Assessment of surgical outcomes and factors affecting vision after cataract surgery: A cross-sectional prospective study at Al-Zubair general hospital, Basrah, Iraq

Abstract

Background: Cataract is the most common elective and ambulatory procedure globally, and its incidence continues to rise, leading to an increasing number of cataract surgeries aimed at eliminating the burden of cataract blindness in the aging population. Cataract surgery is safe, predictable, and cost-effective. Aim: This study aimed to evaluate the surgical visual outcomes and factors influencing vision in patients who underwent cataract surgery in the Al-Zubair district, Basrah, Iraq. Methods: A cross-sectional prospective study was conducted on cataract surgeries of all ages performed at Al-Zubair General Hospital between October 2014 and November 2022. Data based on demographic characteristics, preoperative risk factors, visual acuity, postoperative visual acuity, and surgical complications were collected, along with a review of the factors influencing vision after cataract surgery. The postoperative visual status was assessed and compared with the World Health Organization’s (WHO) categories of Visual Impairment and Blindness. Standard parameters for assessing the outcomes of cataract surgery and WHO criteria for grading these outcomes were utilized. Evaluations of the outcomes over the years of the study were carried out. Results: A total of 2,710 eyes from 2,358 patients who underwent cataract surgery during the study period were studies. About 1,293 were included, with 1,293 females and 1,065 males. The mean age at the time of surgery was 62.74 ± 13.8 years. The primary surgical technique was phacoemulsification (1,786 eyes, 68.3%), followed by extra capsular cataract extraction (ECCE) (884 eyes, 31.6%), both with intraocular lens implantation. Significant improvement was observed throughout the study period, with 80.8% of eyes achieving good postoperative vision (Best Corrected Visual Acuity [BCVA] 6/6-6/18). Approximately 15.84% of the operative eyes had borderline outcomes (BCVA 6/24-6/60), while poor outcomes were observed in 34% of the eyes. Poor visual outcomes were significantly higher in patients with diabetic retinopathy and corneal Diseases glaucoma. Intraoperative and postoperative complications occurred in 9.88% of cases, with rupture of the posterior capsule, vitreous loss, and corneal edema being the major causes. Conclusions: Visual outcomes after cataract surgery (whether phacoemulsification or ECCE) are generally good, even in patients with risk factors. Patients with visually significant cataracts should be encouraged to undergo cataract surgery despite the potential for intraoperative and postoperative complications.