Posters

Experience of cataract operations in an ethnically diverse east London population: post-operative outcomes and complications

Poster Details

First Author: J.Halim UK

Co Author(s):    J. Halim   N. Cascone   A. Coombes   M. Westcott           

Abstract Details

Purpose:

Cataract surgery is the most commonly performed ophthalmic surgery in the world. East London has a multi-ethnic population comprising Asian, Afro-Caribbean and White-Caucasian ethnicities. Differences in cataract surgery outcomes between ethnic groups are unclear. The aim of the study is to describe the visual outcomes and factors associated with unfavourable outcomes of cataract surgery in an ethnically diverse population.

Setting:

Ophthalmology Department, The Royal London Hospital and Mile End Hospital, Barts Health NHS Trust, London, UK.

Methods:

A population-based review of cataract operations in an inner London ophthalmology department at two hospital sites within a one-year period. Patients who underwent phacoemulsification cataract surgery and had their ethnicity stated were included in the review. Cases were identified and data was gathered from an electronic medical database. Demographic, pre-operative, operative, and postoperative data were collected. The primary outcome was postoperative visual acuity (VA) measured on the logMAR scale. Unfavourable visual outcome was defined as a postoperative VA of >0.30 logMAR. The secondary outcomes were postoperative complications and ocular co-pathologies.

Results:

Of the 1011 eligible operations with postoperative VA data available for analysis, 448 were Asian (44.3%), 379 were White-Caucasian (37.5%), 157 were Afro-Caribbean (15.5%), 27 were Mixed/Others (2.7%). Visual outcomes were favourable in 843 cases (83.4%) and unfavourable in 168 cases (16.6%). Older age (OR 1.60 [95%CI 1.14-2.23], p=0.0063) and Asian eyes (OR 1.65 [95%CI 1.19-2.31], p=0.0030) were significantly associated with an unfavourable visual outcome. The main ocular factors associated with an unfavourable visual outcome were postoperative uveitis (OR 2.52 [95%CI 1.38-4.61], p=0.0026), corneal oedema (OR 3.01 [95%CI 1.45-6.24], p=0.0031), and cystoid macular oedema (OR 3.29 [95%CI 1.26-8.61], p=0.0153).

Conclusions:

Unfavourable visual outcomes are related to eyes of Asian ethnicity and older patients, as well as disorders of postoperative inflammation, especially postoperative uveitis. Managing ocular inflammation after cataract surgery is important in ensuring favourable visual outcomes, especially in older and Asian patients who are more likely to have unfavourable visual outcomes. Future work should involve looking at the relationship between ethnicity, ocular co-pathologies, systemic conditions and postoperative conditions, in particular postoperative uveitis and cystoid macular oedema to quantify the risk of developing these conditions.

Financial Disclosure:

None