Clinical Outcomes of Surgery for Age-related Cataract with Intraocular Lens Implantation in Two Hospitals in North-Central Nigeria

Abstract

Background: Pre-operative biometry for cataract surgery may not be routinely performed particularly in resource-limited settings. Hence, the use of available intraocular lens (IOL) is not uncommon. Aim: To assess the post-operative presenting visual acuity (PVA) and best corrected visual acuity (BCVA) of patients operated for age-related cataract with biometry-calculated IOL power and available IOL power implantation at two mission hospitals in Jos, Nigeria. Methodology: A retrospective cross-sectional survey carried out between June and August 2021. Patients aged 40 years and above, who had undergone surgery for age-related cataract in the preceding 18 months in the two hospitals and were six weeks or more post-surgery were consecutively enrolled into the study, after obtaining informed consent. Sociodemographic data and surgical history were obtained from patients and their surgical records. The PVA and BCVA were assessed and categorized based on World Health Organization guidelines. Results: A total of 87 patients were examined within the study period. The PVA was good (≥6/18) in 32 (36.8%), borderline (<6/18-6/60) in 41 (47.1%) and poor (<6/60) in 14 (16.1%) participants. After refraction, the proportion of good outcomes increased to 78.2% with only 8.1% of outcomes remaining poor. Biometry-calculated IOL power and available IOL power use did not significantly influence visual outcome (P=0.645 and P=0.146 for PVA and BCVA respectively). Conclusion: The PVA was in the borderline category in majority of the patients with residual uncorrected refractive error as the principal cause. Regardless of the IOL power implanted, surgery for age-related cataract enhanced patients’ vision.