Cataract Surgery Visual Outcomes and Associated Risk Factors in Liberia

Abstract

Purpose : To report the initial outcomes and associated risk factors of cataract surgery performed in Liberia

Methods : Electronic Medical Records of 573 patients operated for age-related cataract from July 2017 to January 2019 were reviewed. One eye per patient was included for analysis. All patients underwent either phacoemulsification or manual small incision cataract surgery (MSICS). Pre and postoperative uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA) were recorded at one day, 1-3 weeks and 4-11 weeks. Main outcome measure was BCVA at 4-11 weeks; Intraoperative complications and preoperative ocular comorbidities (POC) were noted. BCVA less than 6/12 was classified as visual impairment (VI). Risk factor for VI was analysed using the logistic regression model. The statistical analysis was done using STATA 13 software.

Results : Of the 573 patients, 288 were males and 285 were females (49.7%). Mean age was 65.9±10.9 years; 14.3% had POC. The surgical technique was mainly MSICS (94.59%,n=542). Majority of patients (94.59%, n=542) underwent cataract surgery by MSICS technique. 31 patients (5.41%) underwent surgeries by Phacoemulsification technique. At 4–11 weeks, good outcome of 6/12 or better was noted in 38.55% (UCVA) and 82.54% (BCVA). Visual acuity (VA) of 6/18 or better as UCVA and BCVA was noted in 63.5% and 88% eyes respectively. Poor outcome of less than 6/60 was noted as UCVA (11.11%) and BCVA (5.22%). Multivariable analysis showed poor visual outcomes significantly higher in patients with POC (odds ratio 3.28; 95% CI: 1.70,6.34).The preoperative comorbidities were present in 14.3% of patients.

Conclusions : This study shows that cataract surgeries carried out in Liberia had good outcomes and comparable to that recommended by the World Health Organization. Presence of comorbidities was associated with poor outcome.

This is a 2020 ARVO Annual Meeting abstract.