Clinical Study
Eye (2008) 22, 1054–1056; doi:10.1038/sj.eye.6702836; published online 13 April 2007
Causes of poor outcome after cataract surgery in Satkhira district, Bangladesh
R Lindfield1, S Polack2, Z Wadud3, K A Choudhury4, A K M M Rashid5 and H Kuper2
- 1Maidstone & Tunbridge Wells National Health Service Trust, Maidstone Hospital, Maidstone, UK
- 2International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK
- 3Child Sight Foundation, Dhaka, Bangladesh
- 4National Institute of Ophthalmology, Dhaka, Bangladesh
- 5CSS Rawm Hospital, Khulna, Bangladesh
Correspondence: H Kuper, International Centre for Eye Health, London School of Hygiene & Tropical Medicine, Keppel street, London WC1E 7HT, UK. Tel: +44 20 7958 8170; Fax: +44 20 7958 8317. E-mail: hannah.kuper@lshtm.ac.uk
Received 13 July 2006; Accepted 20 March 2007; Published online 13 April 2007.
Abstract
Aims
Recent data have raised concerns about visual outcome following cataract surgery. The aim of this study was to assess the frequency and causes of poor and borderline outcome after cataract surgery in a population-based case series in Satkhira district, Bangladesh.
Methods
A population-based case series was conducted within a population-based cluster survey of people aged over 50 years in Satkhira district where 4868 people underwent visual acuity (VA) screening. Eyes operated for cataract with VA<6/18 were examined in detail by an ophthalmologist, including a full history and dilated fundoscopy, to determine the cause of the visual outcome.
Results
Cataract surgery was performed on 213 eyes. Outcome was good (VA>6/18) for 128 eyes (60.1%), borderline (VA<6/18 to 6/60) for 35 eyes (16.4%), and poor (VA<6/60) for 50 eyes (23.5%) with available correction. Borderline and poor outcomes were most commonly due to lack of spectacles (25.8%), poor selection (33.8%), or surgical complications (30.6%). Surgical sequelae, namely posterior capsule opacification, was a less common cause of poor or borderline outcome (9.7%).
Conclusions
Quality of surgical outcomes is of concern in Satkhira district. Increased emphasis on selection of subjects for surgery, provision of spectacles, and monitoring of surgery may improve outcomes.
Keywords:
cataract, Bangladesh, surgical outcome, case series
