Visual Outcome of Cataract Surgery in a Tertiary Hospital, South East Nigeria: A Three-Year Retrospective Study

Abstract

The visual outcome of cataract surgery is a critical measure of its effectiveness and is an essential aspect of quality control in ophthalmic care. The burden of cataracts is especially pronounced in developing countries. This study investigated the characteristics of patients who had cataract surgery and their subsequent visual outcomes. Data was collected from a total of 117 patients, with a mean age of 65.23 years. The majority of the patients had mature cataracts (76.9%) and underwent Small Incision Cataract Surgery (SICS) (94.0%). Pre-operative visual acuity was poor in the majority of patients, with 88.0% having visual acuity better than 6/60 to LP. The visual outcome improved significantly on the first post-op day with 71.8% of patients having a visual acuity better than 6/18 to 6/60. This improvement was sustained at 6 weeks post-op. Pre-operative Intraocular Pressure (IOP) ranged between 10-19 mmHg for the majority (72.7%) of the patients. Post-operative IOP was largely reduced, with >90% % of patients having an IOP of 19 mmHg or less. Complications were relatively rare, with 94% of surgeries occurring without intra-op complications and 87.2% of patients having no post-op complications. High Intraocular Pressure and a hazy cornea were the most common post-op complications, occurring in 2.6% and 5.1% of cases, respectively. At 2 months post-op, 49.6% of patients had visual acuity of 6/18 or better with best correction. Without correction, 21.4% of patients had visual acuity of 6/18 or better. Patient characteristics (age and sex) and the type of cataract surgery performed did not show a statistically significant relationship with the visual outcome at 2 months post-op (P= 0.14,0.42). However, the nature of the cataract showed a significant association with the visual outcome, with mature cataracts having better visual acuity compared to hypermature cataracts (P=0.047). The study concludes that the majority of patients show significant improvement in visual acuity following surgery, but a considerable number of patients continue to exhibit suboptimal visual acuity and require additional corrective measures. The need for ongoing management and regular ophthalmological follow-up is recommended.