Audit of visual outcome of cataract surgeries in a private eye hospital in Port Harcourt, Nigeria

Abstract

Aim: The aim was to determine the quality of cataract surgeries in Port Harcourt, and ascertain the difference in the outcome, if any, between small incision cataract surgery (SICS) and extra capsular cataract extraction (ECCE).

Materials and Methods: This is a retrospective study carried out in a Private Eye Hospital in Port Harcourt between August 2006 and November 2012. Case notes of 83 consecutive patients (92 eyes) who had either SICS OR ECCE with posterior chamber intraocular lens (PCIOL) were included in the study. Demographic data and data concerning ocular and systemic co-morbidities were retrieved from patients’ case notes. Best-corrected visual acuity was measured with Snellen’s chart preoperatively, and 6 weeks following surgery. The visual outcome was categorized, using the World Health Organization (WHO) recommendation, as good (>6/18), borderline (6/24-6/60), or poor (<6/60). Statistical software package Epi-info version 6.04d was used to analyze our data.

Result: A total of 92 eyes of 83 patients who had cataract surgeries was included in the study. Sixty-seven eyes (73%) had ECCE + intraocular lens (IOL) while 25 eyes (27%) had SICS + IOL. At 6 weeks postoperative, 66.3% of cases had good visual outcome while about 9.8% of cases had a poor outcome.

Conclusion: Since only 66.3% of cases had good visual outcome and 9.8% had poor outcome, cataract surgical outcome in Port Harcourt is below the acceptable WHO standards of >85% and <5% for good and poor outcomes respectively. Steps to improve good outcome will include proper postoperative hygiene of patients, good preoperative evaluation of all cases, and improvement in surgeons’ skills. Good visual outcome was associated more with ECCE (71.7% of 67 eyes) than SICS (52% of 25 eyes) probably due to inadequate experience of the surgeons in SICS. This difference was, however, not statistically signifi cant.

Keywords: Audit, cataract surgery, visual outcome