Ocular Biometry services in Jos, North-central Nigeria: A situational analysis

Abstract

Background: Advances in cataract surgical technique, instrumentation and ocular biometry, have led to universal adoption of intraocular lenses (IOLs) in the management of cataract. Biometry selected IOL usage requires specialist equipment, along with maintenance of a range of IOL powers. There is no published data regarding the extent of uptake of routine biometry in cataract surgical facilities in Nigeria and other low resource settings. In this survey, we conducted a situational analysis of the availability and functionality of ocular biometry equipment(s) in a setting where cataract surgery with IOL is routine. Methodology: The study was a situational analysis involving all cataract surgical facilities in Jos, North-central Nigeria, who consented to participate in the study. Cataract surgical facilities were identified through snow balling and consecutively recruited between June and August 2021(10 weeks). Information on availability and functionality of biometry equipment(s) were obtained through an online questionnaire completed by the head of each cataract surgical facility. All responses were analyzed using STATA 16 using frequency and percentages. Results: A total of nine cataract surgical facilities in Jos participated in the study. Of these, seven (77.8%) reported having functional auto-keratometers/A-scan machines. None was using manual keratometer or IOL Master. There are four (44.4%) facilities that always perform biometry in their centers, but only two (22.2%) use biometry-calculated IOL (BcIOL) powers always. The two main reasons for infrequent use of BcIOL are incomplete IOL banks (30%) and deliberate under or over correction to achieve a desired post-operative outcome other than emmetropia (30%). Less common reasons were power outage and faulty equipment(s). Conclusion: Although biometry services are widely available and functional in Jos, there is a need to improve the utilization of BcIOL power through central purchasing of the not too common IOL powers and establishment of a robust IOL bank. Key words: Ocular-biometry, Cataract, biometry-calculated intraocular lens. Key message: There is need to prioritize and promote the utilization of ocular biometry for sustained improvement in cataract surgical outcome.