Fathallah Mohammed, Eltanamly Rasha M, Saadeldin Hala, Elnahry Gehad H
Department of Ophthalmology, Kasr Alainy Medical School, Cairo University, Cairo - Egypt.
Eur J Ophthalmol. 2017 Mar 10;27(2):169-173. doi: 10.5301/ejo.5000824. Epub 2016 Jul 11.
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.
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.
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.
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.
白内障是发展中国家可逆性失明的主要原因，手术后视力结果各不相同。本研究旨在评估开罗大学艾因夏姆斯医院眼科（Kasr Al Ainy Hospital）白内障手术的效果，并确定研究组中视力临界和不佳的原因。
本研究共纳入150例患有白内障且无其他眼部病变的患者。对所有患者进行未矫正视力（UCVA）和矫正视力（CVA）检查，使用裂隙灯、压平眼压计和检眼镜进行全面的眼部检查。记录用于计算人工晶状体度数的生物测量数据和手术数据。对患者进行6周的随访，记录UCVA、CVA及任何并发症情况。
术前平均CVA为0.16±0.16（标准差），术后平均CVA为0.66±0.33（p<0.001）。42%的手术由正在接受培训的初级工作人员进行。35例手术发生后囊破裂并发症。未发生并发症组6周时的平均CVA为0.77±0.22；发生并发症组为0.28±0.34（p<0.001）。生物测量在51.6%的病例中是准确的。导致效果欠佳的最重要原因是无晶状体、散光、后囊混浊和角膜水肿。
开罗大学艾因夏姆斯医院眼科69.3%的患者术后CVA达到6/9或更好，81.3%的患者CVA达到6/18或更好。囊膜并发症发生率较高，为23.3%。并发症发生率高归因于教学医院的性质，大多数外科医生处于学习阶段。
