Evaluation of cataract surgery outcome in Western Nigeria.

OBJECTIVE To evaluate the baseline visual outcome of cataract surgeries and improve on these towards achieving one of the objectives of vision 2020. DESIGN A retrospective study. SETTING Hospital-based, utilizing 3 eye centres in Osun State, Nigeria between January 2000 and December 2002. METHODS Records of 283 hospital-elective-cataract-surgeries only of all ages in 3 centres were evaluated. RESULTS Mean age was 62.2 years. Fifty-eight 58% were blind before while only 6.3% remained blind post op. With best correction, visual outcome was good in 47.5%, moderate in 37.6% and poor in 15%. The commonest co-morbidity was glaucoma 33 (71.7%). The most common intra operative complications were vitreous loss 61 (27.35%) and posterior capsular rupture (6.28%). Capsular opacity (6.28%) was commonest post operatively with significantly poor visual outcome (χ(2)= 51.46, p-value = <0.05). Causes of poor visual outcome were uncorrected refractive error (59.37%), co-morbidity (24.22%), and surgery related complications (16.41%). Visual outcome was significantly better with IOL or prescribed glasses (χ(2)=19.66, p-value <0.05) and better still with ECCE +IOL (χ(2)=8.46, p-value <0.05). Poor visual outcome was significantly associated with co-morbidity (χ(2) = 23.88, p-value <0.05), surgical complications (χ(2)= 51.46, p-value = <0.05). CONCLUSION The baseline cataract visual outcome was poor due to delay in correction of refractive error, comorbidities, and surgical complications. Good outcome could be attained by routinely ensuring different methods of adequate postoperative visual rehabilitation. Skills acquisition, availability of adequate equipments, establishment of a good records system to achieve effective evaluation and monitoring of outcome cannot be over emphasized.