Visual outcome after high volume cataract surgery in Pakistan

Aim: To determine the visual outcome and factors influencing visual outcome after cataract surgery in an urban charity hospital in Pakistan. Methods: A series of selected outpatients were examined who had undergone cataract surgery in the preceding 24 months. Results: 181 patients aged 45 - 82 years were examined. The type of cataract operations they had had were extracapsular cataract extraction ( ECCE) only in 50% ( 91), phacoemulsification (phaco) only in 11% ( 20), ECCE with intraocular lens (IOL) in 17% ( 31), and phaco with IOL in 22% ( 39). At presentation, 49.7% ( 90) had poor functional vision; after refraction 68% ( 123) had a good visual outcome. Functional vision in eyes undergoing ECCE with IOL was good in 77% ( 22) and with phaco with IOL in 71.8% ( 28). After refraction a higher proportion of eyes with IOL surgery 93%) had a good outcome than those with non-IOL surgery (53%). Uncorrected refractive error, present in 75.5% ( 68), was the commonest cause of poor functional vision. Conclusion: This study demonstrates that it is possible to obtain good results with IOL surgery in the developing world. Increasing cataract surgery with IOL implantation should reduce the number of eyes with poor functional vision after cataract surgery. More attention should be directed towards ensuring that successful outcomes are indeed being realised by continued visual monitoring postoperatively.