A comparative evaluation of outcome of cataract surgery at Ago- Iwoye, Ogun State

Objective : To compare the outcome of cataract surgery using intracapsular/ extracapsular extraction alone to surgery with lens implantation. Methods : A retrospective review of all patients who had cataract surgery by all methods between February 1998 and October 1999 at St Mary’s Catholic eye hospital Ago-Iwoye, Ogun state, for post operative visual acuity and surgery related complications. Results : Two hundred and forty nine eyes of 211 patients were reviewed. 128 (60.7 %) were males and 83(39.3) were females. The age range was from 9years to 90years. Post op vision of 6/18 or better was present in 71% of the posterior chamber intra ocular lens (PC-IOL) group; 50% of anterior chamber lens (AC-IOL) group, 62% of intracapsular cataract extraction (ICCE) group and 31.2% of the extracapsular cataract extraction group. Preventable causes of poor visual outcome were present in 14.9% 0f the cases reviewed especially the ECCE and ICCE groups and included: posterior capsule opacity, uveitis, cystoid macular oedema and endophthalmitis. Poor outcome was associated with pre-existing ocular disease in 10.8% of the eyes operated and were due to pre-existing glaucoma, macular degeneration, optic atrophy and diabetic retinopathy. Conclusion : Best functional visual results are obtained by modern techniques of ECCE with IOL, which ensures that the patient has adequate post op vision for his needs. Adequate case selection to exclude pre-existing ocular morbidity as well as prevention or proper management of surgery related complications when they occur are also essential for satisfactory results. Older techniques of ICCE or ECCE with out IOL are associated with less satisfactory functional visual acuity and should therefore be discouraged.