Factors Associated With Postoperative Complications In Adult Patients Undergoing Cataract Surgery At KCMC Hospital

Objective  This study aims to assess the incidence, types, and associated risk factors of postoperative complications following cataract surgery at Kilimanjaro Christian Medical Centre (KCMC) from 2023 to 2024 Background: Cataracts remain a leading cause of blindness globally, with disproportionate burdens in low-resource settings. Despite advancements in surgical techniques like phacoemulsification (PHACO), extracapsular cataract extraction (ECCE) remains widely used in sub-Saharan Africa. Limited data exist on postoperative complications and comparative outcomes in Tanzania. Methods: A prospective cohort study was conducted at Kilimanjaro Christian Medical Centre (August 2023–July 2024) involving 308 adults undergoing ECCE or PHACO. Participants were followed for six months postoperatively. Primary outcomes included visual acuity (VA) and complications (e.g., corneal edema, raised intraocular pressure [IOP]). Multivariable logistic regression identified risk factors for poor outcomes. Results: The cohort (median age: 68 years; 51.6% male) underwent ECCE (65.3%) or PHACO (34.7%). PHACO demonstrated superior outcomes: patients undergoing ECCE had 2.5-fold higher odds of poor VA (adjusted OR: 2.4, 95% CI: 1.21–5.01, p=0.013) and 34% higher complication risk (adjusted RR: 0.66, 95% CI: 0.50–0.88, p=0.004). Complications occurred in 58.8%, primarily corneal edema (40.6%) and posterior capsular opacity (38%). Specialist-performed surgeries reduced complications by 62% versus trainees (p<0.001). Conclusion: PHACO outperformed ECCE in visual outcomes and safety, with specialist expertise further reducing risks. Findings support prioritizing PHACO adoption, enhancing surgical training, and standardizing postoperative care in resource-limited settings. Multicenter randomized trials are needed to validate these results