Causes of suboptimal corrected visual acuity following phacoemulsification in a teaching university hospital.

PURPOSE

Cataract is the leading cause of reversible blindness in developing countries, with variable visual outcome following surgery. This work aims at assessing the outcomes of cataract surgery at Kasr Al Ainy Hospital and identifying the reasons for borderline and poor outcome in the studied group.

METHODS

A total of 150 eyes of patients with cataract and no other ocular pathology were included in this study. Uncorrected visual acuity (UCVA) and corrected visual acuity (CVA), complete ocular examination using slit-lamp, applanation tonometry, and ophthalmoscopy were performed for all patients. Biometry for intraocular lens power calculation and operative data were recorded. Patients were followed for 6 weeks; UCVA, CVA, and any complications were noted.

RESULTS

Mean preoperative CVA was 0.16 ± 0.16 (SD) and mean postoperative CVA was 0.66 ± 0.33 (p<0.001). Forty-two percent of surgeries were performed by junior staff under training. Thirty-five surgeries were complicated by posterior capsular rupture. Mean CVA at 6 weeks in the uncomplicated group was 0.77 ± 0.22; in the complicated group, 0.28 ± 0.34 (p<0.001). Biometry was accurate in 51.6% of cases. Most important causes for suboptimal outcome were aphakia, astigmatism, posterior capsular opacification, and corneal edema.

CONCLUSIONS

Kasr Al Ainy Hospital achieved CVA 6/9 or more in 69.3% and CVA 6/18 or more in 81.3% of patients. The capsular complication rate was high at 23.3%. The high complication rate is attributed to the nature of the teaching hospital where most surgeons were in their learning periods.