scholarly journals Visual outcomes of cataract surgery: An observational study of ten years from a tertiary eye care hospital in Pakistan

2021 ◽  
Vol 37 (7) ◽  
Author(s):  
Shahid Ahsan ◽  
Muhammad Saleh Memon ◽  
Sadia Bukhari ◽  
Tauseef Mahmood ◽  
Muhammad Faisal Fahim ◽  
...  

Objectives: To observe and analyze the visual outcomes of cataract surgery of ten years at a tertiary eye care hospital, Karachi. Methods: An observational study with retrospective data search was conducted in Al Ibrahim Eye Hospital (AIEH), Karachi. Data of all adults (above 16 years) who underwent cataract surgery from 2010-2019 was retrieved from HIMS. Presence of opacity in the lens was labelled as cataract. Surgery was advised when patient’s BCVA was found to be 6/18. Visual assessments of the patients were done on day 01, one week and six weeks postoperatively. Postoperatively, 6/6 – 6/12 was considered as good, 6/18 as mild visual impairment, < 6/18 to 6/60 as moderate visual impairment and < 6/60 as severe visual impairment. Results: A total of 1,027,840 patients visited AIEH with different eye diseases. Among 1027840 individuals, cataract was identified in 88443 (8.6%). Surgery was advised to 58371 and performed in 38616. Records of operated cases (38616) were retrieved. Mean age of patients was 54.96±14.22 years. There were 20578 (53.29%) males and 18038 (46.71%) females who underwent surgery . At the end of sixth week, 3561 (18.4%), patients were found to have “good vision”, 12242 (63.43%) had mild visual impairment, 2676 (13.86%) had moderate visual impairment and 822 (4.26%) had severe visual impairment. Corneal Complications was the commonest cause (33.56%) at sixth week. Conclusions: The institution achieved WHO recommended criteria of “good visual outcome” (6/6 to 6/18) of 81.83% which is near to recommended ≥ 90% and severe visual impairment of 4.26%. doi: https://doi.org/10.12669/pjms.37.7.4428 How to cite this:Ahsan S, Memon MS, Bukhari S, Mahmood T, Fahim MF, Haseeb U, et al. Visual outcomes of cataract surgery: An observational study of ten years from a tertiary eye care hospital in Pakistan. Pak J Med Sci. 2021;37(7):---------.  doi: https://doi.org/10.12669/pjms.37.7.4428 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

2016 ◽  
Vol 4 (1) ◽  
pp. 13 ◽  
Author(s):  
Kaduskar-Aney Anushree ◽  
Rishikeshi Nikhil ◽  
Tripathi Shubhi ◽  
Taras Sudhir ◽  
Deshpande Madan

2019 ◽  
Vol 104 (4) ◽  
pp. 588-592 ◽  
Author(s):  
Serge Resnikoff ◽  
Van Charles Lansingh ◽  
Lindsey Washburn ◽  
William Felch ◽  
Tina-Marie Gauthier ◽  
...  

Background/aimsTo estimate 2015 global ophthalmologist data and analyse their relationship to income groups, prevalence rates of blindness and visual impairment and gross domestic product (GDP) per capita.MethodsOnline surveys were emailed to presidents/chairpersons of national societies of ophthalmology and Ministry of Health representatives from all 194 countries to capture the number and density (per million population) of ophthalmologists, the number/density performing cataract surgery and refraction, and annual ophthalmologist population growth trends. Correlations between these data and income group, GDP per capita and prevalence rates of blindness and visual impairment were analysed.ResultsIn 2015, there were an estimated 232 866 ophthalmologists in 194 countries. Income was positively associated with ophthalmologist density (a mean 3.7 per million population in low-income countries vs a mean 76.2 in high-income countries). Most countries reported positive growth (94/156; 60.3%). There was a weak, inverse correlation between the prevalence of blindness and the ophthalmologist density. There were weak, positive correlations between the density of ophthalmologists performing cataract surgery and GDP per capita and the prevalence of blindness, as well as between GDP per capita and the density of ophthalmologists doing refractions.ConclusionsAlthough the estimated global ophthalmologist workforce appears to be growing, the appropriate distribution of the eye care workforce and the development of comprehensive eye care delivery systems are needed to ensure that eye care needs are universally met.


1970 ◽  
Vol 1 (2) ◽  
pp. 118-122 ◽  
Author(s):  
P Karki ◽  
JK Shrestha ◽  
JB Shrestha

Introduction: The small-incision cataract surgery is gaining popularity among the ophthalmic surgeons. Objective: To compare the visual outcome of conventional extra-capsular cataract extraction (ECCE) and small-incision cataract surgery (SICS) in a hospital based community cataract program. Materials and methods: A prospective interventional study without randomization was carried out including the patients undergoing cataract surgery by either conventional ECCE or manual SICS. They were followed up for 6 weeks postoperatively. The visual outcomes were compared between the two groups. Statistics: The statistical program Epi-Info version 2000 was used to analyze the data. Mean values with standard deviations, 95% CI and p value were calculated. The p value of <0.05 was considered significant. Results: Of 85 patients, 44 (M: F=10:34) underwent ECCE and 41 (M: F=15:26) SICS (RR= 0.71, 95% CI=0.42-1.2, p value=0.16). Unaided visual acuity on the 1st postoperative day in the ECCE group was e"6/ 18 in 22.7%,<6/18-6/60 in 63.6 %,< 6/60 in 13.7%, whereas in the SICS group, the same was e"6/18 in 70.7%,<6/18-6/60 in 22 %,< 6/60 in 7.3% (95% CI = 0.23 - 0.48, p=0.001). Best corrected visual acuity on the 6th week follow-up in the ECCE group was e"6/18 in 79.5%,<6/18-6/60 in 18.2 %,< 6/60 in 2.3% and in the SICS group the same was 6/18 in 90.5% and <6/18-6/60 in 4.9% (95% CI=0.44 - 0.73; p=0.0012). Conclusion: Both ECCE and SICS are good procedures for hospital based community cataract surgery but within the 6 weeks postoperative period SICS gives better visual outcome. Remarkably higher number of female patients can be provided service in a hospital based community cataract programme as compared to males. Keywords: cataract; small incision; extra-capsular DOI: 10.3126/nepjoph.v1i2.3686 Nep J Oph 2009;1(2):118-122


2021 ◽  
Vol 7 (3) ◽  
pp. 482-485
Author(s):  
Harshika Chawla ◽  
Vishal Vohra ◽  
Asif Khan ◽  
Monika Bareja

To identify the preoperative risk factors, type of cataract surgery, cataract grade, and final visual outcome in patients undergoing descemetopexy for DMD. This was a retrospective study in which records of patients who underwent descemetopexy with either air or 20% sulfur hexafluoride (SF6) between 1st July 2014 and 30th June 2017. Grade of cataract, type of surgery, visual outcomes, and site of DMD were recorded.The mean age of the patients was 63.21 ± 5.8 years. Of the total 23 cases undergoing descemetopexy, 20 cases (87%) were after manual small incision cataract surgery (MSICS) and three cases (13%) were post phacoemulsification. The mean duration of presentation with a detachment was 13.03± 10.9 days (1-40 days). The most common types of DMD were total (34.8%) followed by temporal (30.4%) and superior (26.1%). Two patients (8.6%) obtained LOGMAR visual acuity (VA) of 0.0 and 5 of 23 patients (21.7%) achieved LOGMAR VA 0.3 after descemetopexy. Reattachment rates were 87% and three cases had reintervention. : This study identifies mature cataract and pre-existing corneal pathology as major risk factors for DMD during cataract surgery. DMD can be treated effectively and good visual outcome after successful descemetopexy.


Author(s):  
Hazra Soumyadeep ◽  
Saha Tapes Kanti

Background: In developing countries, manual small incision cataract surgery is a better alternative and less expensive in comparison to phacoemulsification and thus the incision is an important factor causing high rates of postoperative astigmatism resulting into poor visual outcome. Thus, modifications to the site of the incision is needed to reduce the pre-existing astigmatism and also to prevent postoperative astigmatism. Modification to superotemporal incision relieves pre-existing astigmatism majorly due to its characteristic of neutralizing against-the-rule astigmatism, which is more prevalent among elderly population and thus improves the visual outcome. Aims: To study the incidence, amount and type of surgically induced astigmatism in superior and superotemporal scleral incision in manual SICS. Methodology: It is a randomized, comparative clinical study done on 100 patients attending the OPD of Ophthalmology at a tertiary care hospital, with senile cataract within a period of one year and underwent manual SICS. 50 of them chosen randomly for superior incision and rest 50 with superotemporal incision. MSICS with PCIOL implantation were performed through unsutured 6.5 mm scleral incision in all. Patients were examined post-operatively on 1st day, 7th day, 2nd week and 4th week and astigmatism was evaluated and compared in both groups. Results: It is seen that on postoperative follow up on 4th week, 77.78% of the patients with ATR astigmatism who underwent superior incision had increased astigmatism whereas, only 13.63% of the patients with ATR astigmatism who underwent supero-temporal incision, had increased astigmatism but 81.82% had decreased ATR astigmatism. However, 77.78% of the patients with preoperative WTR astigmatism who underwent supero-temporal incision, had increased astigmatism, whereas 44.45% of the patients with WTR astigmatism preoperatively, had increased astigmatism in contrast to 50% had decreased amount of astigmatism. It is also seen that the supero-temporal incision group had more number of patients (78%) with visual acuity better than 6/9 at 4th postoperative week than superior incision group (42%). Conclusion: This study concludes that superior incision cause more ATR astigmatism postoperatively whereas superotemporal incision causes lower magnitude of WTR astigmatism, which is advantageous for the elderly. Besides superotemporal incision provides better and early visual acuity postoperatively.


2021 ◽  
Vol 8 (25) ◽  
pp. 2210-2215
Author(s):  
Sachala Bhoi ◽  
Pallavi Ray ◽  
Sanjukta Mahapatro ◽  
Kasturi Mohapatra ◽  
Chinmaya Mahapatra

BACKGROUND Traumatic cataract is one of the common sequelae following ocular injury. It is one of the leading causes of preventable blindness. Ocular trauma leading to traumatic cataract, if managed early gives good visual outcome. Associated ocular structure involvement has much bearing on the management and prognosis of traumatic cataract. We wanted to study the visual outcome of cataract surgery in traumatic cataract. METHODS All patients included in this prospective study were subjected complete ocular examination, intra ocular lens (IOL) power calculation and small incision cataract surgery (SICS) with IOL implantation. Visual outcome was assessed after 1st week, 2 nd week, 6th week and 6 months. Postoperative visual outcome and post-operative complications were assessed. RESULTS Out of 50 cases studied, 56 % of cases were in the age group of less than 20 years. Male: Female ratio was 2.57 : 1. Traumatic cataract was higher in patients of rural background as compared to urban background (64 % vs 32 %). In 58 % of cases, penetrating injury was the type of trauma. 60 % of patients had visual acuity of less than 3/60 at presentation. Corneal injuries (34 %), scleral tear in (22 %) and iris related problems (18 %) were the most common associated findings. All the patients were treated with SICS with IOL implantation. Most common intra-operative complication was posterior capsule rupture seen in 14 % of cases, 34 % of patients had anterior uveitis as early post-operative complication and 24 % of patients developed PCO as late post-operative complication; 68 % of the patients achieved visual acuity of above 6/18. CONCLUSIONS Timely management and involvement of other structures in traumatic cataract determines the visual prognosis of cataract surgery in traumatic cataract. Thus, our study showed that traumatic cataract can be successfully managed surgically with intraocular lens implantation with good visual outcome, unless there is associated corneal opacity or posterior segment involvement. More emphasis should be laid on the preventive measures like mass health education and awareness about risk of ocular trauma, and need to adopt safety measures should be focused, especially during playground, and at workplace. KEYWORDS Traumatic Cataract, Small Incision Cataract Surgery, IOL, Visual Acuity


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