Visual outcome of the first 500 cataract extractions done in the field; Jimma, Ethiopia.

In 1998, a total of 617 cataract operations were performed on 523 patients at five outreach sites in Jimma Zone; south-western Ethiopia. The first 500 consecutive operations performed on 423 patients were analysed for visual outcome two weeks following field surgery. Four hundred and seventy-seven eyes underwent standard intra capsular cataract extraction (ICCE) while 23 eyes underwent extra capsular cataract extraction (ECCE). Seventy-seven patients underwent bilateral cataract surgery while 346 patients had been operated on only one eye. Forty-two patients (10.1%) or eighty-one eyes were lost for follow up. Thirty-nine of the 77 patients (50.6%) who received bilateral surgery and only 3 of 346 patients (0.9%) who received unilateral surgery were lost for follow up. Seventy-seven eyes (18.4%) had final visual acuity (v/a) of > or = 6/18; 388 eyes (92.6%) had v/a of > or = 6/60 and 395 eyes (94.3%) had v/a > or = 3/60. Capsule rupture and vitreous loss were the most common intra operative complications, accounting for 7.4% and 6%, respectively. Both complications were encountered in 1.8% of the eyes. Twenty-four eyes (5.7%) were blind despite surgery. However, only three eyes were blind as a result of complications related to surgery. There is a need for improvement in the screening of patients for surgery. The overall visual outcome obtained was satisfactory. Possible factors affecting visual outcome are considered and recommendations to effect improvement discussed.