Literature DB >> 21055820

Outcome of cataract surgery in Nigeria: visual acuity, autorefraction, and optimal intraocular lens powers--results from the Nigeria national survey.

Abdullahi U Imam1, Clare E Gilbert, Selvaraj Sivasubramaniam, Gudlavalleti V S Murthy, Raj Maini, Mansur M Rabiu.   

Abstract

OBJECTIVE: To describe presenting and corrected visual acuities after cataract surgery in a nationally representative sample of adults. Another objective was to describe refractive errors in operated eyes and to determine the optimal range of intraocular lens (IOL) powers for this population.
DESIGN: Cross-sectional, population-based survey. PARTICIPANTS: Adults aged 40 years and more were selected using multistage stratified sampling and proportional to size procedures. A sample size of 15027 was calculated, and clusters were selected from all states.
METHODS: Individuals who had undergone cataract surgery were identified from interview and examination. All had their presenting visual acuity (VA) measured using a reduced logarithm of the minimum angle of resolution chart and underwent autorefraction. Corrected VAs were assessed using the autorefraction results in a trial set. An ophthalmologist conducted all examinations, including slit-lamp and dilated fundus examination. Causes of visual loss were determined for all eyes with a presenting VA <6/12 using the World Health Organization recommendations. Biometry data were derived from 20449 phakic eyes using the SRK-T formula after excluding those with poor VA or corneal opacities. MAIN OUTCOME MEASURES: Presenting and corrected visual acuities in pseudo/aphakic individuals and autorefraction findings; biometry profile of Nigerian adults.
RESULTS: Data from 288 eyes of 217 participants were analyzed. Only 39.5% of eyes had undergone IOL implantation at surgery. Only 29.9% of eyes had a good outcome (i.e., ≥6/18) at presentation, increasing to 55.9% with correction. Use of an IOL was the only factor associated with a good outcome at presentation (odds ratio 9.0; 95% confidence interval, 4.3-18.9; P=0.001). Eyes undergoing cataract surgery had a higher prevalence and degree of astigmatism than phakic eyes. Biometry data reveal that posterior chamber IOL powers of 20, 21, and 22 diopters (D) (A constant 118.0) will give a postoperative refraction range of -2.0 D to emmetropia in 71.4% of eyes, which increases to 82.6% if 19 D is also included.
CONCLUSIONS: Postoperative astigmatism needs to be reduced through better surgical techniques and training, and use of biometry should be standard of care.
Copyright © 2011 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

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Year:  2010        PMID: 21055820     DOI: 10.1016/j.ophtha.2010.08.025

Source DB:  PubMed          Journal:  Ophthalmology        ISSN: 0161-6420            Impact factor:   12.079


  4 in total

1.  Outcomes of manual small-incision cataract surgery using standard 22 dioptre intraocular lenses at Nkhoma Eye Hospital, Malawi.

Authors:  Justin C Sherwin; William H Dean; Isabelle Schaefers; Paul Courtright; Nick Metcalfe
Journal:  Int Ophthalmol       Date:  2012-05-04       Impact factor: 2.031

2.  Cost-effectiveness of eye care services in Zambia.

Authors:  Ulla K Griffiths; Fiammetta M Bozzani; Adrian Gheorghe; Lawrence Mwenge; Clare Gilbert
Journal:  Cost Eff Resour Alloc       Date:  2014-02-25

3.  Changing patterns of cataract services in North-West Nigeria: 2005-2016.

Authors:  Nasiru Muhammad; Mohammed Dantani Adamu; Mpyet Caleb; Nuhu Mohammed Maishanu; Aliyu Mohammed Jabo; Muhammad Mansur Rabiu; Covadonga Bascaran; Sunday Isiyaku; Allen Foster
Journal:  PLoS One       Date:  2017-08-17       Impact factor: 3.240

Review 4.  Elimination of avoidable blindness due to cataract: where do we prioritize and how should we monitor this decade?

Authors:  Gudlavalleti V S Murthy; Neena John; Bindiganavale R Shamanna; Hira B Pant
Journal:  Indian J Ophthalmol       Date:  2012 Sep-Oct       Impact factor: 1.848

  4 in total

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