VISUAL OUTCOME AND ASSOCIATED FACOTRS OF CATARACT SURGERY AMONG ADULT PATIENTS IN SAINT PAUL’S HOSPITAL MILLENIUM MEDICAL COLLEGE, ADDIS ABABA; ETHIOPIA

Abstract

ABSTRACT BACKGROUND: Cataract is the main cause of blindness throughout the world and more than 90% of this blindness related with cataract is found in low-and middle-income countries. Cataract surgery is the only solution to restore vision in cataract blindness, so having effective surgical skill of cataract extraction and regular monitoring of cataract surgery outcomes are important parameters to achieve patients visual demand and world health organization target of cataract surgery outcome. The outcomes of cataract surgery can be measured in different ways, of which postoperative visual acuity is the routine one. There are different factors associated with poor cataract surgical outcome and may vary from country to country and within country. World health organization recommends good visual acuity (≥ 6/18) to be greater than 80% and poor visual acuity (<6/60) to be less than 5% in developing countries. Thus, the main aim of this study is to evaluate visual outcome and associated factors of cataract surgery among adult patients in St. Paul’s Hospital Millennium Medical college, Addis Ababa; Ethiopia. OBJECTIVES: The main objective of this study was to evaluate visual outcome and associated factors of cataract surgery among adult patients in St. Paul’s Hospital Millennium Medical college, Addis Ababa; Ethiopia. METHODS: Prospective cross-sectional, hospital based study was conducted and detailed preoperative, intraoperative and postoperative data were collected and analyzed for 314 study participants. The standard parameters of assessing outcome of cataract surgery and the world health organization criteria for grading the outcome of cataract surgery were used. Descriptive statistics and Binary logistic regressions were used. RESULTS: Three hundred fourteen eyes of 314 participants (mean age 64.16±8.83 SD, 52.2% females, 56.1% from urban) were included in the study. Most of the participants 283 (90.1%) had preoperative visual acuity less than 6/60. At final follow up visit (6 to 8 weeks), best-corrected visual acuity was good (≥ 6/18) in 215 (68.5%), borderline (<6/18-6/60) in 63 (20.1%) and poor (<6/60) in 36 (11.5%) eyes. Age related macular degeneration OR= 4.57 95%CI (1.12,17.24) p=0.03 and preoperative astigmatism 3.22 95%CI (1.25,8.33) p=0.01 were significantly associated with poor visual outcome. CONCLUSIONS: In this study, good visual outcome was significantly low and poor visual outcome was higher than the WHO minimum set standard. Therefore, great attention and care should be given in order to improve outcomes of cataract surgery. KEY WORDS: Visual outcome, associated factors, cataract surgery, Ethiopia