Factors associated with the outcome of cataract surgery at university teaching hospitals - eye hospital in Lusaka, Zambia.

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Umerji, Fatima
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The University of Zambia
Cataract is a major cause of blindness universally. The 2012 report from the World Health Organization stated that cataract was accountable for 50% of avoidable blindness in sub-Saharan Africa. The objective of this study was to determine the factors associated with the outcome of cataract surgery at UTHs-Eye Hospital in Lusaka Zambia. A hospital based quantitative cross-sectional study was done on 197 patients who under-went cataract surgery at the UTHs Eye Hospital from May 2019 to November 2019. Data was collected using a well-organized data extraction sheet that consisted of variables concerning demographic data, preoperative information, surgical techniques, intra-operative complications and postoperative findings. The postoperative evaluations were done at day one, week two and week six. Post-operative visual acuity at six weeks was transformed into a dichotomous variable with borderline and poor outcomes as one and good outcomes as other. Data was analyzed using univariate and multivariate logistic regression analysis. The mean age was 65 (SD 15.15) years old and 118 patients (59.9%) were males. Ninety-six patients (48.7%) had systemic co-morbidities and 50 (25.5%) patients had an ocular pathology. Intra-operative complications were seen in 45 (22.8%) patients. Immediate post-operative complications were seen in 56 (28.4%) patients while late post-operative complications were present in 16 (12.8%). A good outcome was seen in 75.2% of patients based on best-corrected visual acuity (BCVA), 15.2% had an intermediate outcome and 9.6 % had a poor outcome at six weeks follow up. Using multivariable analysis, poor visual outcomes were significantly higher in patients with ocular pathology (OR 3.3; 95% CI 1.64, 6.60), intraoperative complications (OR 3.7; 95% CI 1.87, 7.42), those with immediate post-operative complications (odds ratio 2; 95% CI 1.04, 3.66), and late post-operative complications (OR 5.8; 95% CI 2.19, 13.84). This study showed that monitoring visual outcomes and working on reducing intra-operative and post-operative complications can significantly improve the outcome of cataract surgery.
Thesis of Master of Medicine-Ophthalmology.