Causes of subnormal vision in patients following cataract surgery at a tertiary hospital in Kashmir.

Cataract surgery is aimed at restoring sight to near normal vision. This study, conducted at the Department of Ophthalmology, Government Medical College, Srinagar, is an attempt to determine the causes of subnormal vision in patients following cataract surgery at a tertiary hospital in Kashmir. One hundred patients who underwent cataract surgery with an unaided visual acuity of <6/9 at 16 weeks postoperatively were included in the study. Postoperative follow-up examinations were conducted until the 16th week. Intraoperative and postoperative complications were recorded to determine the cause of subnormal vision. Of 100 patients, 40 underwent extracapsular cataract extraction (ECCE), 30 underwent small incision cataract surgery (SICS) and 30 underwent phacoemulsification. Seventy-five percent of the patients who underwent ECCE had postoperative astigmatism with a mean astigmatism of 2.2 ± 0.81 diopters at 16 weeks, with the majority having with-the-rule astigmatism. In the SICS group, 17 (56.6 %) patients had a mean postoperative astigmatism of 0.75 ± 0.40 diopters, with the majority (82.3 %) having against-the-rule (ATR) astigmatism. In the phacoemulsification group, 13 (43.3 %) of the patients had a mean postoperative astigmatism of 0.48 ± 0.23 diopters with the majority having ATR astigmatism. Other causes of subnormal vision were pseudophakic ametropia, posterior capsular opacity and intraoperative complications like posterior capsular rent and vitreous loss. Postoperative astigmatism was the major cause of subnormal vision with greater astigmatism seen in the ECCE group. Therefore, procedures like smaller incision sutureless surgery and careful biometry are advocated to improve visual outcome and patient satisfaction.