Outcomes of cataract surgery in Bosnia and Herzegovina, associated risk factors and the importance of preoperative ocular ultrasonography

Jasmin Zvornicanin, Igor Hudic

Abstract


Objectives: To evaluate cataract surgery outcomes, the causes of poor postoperative visual acuity, and the importance of preoperative ultrasonography in cataract surgery patients.

Design: prospective observational consecutive case study.

Patients and Methods:  This prospective cross-sectional study included all patients planned for cataract surgery from January to December 2017. Detailed analysis of preoperative status, surgical and follow-up details was performed.  The outcomes were classified as good (?6/18), borderline, and poor (?6/60). The causes for poor visual outcome were classified as selection, surgery, spectacles, or sequelae. Special attention was given to preoperative ocular ultrasonography.

Results: This study included 1298 cataract surgery patients. Mean age was 67.5±7.7 years and 667 (51.4%) surgeries were performed on female patients. Ocular and systemic comorbidities were found in 331 (25.7%; 95%CI:23.3-28.2) and 930 (71.6%; 95%CI:69.1-74.1) patients. Intraoperative complications were noted in 38 (2.9%; 95%CI:2.1-4.0) patients. Good, borderline, and poor postoperative best corrected visual acuity (BCVA) at the 4 weeks follow-up was found in 925 (93.3%; 95%CI:91.6-94.8), 40 (4.0%; 95%CI:2.9-5.5) and 26 (2.6%; 95%CI:1.7-3.8) patients respectively. Selection was the main cause for BCVA less than 6/18 (83.3%; 95%CI:72.1-91.4), while surgical complications were responsible for 7 (0.7%; 95%CI:0.3-1.4) cases with poor postoperative BCVA. Presence of ocular comorbidities, significant ultrasonography findings as well as the presence of posterior vitreous detachment were associated with poor postoperative BCVA.

Conclusions: This study shows that good postoperative BCVA can be achieved in Bosnia and Herzegovina. A detailed preoperative ultrasonography in eyes with poor visualization may indicate a possible poor postoperative outcome.


Keywords


visual acuity; complications; preoperative assessment; B scan

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DOI: 10.5457/ams.v55i1.889