Article Text

other Versions

PDF
Outcome of cataract surgery at one year in Kenya, the Philippines and Bangladesh
  1. Robert Lindfield (robert.lindfield{at}lshtm.ac.uk),
  2. Hannah Kuper,
  3. Sarah Polack,
  4. Christina Eusebio,
  5. Wanjiku Mathenge,
  6. Zakia Wadud,
  7. Rashid Mamun,
  8. Allen Foster
  1. International Centre for Eye Health, London School of Hygiene and Tropical Medicine, United Kingdom
  2. International Centre for Eye Health, London School of Hygiene and Tropical Medicine, United Kingdom
  3. International Centre for Eye Health, London School of Hygiene and Tropical Medicine, United Kingdom
  4. Cataract Foundation of the Philippines, Philippines
  5. Rift Valley Provincial Hospital, Kenya
  6. Child Sight Foundation, Bangladesh
  7. CHER Foundation, Bangladesh
  8. International Centre for Eye Health, London School of Hygiene and Tropical Medicine, United Kingdom

    Abstract

    Aims: To assess the change in vision following cataract surgery in Kenya, Bangladesh and the Philippines and to identify causes and predictors of poor outcome.

    Methods: Cases were identified through cross-sectional surveys, community outreach and hospital clinics. They underwent pre-operative visual acuity measurement and ophthalmic examination. Cases were re-examined by an ophthalmologist 8-15 months after cataract surgery. Information on age, gender, poverty and literacy was collected at baseline.

    Results: 452 eyes of 346 people underwent surgery. 124 (27%) eyes had an adverse outcome. In Kenya and the Philippines the main cause of adverse outcome was refractive error (37% and 49% respectively of all adverse outcomes) then co-morbid ocular disease (26% and 27%), whilst in Bangladesh this was co-morbid disease (58%) then surgical complications (21%). There was no significant association between adverse outcome and gender, age, literacy, poverty or pre-operative visual acuity.

    Conclusions: Adverse outcomes following cataract surgery were frequent in the three countries. The main causes were uncorrected refractive error and pre-operative co-morbidities. Cataract surgical programmes need to improve post-operative outcomes, as many patients are not reaching the potential vision available with modern surgery. There should be a focus on correcting refractive error either through operative techniques or post-operative refraction alongside a system for assessing co morbidities and communicating risk to patients. These can only be achieved if there is a commitment to ongoing surgical audit.

    Statistics from Altmetric.com

    Request permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.