Profile of Cataract Surgical Patients at National Eye Centre, Kaduna, Nigeria.

Main Article Content

Thelma Imaobong Ndife https://orcid.org/0009-0009-0316-1372
Mahmoud Babani Alhassan
Danjuma Musa

Keywords

Cataract surgery technique, intra ocular lens power, complications, Nigeria

Abstract

Background: Cataract surgery has evolved over the years. This study aims to highlight the profile of the patients who underwent cataract surgery at a tertiary hospital with emphasis on patient demographics, surgical techniques performed, intraocular lens powers implanted and the complications managed.


Methodology: A retrospective cross-sectional descriptive study of all patients who had undergone cataract surgery within two years at the National Eye Centre, Kaduna, Nigeria. Results: One thousand four hundred and seventy- two (1,472) patient records of all ages met the inclusion criteria with a male-female ratio of 1.4:1. The mean age was 51.4 ± 22.6 years. The difference in the mean age of the sexes was statistically significant (p=0.01) and 95% CI was 7.37- 10.40 years. Glaucoma was the commonest ocular comorbidity 142(9.65%) and only 5% (74) had systemic comorbidities. The mean intraocular lens (IOL) power was 19.25 ± 1.8 Diopters (Range 10.5D to 26D). The commonest surgery performed was small incision cataract extraction with posterior chamber intraocular lens implant (SICS + PCIOL) 91.2% followed by Trabeculectomy with SICS + PCIOL (3.87%). Phacoemulsification accounted for 2.72% of surgeries. Intra-operative complications were posterior capsular rent in 7.1% (104) and vitreous loss in 4% (58). The commonest post-operative complications were corneal oedema 6.9% (103) and striae keratopathy 4.6% (68).


Conclusion: Most cataract patients were male, above 50 years of age and likely to be older than the females at the surgery. The most performed surgical technique was small incision cataract surgery with posterior chamber intraocular lens implantation (SICS + PCIOL) while the mean intra-ocular lens power was 19.25 ± 1.8Dioptres. Globally accepted cataract surgical techniques utilizing recent technological advancements were employed with biometry-guided intraocular lens power calculation and implantation. Complications fell within the accepted global rates.

Abstract 37 | PDF Downloads 29 EPUB Downloads 10 HTML Downloads 3

References

1. GBD 2019 Blindness and Vision Impairment Collaborators; Vision Loss Expert Group of the Global Burden of Disease Study. Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the Right to Sight: an analysis for the Global Burden of Disease Study. Lancet Glob Health. 2021; 9(2):e144-e160. doi: 10.1016/S2214-109X (20)30489-7

2. Abdul MA, Sivasubramaniam S, Murthy GVS, Gilbert C, Abubakar T, Ezelum C, Rabiu MM.Causes of blindness and Visual Impairment in Nigeria: The Nigeria National Blindness and Visual Impairment Survey. Investigative Ophthalmology & Visual Science, 2009;50:4114-4120. doi:https://doi.org/10.1167/iovs.09-3507

3. Bjorn T. Global initiative for the elimination of avoidable blindness. Comm Eye Health J. 1998; 11(26):29.

4. Chen X, Xu J, Chen X, YaoK. Cataract: Advances in surgery and whether surgery remains the only treatment in the future. Advances in Ophthalmology Practice and Research 2021; 1(1):100008.https://doi.org/10.1016/j.aopr.2021.100008

5. Norrby S. Sources of error in intraocular lens power calculation. J Cataract Refract Surg. 2008; 34:368–376.

6. Hrebcova J, Skorkovska S, Vasku A. Comparison of contact and immersion techniques of ultrasound biometry in terms of target postoperative refraction. Cesk Slov Oftalmol. 2009; 65:143–146.

7. Isawumi MA, Soetan EO, Adeoye AO, Adeoti CO. Evaluation of Cataract Surgery Outcome in Western Nigeria. Ghana Med J. 2009 Dec; 43(4): 169–174.

8. Fasina O, Okwudishi IA, Bekibele C. Cataract surgery in Ibadan, Nigeria: Visual outcome and post-operative refractive error. Annals of Health Research, 2017; 3 (1): 43-49

9. Kurawa MS, Abdul L. Demographic Characteristics and Visual Status of Patients Undergoing Cataract Surgery at a Tertiary Hospital in Kano, Nigeria. Ann Afr Med 2017:16(4):170-174.

10. Silas AB, Adegboyega Moses O, Akang J. Gender Differences and Financing Patterns of Cataract Operated Adult Patients Attending a Tertiary Health Facility in Northern- western Nigeria. Wes J Med Biomed Sci. 2022;3(3-4):59-65

11. Ezegwi IR, Ajewole J. Monitoring Cataract Surgical Outcome in a Nigerian Mission Hospital. International Ophthalmology 2007;29(1): 7-9

12. Alhassan MB, Kyari F, Achi IB, Ozemela CP, Abiose A. Audit of outcome of an ECCE+PCIOL Training course: Br J Ophthalmol 2000;84(8):848-51

13. Odugbo OP, Babalola OE, Morgano RE. Outcome of cataract surgeries in Plateau State, Nigeria. Highland medical research journal 2009;8 (1) 52874.doi:10.4314/hmrj,v8i1.52874

14. Mayor AO, Ugbede I, Oyeroke K, OtomiEO, Shimizu E, Nakayamo S, et al. Retrospective study of the temporal approach in cataract surgery at Evangelical Church Winning All Hospital.African Vision and Health Science, 2022;81(1):782

15. Ilechie AA, Boadi-Kusi BS, Ndudiri OV, Ofori EA. Evaluation of Post-Operative Visual Outcomes of Cataract Surgery in Ghana, International Journal of Health Research 2012; 5 (1):35-42

16. Nwosu SNN. Survey of Cataract Surgical Technique in Nigeria. NJO 2011;19(1)

17. Gogate P, Kulkarni S, Krishnaiah S, Deshpande R, Joshi S, Palimkar A, et al. Safety and efficacy of phacoemulsification compared with manual small incision cataract surgery by a randomized control trial: Six weeks results. Ophthalmology 2005; 112:869–74.

18. Gogate P, Deshpande M, Nirmalan P. Why do phacoemulsification? Manual small incision cataract surgery is almost as effective and more economical. Ophthalmology 2007; 114:965–8.

19. Ruit S, Tabin G, Chang D, Bajracharya L, Kline DC, Richheimer R, et al. A prospective randomized clinical trial of phacoemulsification vs. manual sutureless small-incision extracapsular cataract surgery in Nepal. Am J Ophthalmol 2007; 143:32–8.

20. Kassa MS, , Gessesse GW. Ocular Biometry and Intra Ocular Lens Power among Cataract Patients in Rural Eastern Ethiopia. Ethiop J Health Sci. 2021 Jul; 31(4): 823–830.doi: 10.4314/ejhs.v31i4.17

21. Yoon JJ, Misra SL, McGhee CNJ, et al. Demographics and ocular biometric characteristics of patients undergoing cataract surgery in Auckland, New Zealand. Clinical and Experimental Ophthalmology. 2016; 44:106–113.

22. Shoaib KK, Shakoor T. Biometric Findings in Patients Undergoing Cataract Surgery; Gender Comparison. Pak J Ophthalmol. 2018;34(4):24

23. Baral P, Baral N, Maharjan IM, Gautam BR, Bhandari M. Biometric parameters and intraocular lens power used for cataract eyes in Karnali, Nepal. Nepal J Ophthalmology. 2014;6(2):192–196.

24. Feleke B, Mulugeta W, WondaleT, Tsegaw A. Ocular Biometry Profile of Adult Cataract Surgery Candidates at University of Gondar, Tertiary Eye Care and Training Center, Northwest Ethiopia. BMJ 2022; doi:10.1101/2022.07.20.22277853

25. Chakrabarti A, Nazm N. Posterior capsular rent: Prevention and management. Indian J Ophthalmol. 2017; 65(12): 1359–1369.doi: 10.4103/ijo.IJO-1057-17

26. Kothari M, Thomas R, Parikh R, Braganza A, Kuriakose T, Muliyi J. The incidence of vitreous loss and visual outcome in patients undergoing cataract surgery in a teaching hospital. Indian J Ophthalmol 2003 Mar;51(1):45-52.

27. Zaidi FH, Corbett MC, Burton BJL, Bloom PA. Raising the benchmark for the 21st century—the 1000 cataract operations audit and survey: outcomes, Consultant‐supervised training, and sourcing NHS choice. Br J Ophthalmol 2007 Jun; 91(6): 731–736, doi: 10.1136/bjo.2006.104216.