Outcome of cataract surgery in Nigeria

visual acuity, autorefraction, and optimal intraocular lens powers - results from the Nigeria National Survey

Abdullahi U. Imam, Clare E. Gilbert, Selvaraj Sivasubramaniam, Gudlavalleti V. S. Murthy*, Raj Maini, Mansur M. Rabiu, Nigeria Natl Blindness Visual

*Corresponding author for this work

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Objective: To describe presenting and corrected visual acuities after cataract surgery in a nationally representative sample of adults. Another objective was to describe refractive errors in operated eyes and to determine the optimal range of intraocular lens (IOL) powers for this population.

Design: Cross-sectional, population-based survey.

Participants: Adults aged 40 years and more were selected using multistage stratified sampling and proportional to size procedures. A sample size of 15 027 was calculated, and clusters were selected from all states.

Methods: Individuals who had undergone cataract surgery were identified from interview and examination. All had their presenting visual acuity (VA) measured using a reduced logarithm of the minimum angle of resolution chart and underwent autorefraction. Corrected VAs were assessed using the autorefraction results in a trial set. An ophthalmologist conducted all examinations, including slit-lamp and dilated fundus examination. Causes of visual loss were determined for all eyes with a presenting VA

Main Outcome Measures: Presenting and corrected visual acuities in pseudo/aphakic individuals and autorefraction findings; biometry profile of Nigerian adults.

Results: Data from 288 eyes of 217 participants were analyzed. Only 39.5% of eyes had undergone IOL implantation at surgery. Only 29.9% of eyes had a good outcome (i.e., >= 6/18) at presentation, increasing to 55.9% with correction. Use of an IOL was the only factor associated with a good outcome at presentation (odds ratio 9.0; 95% confidence interval, 4.3-18.9; P = 0.001). Eyes undergoing cataract surgery had a higher prevalence and degree of astigmatism than phakic eyes. Biometry data reveal that posterior chamber IOL powers of 20, 21, and 22 diopters (D) (A constant 118.0) will give a postoperative refraction range of -2.0 D to emmetropia in 71.4% of eyes, which increases to 82.6% if 19 D is also included.

Conclusions: Postoperative astigmatism needs to be reduced through better surgical techniques and training, and use of biometry should be standard of care.

Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article Ophthalmology 2011;118:719-724 (C) 2011 by the American Academy of Ophthalmology.

Original languageEnglish
Pages (from-to)719-724
Number of pages6
JournalOphthalmology
Volume118
Issue number4
DOIs
Publication statusPublished - Apr 2011

Keywords

  • district
  • surgical coverage
  • rapid assessment
  • barriers
  • avoidable blindness
  • South-West Province
  • impairment survey
  • prevalence
  • India
  • Bangladesh

Cite this

Imam, A. U., Gilbert, C. E., Sivasubramaniam, S., Murthy, G. V. S., Maini, R., Rabiu, M. M., & Nigeria Natl Blindness Visual (2011). Outcome of cataract surgery in Nigeria: visual acuity, autorefraction, and optimal intraocular lens powers - results from the Nigeria National Survey. Ophthalmology, 118(4), 719-724. https://doi.org/10.1016/j.ophtha.2010.08.025

Outcome of cataract surgery in Nigeria : visual acuity, autorefraction, and optimal intraocular lens powers - results from the Nigeria National Survey. / Imam, Abdullahi U.; Gilbert, Clare E.; Sivasubramaniam, Selvaraj; Murthy, Gudlavalleti V. S.; Maini, Raj; Rabiu, Mansur M.; Nigeria Natl Blindness Visual.

In: Ophthalmology, Vol. 118, No. 4, 04.2011, p. 719-724.

Research output: Contribution to journalArticle

Imam, AU, Gilbert, CE, Sivasubramaniam, S, Murthy, GVS, Maini, R, Rabiu, MM & Nigeria Natl Blindness Visual 2011, 'Outcome of cataract surgery in Nigeria: visual acuity, autorefraction, and optimal intraocular lens powers - results from the Nigeria National Survey', Ophthalmology, vol. 118, no. 4, pp. 719-724. https://doi.org/10.1016/j.ophtha.2010.08.025
Imam, Abdullahi U. ; Gilbert, Clare E. ; Sivasubramaniam, Selvaraj ; Murthy, Gudlavalleti V. S. ; Maini, Raj ; Rabiu, Mansur M. ; Nigeria Natl Blindness Visual. / Outcome of cataract surgery in Nigeria : visual acuity, autorefraction, and optimal intraocular lens powers - results from the Nigeria National Survey. In: Ophthalmology. 2011 ; Vol. 118, No. 4. pp. 719-724.
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abstract = "Objective: To describe presenting and corrected visual acuities after cataract surgery in a nationally representative sample of adults. Another objective was to describe refractive errors in operated eyes and to determine the optimal range of intraocular lens (IOL) powers for this population.Design: Cross-sectional, population-based survey.Participants: Adults aged 40 years and more were selected using multistage stratified sampling and proportional to size procedures. A sample size of 15 027 was calculated, and clusters were selected from all states.Methods: Individuals who had undergone cataract surgery were identified from interview and examination. All had their presenting visual acuity (VA) measured using a reduced logarithm of the minimum angle of resolution chart and underwent autorefraction. Corrected VAs were assessed using the autorefraction results in a trial set. An ophthalmologist conducted all examinations, including slit-lamp and dilated fundus examination. Causes of visual loss were determined for all eyes with a presenting VA Main Outcome Measures: Presenting and corrected visual acuities in pseudo/aphakic individuals and autorefraction findings; biometry profile of Nigerian adults.Results: Data from 288 eyes of 217 participants were analyzed. Only 39.5{\%} of eyes had undergone IOL implantation at surgery. Only 29.9{\%} of eyes had a good outcome (i.e., >= 6/18) at presentation, increasing to 55.9{\%} with correction. Use of an IOL was the only factor associated with a good outcome at presentation (odds ratio 9.0; 95{\%} confidence interval, 4.3-18.9; P = 0.001). Eyes undergoing cataract surgery had a higher prevalence and degree of astigmatism than phakic eyes. Biometry data reveal that posterior chamber IOL powers of 20, 21, and 22 diopters (D) (A constant 118.0) will give a postoperative refraction range of -2.0 D to emmetropia in 71.4{\%} of eyes, which increases to 82.6{\%} if 19 D is also included.Conclusions: Postoperative astigmatism needs to be reduced through better surgical techniques and training, and use of biometry should be standard of care.Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article Ophthalmology 2011;118:719-724 (C) 2011 by the American Academy of Ophthalmology.",
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author = "Imam, {Abdullahi U.} and Gilbert, {Clare E.} and Selvaraj Sivasubramaniam and Murthy, {Gudlavalleti V. S.} and Raj Maini and Rabiu, {Mansur M.} and {Nigeria Natl Blindness Visual}",
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AU - Gilbert, Clare E.

AU - Sivasubramaniam, Selvaraj

AU - Murthy, Gudlavalleti V. S.

AU - Maini, Raj

AU - Rabiu, Mansur M.

AU - Nigeria Natl Blindness Visual

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N2 - Objective: To describe presenting and corrected visual acuities after cataract surgery in a nationally representative sample of adults. Another objective was to describe refractive errors in operated eyes and to determine the optimal range of intraocular lens (IOL) powers for this population.Design: Cross-sectional, population-based survey.Participants: Adults aged 40 years and more were selected using multistage stratified sampling and proportional to size procedures. A sample size of 15 027 was calculated, and clusters were selected from all states.Methods: Individuals who had undergone cataract surgery were identified from interview and examination. All had their presenting visual acuity (VA) measured using a reduced logarithm of the minimum angle of resolution chart and underwent autorefraction. Corrected VAs were assessed using the autorefraction results in a trial set. An ophthalmologist conducted all examinations, including slit-lamp and dilated fundus examination. Causes of visual loss were determined for all eyes with a presenting VA Main Outcome Measures: Presenting and corrected visual acuities in pseudo/aphakic individuals and autorefraction findings; biometry profile of Nigerian adults.Results: Data from 288 eyes of 217 participants were analyzed. Only 39.5% of eyes had undergone IOL implantation at surgery. Only 29.9% of eyes had a good outcome (i.e., >= 6/18) at presentation, increasing to 55.9% with correction. Use of an IOL was the only factor associated with a good outcome at presentation (odds ratio 9.0; 95% confidence interval, 4.3-18.9; P = 0.001). Eyes undergoing cataract surgery had a higher prevalence and degree of astigmatism than phakic eyes. Biometry data reveal that posterior chamber IOL powers of 20, 21, and 22 diopters (D) (A constant 118.0) will give a postoperative refraction range of -2.0 D to emmetropia in 71.4% of eyes, which increases to 82.6% if 19 D is also included.Conclusions: Postoperative astigmatism needs to be reduced through better surgical techniques and training, and use of biometry should be standard of care.Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article Ophthalmology 2011;118:719-724 (C) 2011 by the American Academy of Ophthalmology.

AB - Objective: To describe presenting and corrected visual acuities after cataract surgery in a nationally representative sample of adults. Another objective was to describe refractive errors in operated eyes and to determine the optimal range of intraocular lens (IOL) powers for this population.Design: Cross-sectional, population-based survey.Participants: Adults aged 40 years and more were selected using multistage stratified sampling and proportional to size procedures. A sample size of 15 027 was calculated, and clusters were selected from all states.Methods: Individuals who had undergone cataract surgery were identified from interview and examination. All had their presenting visual acuity (VA) measured using a reduced logarithm of the minimum angle of resolution chart and underwent autorefraction. Corrected VAs were assessed using the autorefraction results in a trial set. An ophthalmologist conducted all examinations, including slit-lamp and dilated fundus examination. Causes of visual loss were determined for all eyes with a presenting VA Main Outcome Measures: Presenting and corrected visual acuities in pseudo/aphakic individuals and autorefraction findings; biometry profile of Nigerian adults.Results: Data from 288 eyes of 217 participants were analyzed. Only 39.5% of eyes had undergone IOL implantation at surgery. Only 29.9% of eyes had a good outcome (i.e., >= 6/18) at presentation, increasing to 55.9% with correction. Use of an IOL was the only factor associated with a good outcome at presentation (odds ratio 9.0; 95% confidence interval, 4.3-18.9; P = 0.001). Eyes undergoing cataract surgery had a higher prevalence and degree of astigmatism than phakic eyes. Biometry data reveal that posterior chamber IOL powers of 20, 21, and 22 diopters (D) (A constant 118.0) will give a postoperative refraction range of -2.0 D to emmetropia in 71.4% of eyes, which increases to 82.6% if 19 D is also included.Conclusions: Postoperative astigmatism needs to be reduced through better surgical techniques and training, and use of biometry should be standard of care.Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article Ophthalmology 2011;118:719-724 (C) 2011 by the American Academy of Ophthalmology.

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KW - surgical coverage

KW - rapid assessment

KW - barriers

KW - avoidable blindness

KW - South-West Province

KW - impairment survey

KW - prevalence

KW - India

KW - Bangladesh

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JF - Ophthalmology

SN - 0161-6420

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