Posters

Causes of suboptimal best-corrected visual acuity following phacoemulsification in Kasr Alainy Cairo University Hospital

Poster Details

First Author: R. Eltanamly EGYPT

Co Author(s):    M. Fathallah   H. Saadeldin   G. Elnahri              

Abstract Details

Purpose:

Outcome of cataract surgery is variable in both developed and developing countries. World Health Organization (WHO) standards for cataract surgery outcomes state that; Good Outcome: with BCVA between 6/6-6/18 for 85.0% of cataract cases. Borderline Outcome: with BCVA less than 6/18 and more than 6/60 in less than 15.0% of cases. Poor outcome: with BCVA less than 6/60, in less than 5.0% of cases. This work aims at assessing the outcomes of cataract surgery in Kasr Alainy Hospital in Cairo, and identifying the reasons for borderline and poor outcome.

Setting:

This prospective cohort study was conducted in Kasr Alainy Cairo University hospital

Methods:

150 cataract patients with normal fundus were included in this study, patients with traumatic cataract and those having any ocular pathology that may interfere with visual outcome were excluded. All patients underwent full ocular examination including uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), calculation of intraocular lens (IOL) power, phacoemulsification, postoperative follow up for 6 weeks. Any intraoperative complications were documented, postoperative examination and refraction for BCVA was done, and causes of suboptimal BCVA were recorded.

Results:

50% of patients had dense cataract. Mean postoperative UCVA at 6 weeks was 0.31± (0.23), whereas, mean postoperative BCVA was 0.66± (0.33) [p< 0.001]. Good outcome (>0.33) was reached in 81.3% of cases, borderline outcome in 4% and poor outcome (<0.1) in 14.7%. 42% of cases were done by trainees. 35 cases (23%) were complicated by posterior capsular rupture, mean BCVA at 6 weeks in the uncomplicated group was 0.77± (0.22) compared to 0.28± (0.34) in complicated group [p < 0.001]. Causes of suboptimal BCVA were; astigmatism (6%), aphakia (5.3%), capsular opacities, and corneal edema, and biometry error.

Conclusions:

In a sample study conducted in a tertiary teaching hospital setting, BCVA >0.66 was achieved in 69.3% and BCVA >0.33 in 81.3% of patients following cataract surgery. The capsular complication rate was 23.3%. The main causes of poor outcome were aphakia and surgical induced astigmatism. The high complication rates may be attributed to difficult cases with dense cataract, junior surgeons under training and a high biometry error.

Financial Disclosure:

NONE