visual acuity. Improving pre-operative assessment and refining surgical techniques like phacoemulsification will aid in achieving this goal.

Outcome of Cataract Surgery among Eye Camp Patients of Eastern Nepal

Background: Outreach camp is helpful for reducing the prevalence of blindness due to cataracts and refractive error. The objective was to evaluate the visual outcome of cataract surgery among camp patients operated at a high volume center of Eastern Nepal. Materials and Methods: Descriptive cross sectional study design was used. The comprehensive eye screening program was conducted and those having cataracts were referred to base hospital for cataract surgery, patients were reexamined at the base hospital again and a small incision cataract surgery with posterior chamber intraocular lens was implanted at Biratnagar Eye Hospital, Biratnagar and Sagarmatha Choudhary Eye Hospital, Lahan. The pre-operative vision was taken during screening and post-operative vision was taken after one-month by performing refraction by trained personnel. Data were extracted from the hospital record; analysis was done using SPSS version 17.0. Descriptive analysis by using frequency, parent age and association was done by using Chi square test with a P-value &lt;0.05 considered as significant. Results: A total of 1426 camp patients were operated. Among them 1113 (78%) were visited after one month post operative follow up at the campsite. There were 744 (52%) female and bilateral affected eyes were 735(52%). Pre-operative presenting visual acuity was &lt;3/60 (37%), which was reduced to (0.2%) after one month follows up of cataract surgery. There was a significant association in pre-operative VA with aided one month to follow up VA. Conclusion: The outcome of the cataract surgery of camp patients operated at base hospitals was good in high-volume hospitals. Follow up after one month was good practice to provide services and measure the outcome of cataract surgery.

The outcomes of paediatric cataract surgery with intraocular lens insertion in sub-Saharan Africa: a systematic review

ImportanceCataract is one of the leading causes of childhood blindness in Africa. The management of this condition requires timely surgical extraction of the cataractous lens with immediate optical correction and long-term follow-up to monitor visual improvement and manage complications that may arise. This review provides an opportunity to benchmark outcomes and to shed light on the reasons for those outcomes.ObjectivesTo review the published literature and report on the outcomes of paediatric cataract surgery with intraocular lens insertion in sub-Saharan Africa.Data sourceThe EMBASE, PubMed, Scopus, and Web of Science were searched for relevant articles.Study selectionWe included all published primary studies from sub-Saharan Africa on cataract surgery outcomes in children aged 0–16 years with primary intraocular lens implantation conducted between 1990 and 2020. Eligible studies were those published in English or for which an English translation was available. In addition, reviewers screened the reference lists of all studies included in the full-text review for eligible studies. During the review, studies fitting the inclusion criteria above except for having been conducted in middle and high-income countries were tagged and placed in a comparison arm.Data extraction and synthesisStudy eligibility was determined by two independent reviewers, and data extraction was conducted by one reviewer with entries checked for accuracy by another reviewer. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines for data synthesis were followed. The Joanna Briggs Institute (JBI) critical appraisal checklist was used for quality appraisal of the studies. The statistical software R was used in the analysis, and data were pooled using a random-effects model. Forest plots were generated using the R package ‘metafor’.Main outcomes and measuresThe primary outcome was visual acuity (VA) after cataract surgery and the proportions of eyes that achieved good, borderline, or poor visual outcome according to the World Health Organisation (WHO) categorisation of post-operative visual acuity. The secondary outcome measures reported included lag time to surgery, rates of follow-up, and rate of complications.ResultsEight out of 4763 studies were eligible for inclusion in this review, and seven were included in the quantitative analysis. There was a male preponderance in the study population, and the mean age at the time of cataract surgery ranged from 3.4 to 8.4 years. Visual outcomes were available for short-term visual outcomes (1 to 6 months) as the studies had a significant loss to follow-up. The pooled proportion of eyes that achieved a good visual acuity (i.e. equal to or greater than 6/18) in the short-term period was 31% (CI, 20–42). The comparative studies from middle and high-income countries reported proportions ranging from 41 to 91%, with higher thresholds for good visual acuity of 6/12 and 6/15.Conclusion and relevanceThis review reports that there is a lower proportion of eyes with good outcomes after undergoing paediatric cataract surgery in sub-Saharan Africa than in middle- and high-income countries. Furthermore, this review states that there is a high proportion of patients lost to follow-up and suboptimal refractive correction and amblyopia treatment after paediatric cataract surgery.

Visual Outcome of Cataract Surgeries Performed in A Rural Eye Care Facility in the Philippines: A One-Year Retrospective Study

Visual Outcome of Cataract Surgeries Performed in A Rural Eye Care Facility in the Philippines: A One-Year Retrospective Study