Visual Outcome of Manual Small Incision Cataract Surgery in Patients with Diabetes Mellitus at the University of Gondar Tertiary Eye Care and Training Center
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Background
Manual Small Incision Cataract Surgery /MSICS/ is a widely used, cost-effective surgical technique for cataract removal and diabetic patients with cataract are high-risk groups who often experience poorer visual outcomes after cataract surgery due to various risk factors, including retinopathy progression. Hence, knowing the visual outcome and identifying factors affecting it, is critical for improving surgical success rates and patients’ quality of life.
Objective
To determine Visual Outcome of MSICS and Associated factors in patients with Diabetes and cataract at the University of Gondar Specialized Hospital Tertiary Eye Care and Training Center /UoGSH-TETC/, Gondar, North West Ethiopia.
Methods
A prospective study was conducted at the UoGSH-TETC, from January 2024 to December 2024. Data were collected on each follow-up visit, coded and analyzed using SPSS version 25. Descriptive statistics was used to summarize the data. Qualitative and quantitative data analysis was performed using Student’s Paired t- Test and Chi-square test respectively and p-values < 0.05 was considered as statistically significant. Outcome was measured by improvement in visual acuity (VA) from baseline preoperative acuity using electronic Snellen’s VA chart displayed on a computer screen, and WHO criteria for cataract surgery outcome was used as a reference for comparison.
Results
A total of 72 eyes of 69 patients completed post-operative follow up of 6 weeks and studied. The mean age at the presentation was 59.56 +/−12.12 years. Mean Best Corrected Visual Acuity /BCVA/ of 0.38+/−0.21 logMAR achieved at 6 th post-operative week from pre-operative mean VA of 1.53+/−0.47, p< 0.001. At 6 th post-operative week, 75% and 84.7% eyes had uncorrected visual acuity and BCVA of 6/18 or better, respectively and 62.5% had ≥6/12. At the final follow-up examination 11/15.3%/ eyes had various degrees of progression in their diabetic retinopathy from the baseline level.
Conclusion and Recommendation
This study showed that MSICS in diabetes patients with cataract resulted in an overall improvement in visual acuity and about 85% of operated patients archived good visual outcome after refraction. Although this finding is slightly below the WHO recommendations, it is still better than previous similar cataract surgical outcomes studies done at the same place and other sites in the country.
