Refractive Outcome of Manual Small Incision Cataract Surgery in Tertiary Teaching Hospital
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Date
2024-05
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Addis Ababa University
Abstract
Background: Cataract remains a leading cause of blindness globally, particularly in developing countries. Manual Small Incision Cataract Surgery (MSICS) has emerged as an effective and cost-efficient technique for cataract removal. However, concerns regarding postoperative refractive outcomes persist.
Objective: This study aims to evaluate the refractive outcome after MSICS at Menelik II Referral Hospital, Addis Ababa, Ethiopia.
Methods: A hospital based longitudinal study was conducted involving 385 MSICS patients followed up at 4-6 weeks post op. Data on sociodemographic characteristics, preoperative biometry, surgical details, and postoperative. visual acuity and biometry profile were collected. Refractive outcomes were measured based on pre operative biometry and post operative biometry after 4 weeks post-surgery.
Results: The median age was 65 years, with 60% female participants. The majority of surgeries utilized straight scleral incisions, and the most common intraoperative complication was posterior capsular tear (7.5%). Postoperatively, 73.8% achieved best-corrected visual acuity (BCVA) better than 6/18, but only 53.2% reached target refraction within ±1.0 D. The surgically induced astigmatism for the operated eyes was found to be 0.75 D ± 1.38 D. A significant inverse relationship was found between surgically induced astigmatism (SIA) and the likelihood of achieving target refraction. (OR = 0.707, 95% CI: 0.564 - 0.885, p = 0.002), and a protective pattern between scleral incision size ≤8mm and achieving target refraction (OR = 11.850, 95% CI: 5.447 – 25.778, p = <0.001).
Conclusion: MSICS demonstrates favorable visual outcomes with a significant proportion of patients achieving optimal refractive results. Understanding the determinants of refractive outcomes in this context can enhance surgical practices and improve patient satisfaction in cataract surgery. Further research is warranted to establish best practices tailored to the Ethiopian healthcare setting.
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Keywords
Manual Small Incision Cataract Surgery (MSICS), Refractive outcomes, Surgically Induced Astigmatism