Evaluation of Post-Operative Visual Outcomes of Cataract Surgery in Ghana

Abstract

Purpose: To evaluate post-operative visual outcomes after cataract surgeries performed at 2 tertiary referral hospitals in Ghana
Methods: A retrospective consecutive case review of hospital –elective-cataract surgeries of all ages performed at two tertiary referral centers in Southern Ghana during a 3-year-period was carried out. Data was compiled on demographic characteristics, pre- and postoperative visual acuities and surgical complications. The preoperative and postoperative visual status was classified using the World Health Organization (WHO) category of Visual Impairment and Blindness. The standard parameters of assessing outcome of cataract surgery and the WHO criteria for grading the outcome of cataract surgery were used.
Results: A total of 1288 unilateral cataract extractions were performed within the 3-year-period of this review. Mean age of the patients at operation was 64.47 ± 16.7years. Small incision cataract surgery (SICS) with intraocular lens implant (83.8%) was the major surgical technique. One thousand two hundred and eighty four eyes (99.7%) were blind (VA <3/60) before surgery of which fewer than 9.5% remained blind postoperatively. The proportion of post operative eyes with good outcome (6/6-6/18) was 22.0% within 48 hours of surgery and 41.2% at 4-6 weeks follow up. Outcome was poor (<6/60) in 29.2% within 48 hours of surgery and 9.5% at 4-6 weeks follow up. Nearly half of the operative eyes had borderline outcome (6/24-6/60) within 48 hours of surgery and at follow up. ECCE +IOL operating technique achieved the best results, resulting in 54.6% of the operated eyes achieving good outcome. Only 2.8% of the operated eyes had surgical complications at follow up, of which posterior capsular opacities (50%) and vitreous loss (13.3%) were the major causes. A total of 1164 (90.4%) of the operated eyes did not have optical correction after surgery.
Conclusion: Over 41.2% of post-operative eyes patients in this study had very good visual outcome following cataract surgery in the study population. Nevertheless, greater attention to post-operative care and uncorrected refractive error is needed.

Keywords: Cataract surgery, cataract surgical outcome, visual outcome.