scholarly journals Risk factors that associated with visual outcome of community based cataract surgery

Author(s):  
Hera Dwi Novita ◽  
Eka Rahmawati Wahyuningsih

Background: Cataract is one of the leading cause of blindness in Indonesia and worldwide. Meanwhile the ability to carry out cataract surgery was not balanced by the increasing of cataract backlog of ± 70,000 per year. In addition to increase the number of cataract operations, it is very important to maintain the quality of surgery results by auditing the result of surgery. This study aims to evaluate post-operative visual acuity in social services organized by the Cataract Blindness Prevention Section of IOA Malang Branch in 2015-2017.Methods: This study is a retrospective study based on medical record data of cataract patients underwent cataract surgery at a social service organized by the Cataract Blindness Prevention Section of IOA Malang Branch in January 2015 - December 2017 period. Data collected included demographic data, preoperative and postoperative visual acuity, type cataract surgery, and intraoperative complications.Results: Cataract surgery carried out from 2015-2017 was 1,662 surgeries with 965 male patients (58.06%). Visual acuity before surgery was 1/300 in 583 patients (35.08%). The most cataract surgery procedure performed was SICS (60.17%). Vitreous prolapse was the most common complication found. There was a significant association between age and type of cataract surgery, with postoperative vision (p <0.05, α = 5%). From the analysis, the progress of post-operative visual acuity was found in 85.93% of patients and the results were significant (p <0.05, α = 5%).Conclusions: Cataract surgery may provide significant visual improvement that elevates vision and quality of life for patients.

Author(s):  
Andi Arus Victor ◽  
Fitria Romadiana ◽  
Ari Djatikusumo ◽  
Elvioza ◽  
Gitalisa Andayani Adriono ◽  
...  

Background: Endophthalmitis is one of the emergencies in ophthalmology and can cause blindness. The most common cause of endophthalmitis in intraocular surgery is cataract surgery. Immediate diagnosis and treatment can provide optimal final vision. This research aimed to describe the demographic data, and causative microorganisms, as well as the success rate of visual outcome after pars plana vitrectomy (PPV) in post-cataract surgery endophthalmitis in Cipto Mangunkusumo Hospital. Methods: A retrospective descriptive study of post-cataract surgery endophthalmitis underwent vitrectomy in Cipto Mangunkusumo Hospital, Indonesia, from January 2017 - June 2017. Results: There were twenty one cases of post-cataract surgery endophthalmitis undergoes PPV within the period of January 2017-June 2017. The most frequently identified causative microorganism was Staphylococcus (23%). There was an improvement of visual acuity after PPV procedure in 47,6% post-cataract surgery endophthalmitis. Conclusion: Immediate PPV is an effective treatment and leads to vision improvement in post-cataract surgery endophthalmitis.   Keywords: pars plana vitrectomy, endophthalmitis, cataract surgery


2016 ◽  
Vol 3 (2) ◽  
pp. 35-38
Author(s):  
Hari Bahadur Thapa ◽  
Salma KC Rai ◽  
Arjun Malla Bhari ◽  
Ken Bassett

INTRODUCTION: Pediatric eye care, including cataract surgery, has become much more common in Nepal in recent years in tertiary facilities such as the Lumbini Eye Institute (LEI). This study provides the first report of visual outcome and complications after cataract surgery at that Institute. MATERIAL AND METHODS: This is a prospective observational study of all cataract surgical patients <16 years of age between March 1, 2011, and February 28, 2012. Visual outcome was assessed by two optometrists with pediatric eye care training. Clinical data were gathered in a specifically designed pediatric eye program database and demographic data were taken from hospital administrative records. RESULTS: In 2011-12, 334 children (248 boys [74%]) underwent cataract surgery, including 89 Nepali (27%) and 245 Indian (73%) children. In total, 320 (96%), 270 (81%), and 190 (57%) attended their first, second and third follow up visits respectively. Pre-operative visual acuity was <6/60 (91%), 6/60 to <6/18 (7%) and >6/18 (2%). Post-operatively, visual acuity was <6/60(27.5%), 6/60 to <6/18 (36.5%) and 6/18 or better (36%). The mean best corrected visual acuity was 6/38 first follow up, 6/34 second follow up, and 6/30 third follow up. Intraoperative complications were 1.6% pupillary capture and post-operative complications were 35.3% posterior capsular opacification (PCO). CONCLUSION: For 63% of children, visual acuity significantly improved with cataract surgery beyond their presenting vision of <6/60, with over 38% of children achieving visual acuity (>6/18). Follow up beyond one month needs significant improvement to treat postoperative complications particularly posterior capsular opacification.Journal of Universal College of Medical Sciences (2015) Vol.03 No.02 Issue 10Page: 35-38


2020 ◽  
pp. 173-176
Author(s):  
Kinjal Rathod ◽  
Kinjal Trivedi ◽  
Snehal Nayi ◽  
Somesh Aggarwal

Introduction: Cataract is most common cause of curable blindness worldwide and cataract surgery is most common procedure performed in ophthalmology. Posterior capsular opacification (PCO) is most common complication after cataract surgery which is usually treated with Neodymium-doped: Yttrium Garnet (Nd:YAG) laser posterior capsulotomy or occasionally with a surgical capsulotomy. The incidence and severity of PCO correlates to the type of surgical technique, IOL optic edge designs and IOL materials. Material and Methods: 70 eyes of 64 patients operated for age related cataract were studied in this prospective interventional study. Phacoemulsification was done in 35 eyes and SICS in 35 eyes with hydrophobic single piece biconvex foldable intraocular lens. Patients were followed up at 1, 3, 6, 9 and 12 months for the development of PCO. Clinically significant PCO (loss of 2 or more lines of Snellen’s visual acuity chart) was treated with Nd:YAG laser capsulotomy. Results: The overall incidence of PCO was 22.85%. Amongst the patients who developed PCO, SICS and phacoemulsification was performed in 62.5% and 37.5% patients respectively. Result was statistically significant with p value <0.05 using z test. On first postoperative day, patients operated with phacoemulsification had better visual acuity than SICS. Conclusion: Phacoemulsification can provide early and better visual outcome than SICS and has lower incidence of PCO formation which may be due to difference in irrigation and aspiration and less disruption of blood aqueous barrier than SICS. PCO can be reduced by atraumatic surgery and thorough cortical clean up and capsular polishing.


2014 ◽  
Vol 2 (1) ◽  
pp. 22-27
Author(s):  
Md Shafiqul Alam ◽  
Khaleda Nazneen Bari

Background: Age related cataract is the leading cause of blindness and visual impairment throughout the world. With the advent of microsurgical facilities simple cataract extraction surgery has been replaced by small incision cataract surgery (SICS) with posterior chamber intra ocular lens implant, which can be done either with clear corneal incision or scleral incision. Objective: To compare the post operative visual outcome in these two procedures of cataract surgery. Materials and method: This comparative study was carried out in the department of Ophthalmology, Delta Medical College & Hospital, Dhaka, Bangladesh, during the period of January 2010 to December 2012. Total 60 subjects indicated for age related cataract surgery irrespective of sex with the age range of 40-80 years with predefined inclusion and exclusion criteria were enrolled in the study. Subjects were randomly and equally distributed in 2 groups; Group A for SICS with clear corneal incision and group B for SICS with scleral incision. Post operative visual out come was evaluated by determining visual acuity and astigmatism in different occasions and was compared between groups. Statistical analysis was done by SPSS for windows version12. Results: The highest age incidence (43.3%) was found between 61 to 70 years of age group. Among study subjects 40 were male and 20 were female. Preoperative visual acuity and astigmatism were evenly distributed between groups. Regarding postoperative unaided visual outcome, 6/12 or better visual acuity was found in 19.98% cases in group A and 39.6% cases in group B at 1st week. At 6th week 6/6 vision was found in 36.3% in Group A and 56.1% in Group B and 46.2% in group A and 66% in group B without and with correction respectively. With refractive correction, 6/6 vision was attained in 60% subjects of group A and 86.67% of group B at 8th week. Post operative visual acuity was statistically significant in all occasions. Postoperative astigmatism of >0.50D was in 82.5% subjects of group A and 52.8% subjects of group B at 1st week. At 6th week postoperative astigmatism of less than 1D was in 79.95% subjects of Group A and 83.34% subjects of Group B. About 20% subjects in Group A and only 3.3% in Group B showed astigmatism of more than 1D and these differences on both the occasions were statistically significant. Conclusion: The post operative visual outcome was better in SICS with scleral incision (group B) than in SICS with clear corneal incision (Group-A). DOI: http://dx.doi.org/10.3329/dmcj.v2i1.17793 Delta Med Col J. Jan 2014; 2(1): 22-27


2015 ◽  
Vol 10 (1) ◽  
pp. 14-18
Author(s):  
Md Abdullah Al Masum ◽  
Md Kamrul Hasan Khan ◽  
M Anwar Hossain

Introduction: Manual small incision cataract surgery (MSICS) is a cost-effective alternative to phacoemulsification cataract surgery for developing countries. This prospective study was carried out in Combined Military Hospital (CMH), Chittagong from October 2009 to March 2011 on 75 cataract patients who were operated by MSICS technique. Objectives: Aim of this study was to assess the visual outcome and complications of MSICS in a peripheral CMH. Methods: Seventy five cataract patients were operated by MSICS technique. All surgical procedures were performed by the principal author. Major per-operative and postoperative complications were documented. Visual outcome was assessed by Snellen’s visual acuity test 06 weeks after operation. Results: Uncorrected visual acuity (UCVA) was 6/6 – 6/18 in 57 (76.0%) patients, < 6/18 – 6/60 in 15 (20%) and < 6/60 in 03 (4.0%) patients. Best corrected visual acuity (BCVA) was 6/6-6/18 in 65 (86.7%) patients, < 6/18-6/60 in 07 (9.3%) and < 6/60 in 03(4.0%) patients. Visual outcome was good in 86.7% of patients according to World Health Orgnization (WHO) criteria and was not far away from the WHO expected outcome. Posterior capsule rupture was the most significant per-operative complication which was found in 7(9.3%) cases and surgically induced astigmatism was main postoperative complication that affected visual outcome. Mean postoperative astigmatism (against-the rule) was - 1.25DC. 14 JAFMC Bangladesh. Vol 10, No 1 (June) 2014 Conclusion: MSICS is a safe and cost-effective technique of extra-capsular cataract extraction where surgical skill and experience of the surgeon plays a significant role in the result. DOI: http://dx.doi.org/10.3329/jafmc.v10i1.22895 Journal of Armed Forces Medical College Bangladesh Vol.10(1) 2014


2015 ◽  
Vol 22 (4) ◽  
pp. 274-282 ◽  
Author(s):  
Lachlan Farmer ◽  
Cecilia Innes-Wong ◽  
Caroline Bergman-Hart ◽  
Robert J. Casson ◽  
John Crompton

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


2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Line Kessel ◽  
Jens Andresen ◽  
Ditte Erngaard ◽  
Per Flesner ◽  
Britta Tendal ◽  
...  

The aim of the present systematic review was to examine the benefits and harms associated with immediate sequential bilateral cataract surgery (ISBCS) with specific emphasis on the rate of complications, postoperative anisometropia, and subjective visual function in order to formulate evidence-based national Danish guidelines for cataract surgery. A systematic literature review in PubMed, Embase, and Cochrane central databases identified three randomized controlled trials that compared outcome in patients randomized to ISBCS or bilateral cataract surgery on two different dates. Meta-analyses were performed using the Cochrane Review Manager software. The quality of the evidence was assessed using the GRADE method (Grading of Recommendation, Assessment, Development, and Evaluation). We did not find any difference in the risk of complications or visual outcome in patients randomized to ISBCS or surgery on two different dates. The quality of evidence was rated as low to very low. None of the studies reported the prevalence of postoperative anisometropia. In conclusion, we cannot provide evidence-based recommendations on the use of ISBCS due to the lack of high quality evidence. Therefore, the decision to perform ISBCS should be taken after careful discussion between the surgeon and the patient.


2018 ◽  
Vol 102 (10) ◽  
pp. 1419-1424 ◽  
Author(s):  
Stuart Keel ◽  
Jing Xie ◽  
Joshua Foreman ◽  
Hugh R Taylor ◽  
Mohamed Dirani

AimTo assess the visual outcomes of cataract surgery among a national sample of non-Indigenous and Indigenous Australians.MethodsThis was a population-based study of 3098 non-Indigenous Australians (50–98 years) and 1738 Indigenous Australians (40–92 years), stratified by remoteness. A poor postoperative outcome in an eye that had undergone cataract surgery was defined as presenting distance visual acuity (PVA) <6/12–6/60, and a very poor outcome was defined as PVA <6/60. Effective cataract surgery coverage (eCSC; operated cataract and a good outcome (PVA ≥6/12) as a proportion of operable plus operated cataract) was calculated.ResultsThe sampling weight adjusted cataract surgery prevalence was 19.8% (95% CI 17.9 to 22.0) in non-Indigenous Australians and 8.2% (95% CI 6.0 to 9.6) in Indigenous Australians. Among the non-Indigenous population, poor and very poor PVA outcomes were present in 18.1% and 1.9% of eyes, respectively. For Indigenous Australians, these values were 27.8% and 6.3%, respectively. The main causes of poor vision were refractive error (non-Indigenous=41.8%; Indigenous=41.9%) and coincident disease (non-Indigenous=43.3%; Indigenous=40.3%). The eCSC rates in the non-Indigenous and Indigenous populations were 88.5% (95% CI 85.2 to 91.2) and 51.6% (95% CI 42.4 to 60.7), respectively.ConclusionApproximately half of eyes with a poor visual outcome postcataract surgery could be readily avoided through the appropriate refractive correction. The finding of a lower eCSC rate among Indigenous Australians suggests that improvements in access and quality of cataract services may be warranted in order to reduce cataract-related vision loss in the Indigenous population.


2010 ◽  
Vol 16 (4) ◽  
pp. 665-672
Author(s):  
Jose M. Quintana ◽  
Antonio Escobar ◽  
Amaia Bilbao ◽  
Gemma Navarro ◽  
Jose M. Begiristain ◽  
...  

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