Monitoring cataract surgical outcome in a public hospital in Orlu, south east Nigeria

Objective: To determine the proportion and causes of poor visual outcome of cataract operations done in a public hospital in southeast Nigeria and propose actions to improve the cataract surgical outcome. Method: A prospective observational analysis of the initial hundred cases of cataract operations done in Imo State University Teaching Hospital, Orlu between October, 2007 and June, 2009. The Manual Cataract Surgical Record System developed by the International Center for Eye Health, London was used. Consecutive patients undergoing cataract operation were examined on admission, at discharge, 4-8 weeks follow up and information entered in cataract surgical record forms was collated in manual tally sheets and analyzed. The WHO target guidelines on the visual outcome of cataract surgery were used.                                Result: Total of 108 eyes operated (100 available for 4-8 weeks follow up). All were extracapsular cataract extractions with intraocular lens implants. The proportions of cases with poor outcome were 19.5% at discharge and 9.0% at 4-8 weeks follow up. The causes of poor outcome at discharge were uncorrected refractive error 8.3%, surgical complications 7.4% and coexisting disease 3.7%. The causes of poor outcome at 4-8 weeks follow up were surgical complications 5%, coexisting disease 2% and post-operation sequelae 2%.                                                     Conclusion: There is need to improve the quality of cataract operations in the hospital. Recommended actions include provision of irrigation/aspiration cannulas, improved preoperative examination of cases, provision of biometry facilities and retraining of surgeons. Niger Med J. Vol. 50, No. 4, Oct.–Dec., 2009: 77–79. Key words: monitoring, cataract, visual outcome, surgical complications