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Short‐term outcomes of small incision cataract surgery provided by a regional population in the Pacific
Author(s) -
Bhikoo Riyaz,
Vellara Hans,
Lolokabaira Salome,
Murray Neil,
Sikivou Biu,
McGhee Charles
Publication year - 2017
Publication title -
clinical and experimental ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.3
H-Index - 74
eISSN - 1442-9071
pISSN - 1442-6404
DOI - 10.1111/ceo.12965
Subject(s) - medicine , visual acuity , cataract surgery , ophthalmology , prospective cohort study , surgery , endophthalmitis , astigmatism , physics , optics
Abstract Background This study aims to describe patient demographics, visual and surgical outcomes of a cohort undergoing small incision cataract surgery at a Pacific regional ophthalmic training facility. Design This is a prospective, longitudinal study conducted at the Pacific Eye Institute, Fiji. Participants One hundred fifty‐six patients underwent small incision cataract surgery. Methods Preoperatively, a complete ophthalmic examination, including pachymetry and macular optical coherence tomography performed by two independent investigators. Temporal small incision cataract surgery with intraocular lens insertion was performed by ophthalmologists, and trainee ophthalmologists. Follow‐up occurred at day one, four weeks and 3 months. Main Outcome Measures Patient characteristics, visual outcomes including surgically induced astigmatism and complications. Results Ninety‐one per cent (142/156) attended 3‐month follow‐up with median age 63 years (range 19–82), 52% female (81/156) and 58% (90/156) Fijian ethnicity. In 37% (57/156), the contralateral eye was pseudophakic. Mean preoperative best spectacle‐corrected visual acuity was logMAR 1.44 (6/165). At 3 months, 74% (105/142) achieved ≥6/18 unaided vision (94% [133/142] best spectacle‐corrected visual acuity). Mean postoperative spherical equivalent was −0.78 (SD 0.95) D and mean surgically induced astigmatism 1.04 (0.57) D. Complications included posterior capsular rupture with vitreous loss (4% [6/156]), optical coherence tomography confirmed macular oedema (8% [12/152] at 4 weeks), significant posterior capsular opacity (23% [31/136]) and >5% increase in preoperative pachymetry (1% [1/142]) at 3 months. Reduction in preoperative best spectacle‐corrected visual acuity occurred in 2% (3/142). No cases of endophthalmitis. Conclusion and relevance Small incision cataract surgery provided to a regional population is effective with 94% achieving the World Health Organisation's definition of ‘Good Vision’ (≥6/18). Refinements in biometric and surgical techniques may allow a greater proportion of patients to achieve good unaided vision.