Factors Associated to Cataract Surgery Failure at Kankan Regional Hospital

Abstract

Introduction: Cataract surgery has undergone many changes with the size of incision progressively decreasing over time with an incision of 12.0 mm for intracapsular cataract extraction to 2.2 - 2.8 mm in phacoemulsification. However, phacoemulsification due to high cost and equipment maintenance cannot be employed widely in developing countries. The phacoalternative or Manual small-incision cataract surgery (MSICS) offers similar advantages with the merits of wider applicability, less time consuming, a shorter learning curve, and lower cost. Haven’t not being without complications like any other surgery We have identified the factors influencing the outcome of phacoalternative cataract surgery in order to improve our quality of care for our patients suffering from blindness induced by the world’s first leading cause of legal blindness. We have identified the factors influencing the outcome of cataract surgery. Patients and Methods: This was a prospective observational study of the descriptive type lasting six (6) months from March 1 to August 30, 2020 including all patients operated on for cataracts and having lower visual acuity at 3/10. The operating form included demographic data, the patient’s personal ophthalmological history, postoperative visual acuity, per and postoperative complications and the type of pathology involved. The analysis was carried out using epi-info 7.2.0.1 software. Results: During this study period, we collected 61 cases of failure of cataract surgery out of a total of 1182 operated eyes, i.e. a frequency of 5.16%. Women represented more than half of the sample with 74%. Almost all of our patients, i.e. 96.72%, were over the age of 60. Loss of visual acuity was the main complaint in all our patients, i.e. 100% followed by photophobia with 24.4% of cases. Arterial hypertension present in 8.20% of patients was the most common comorbidity in our series followed by diabetes with 4.92%. 18 patients (29.5%) presented early postoperative complications such as corneal edema in 15 patients (24.6%) and hyphema in 3 patients (4.9%). Late postoperative complications were dominated by capsular fibrosis encountered in 42.89% of our patients. The causes of failure after cataract surgery were dominated by selection errors which accounted for 36.06% followed by late postoperative complications 34.43%. Conclusion: Like any surgery, cataract surgery can often be marred by various complications often occurring during the intraoperative or postoperative period. These complications in addition to negligence and/or non-deep analysis of certain cases (selection) are often associated with poor functional recovery.