Cataract Surgery Visual Outcome and Associated Factors Among Adults Attended Jimma University Medical Center, Jimma, Southwest Ethiopia

Abstract

Background

Cataract is the leading cause of blindness and the second leading cause of visual impairment worldwide, accounting for 51% and 33% of all cases, respectively, in low- and medium-income countries bearing a disproportionately high burden. Hence, this study aimed to assess the visual outcome of age-related cataract surgery and identify factors associated with patients’ postoperative visual outcomes in Jimma University Medical Center, Southwest Ethiopia.

Methods

An institution-based cross-sectional study design was conducted among 386 cataract surgery patients from January 1, 2016, to December 30, 2017. The study participants were selected using a systematic random sampling technique. Data were collected by reviewing the selected patients’ medical records using a pre-tested checklist, entered into EpiData version 3.1, and exported to SPSS 20 for analysis. Proportions, summary statistics, and tables were used for presentations of the findings. Binary logistic regression was carried out to identify independent predictors of visual outcome. Findings were presented with adjusted odds ratios and their 95% confidence interval. A p-value <0.05 was used to declare a statistically significant association.

Results

About 231 individuals (59.8%) had poor visual results following cataract surgery. Furthermore, age >70 (AOR = 3.64; 95% CI [1.35–9.82]), preoperative ocular co-morbidities (AOR = 2.34; [1.32–4.15]), incision-based cataract surgery (AOR = 7.11; [3.16–16.02]), compared phacoemulsification operated by resident surgeons (AOR = 2.19; [1.23–3.89]), presence of intraoperative complication (AOR = 3.41; [1.47–7.92]), lens remnant (AOR = 2.91; [1.11–4.92]), ocular inflammation (OR = 2.56; [1.34–4.92]), and striate keratopathy/corneal edema (AOR = 1.91; [1.07–3.44]) were significantly associated with poor visual outcome.

Conclusion

The visual outcome following cataract surgery fall below WHO recommendation. In this study, age, ocular co-morbidities, surgical method, surgeon status, intraoperative complication, SK, and ocular inflammation associated with post-operative Uveitis and anterior chamber reaction were associated with a poor visual outcome.

Keywords:

• cataract surgery
• visual outcome
• Jimma University Medical Center

Abbreviations

AC IOL, anterior chamber intraocular lens; AOR, adjusted odd ratio; AMD, age-related macular degeneration; COR, crude odd ratio; CI, confidence interval; DM, diabetic mellitus; ECCE, extracapsular cataract surgery; IOL, intraocular lens; IOP, Intraocular pressure; ICCE, intracapsular cataract surgery; JUDO, Jimma University department of ophthalmology; PC IOL, posterior chamber intraocular lens; PHACO, phacoemulsification; PC, posterior capsule; SSA, sub-Saharan Africa; SK, striate keratitis; SICs, small incision cataract surgery; UHC, universal health coverage; VA, visual acuity; WHO, World Health Organization.

Data Sharing Statement

Data will be available upon request from the corresponding author.

Ethics Approval

Ethical approval for the research was obtained from Jimma University, Institute of Health Research Ethics Committee with IRB00097\17 reference number. The consent of the patient to review their medical records was not required by this Ethics Committee and it was conducted according to the waiver of the Declaration of Helsinki for studies on human subjects.

Acknowledgment

We would like to thank Jimma University for its support for the realization of this funding. We are also grateful for Jimma University Medical Center, which provides medical and training services and is the only referral hospital in southwest Ethiopia.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising, or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no conflicts of interest for this work.

Additional information

Funding

This study was funded by the Institute of Health of Jimma University as a partial fulfillment of the MPH degree of the first author.