Department of Optometry, Debre Berhan University, Debre Berhan, North Shewa, Ethiopia.
Department of Optometry, College of Medicine and Health Sciences, University of Gondar, P.O. BOX: 196, Gondar, Ethiopia.
BMC Ophthalmol. 2024 Aug 23;24(1):366. doi: 10.1186/s12886-024-03629-w.
This study aimed to determine the proportion of poor visual outcome and associated factors among adult patients who underwent cataract surgery at Debre Markos and Felege Hiwot Comprehensive Specialized Hospitals in northwestern Ethiopia in 2023.
A hospital based cross-sectional study was conducted on 418 adult patients who had undergone cataract surgery from June 07 to August 07, 2023. Patients were recruited using systematic random sampling with an interval of 2. A pre-tested semi-structured questionnaire, medical record review, and ophthalmologic examination were used to collect data. The collected data was entered into Epi-info version 7 and exported to SPSS version 25 software for analysis. Binary logistic regression was used to determine the factors associated with poor visual outcomes of cataract surgery. Variables with a p-value of less than 0.05 in the multivariable binary logistic regression were considered statistically significant.
A total of 408 study participants with a median age of 65 years and a response rate of 97.6% took part. The proportion of poor visual outcomes of cataract surgery from 4 weeks to one year was 25.7% (95%CI: 21.6%, 30.3%). Factors responsible for poor visual outcomes of cataract surgery were intraocular lens implantation without a posterior chamber (AOR = 2.91, 95%CI:1.46,5.80), per-existing central corneal opacity (AOR = 3.83, 95%CI:1.52,9.69), pseudoexfoliation (AOR = 3.91,95%CI:1.39,11.88), age-related macular degeneration(AOR = 3.75, 95%CI:1.22, 11.88), glaucoma (AOR = 3.11, 95%CI:1.06,9.17) and striate keratopathy(AOR = 3.4, 95%CI: 1.11, 10.88).
In this study, the proportion of poor visual outcomes of cataract surgery is higher than the World Health Organization recommendation. The study found that implantation of an intraocular lens without a posterior chamber, pre-existing central corneal opacity, pre-existing age-related macular degeneration, pre-existing glaucoma, pseudoexfoliation, and striate keratopathy were significantly associated with poor visual outcomes of cataract surgery. We recommend that ophthalmologists and cataract surgeons prioritize the reduction of surgical complications and pre-existing ocular co-morbidities to enhance post-operative visual acuity. Improving pre-operative assessment and refining surgical techniques like phacoemulsification will aid in achieving this goal.
本研究旨在确定 2023 年在埃塞俄比亚西北部的德布雷马克罗斯和费莱盖·希沃特综合专科医院接受白内障手术的成年患者中视力不佳的比例及其相关因素。
这是一项 2023 年 6 月 7 日至 8 月 7 日在 418 名成年白内障手术患者中进行的基于医院的横断面研究。采用系统随机抽样方法，每隔 2 名患者招募一名患者。使用经过预测试的半结构式问卷、病历回顾和眼科检查来收集数据。收集的数据输入 Epi-info 版本 7 并导出到 SPSS 版本 25 软件进行分析。采用二元逻辑回归确定白内障手术视力不佳的相关因素。多变量二元逻辑回归中 p 值小于 0.05 的变量被认为具有统计学意义。
共有 408 名中位年龄为 65 岁、应答率为 97.6%的研究参与者参与了本研究。术后 4 周至 1 年视力不佳的白内障手术比例为 25.7%（95%CI：21.6%，30.3%）。导致白内障手术视力不佳的因素包括无后房型人工晶状体植入（AOR=2.91，95%CI：1.46，5.80）、预先存在的中央角膜混浊（AOR=3.83，95%CI：1.52，9.69）、假性剥脱（AOR=3.91，95%CI：1.39，11.88）、年龄相关性黄斑变性（AOR=3.75，95%CI：1.22，11.88）、青光眼（AOR=3.11，95%CI：1.06，9.17）和条纹状角膜病变（AOR=3.4，95%CI：1.11，10.88）。
在这项研究中，白内障手术视力不佳的比例高于世界卫生组织的建议。研究发现，无后房型人工晶状体植入、预先存在的中央角膜混浊、预先存在的年龄相关性黄斑变性、预先存在的青光眼、假性剥脱和条纹状角膜病变与白内障手术视力不佳显著相关。我们建议眼科医生和白内障外科医生优先考虑减少手术并发症和预先存在的眼部合并症，以提高术后视力。通过改进术前评估和细化超声乳化等手术技术，可以实现这一目标。
