| dc.description.abstract | Aims: To determine if prospective monitoring influences cataract surgical outcomes in east Africa.
Methods: A prospective observational study of all routine extracapsular cataract extractions with posterior
chamber lens implants carried out at Kikuyu Eye Unit, Kenya, between 1 January 1999 and 31
December 1999.
Results: Out of 1845 eligible eyes 1800 were included in the study. Two months’ follow up was available
in 67.2% of patients. The proportion achieving a good outcome increased steadily from 77.1% in
the first quarter to 89.4% in the fourth quarter (c2 for trend, p<0.001). There was no change in the incidence
of operative complications; however, the proportion of patients achieving a good visual
outcome following vitreous loss increased from 47.2% in the first 6 months to 71.0% in the last 6
months (c2 p<0.05). Of the eyes with poor outcome (best corrected acuity <6/60 at 2 months) half
were due to pre-existing eye diseases. The proportion of patients with known ocular comorbidity
decreased from 10.2% in the first quarter to 5.9% in the fourth quarter (c2 for trend, p<0.05). Poor outcome
was associated with age over 80 years, known diabetes, preoperative bilateral blindness, any
ocular comorbidity, and intraoperative vitreous loss.
Conclusions: This study demonstrates improvement in visual outcome results after cataract surgery
over a 1 year period. Monitoring of outcomes appears to be associated with a change in surgeons’
attitudes, leading to greater emphasis on appropriate case selection, better management of surgical
complications, and improved visual outcomes. | en |
