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Ramezani A, Sabbaghi H, Katibeh M, Ahmadieh H, Kheiri B, Yaseri M, Moradian S, Alizadeh Y, Soltani Moghadam R, Medghalchi A, Etemad K, Behboudi H. Prevalence of cataract and its contributing factors in Iranian elderly population: the Gilan eye study. Int Ophthalmol 2023; 43:4503-4514. [PMID: 37584824 DOI: 10.1007/s10792-023-02851-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 08/03/2023] [Indexed: 08/17/2023]
Abstract
PURPOSE To report the prevalence and the associated factors leading to cataract among the Iranian population living in Gilan Province, Iran. METHODS This population-based cross-sectional study was performed from June to November 2014 on 2,975 residents aged ≥ 50 years old living in urban and rural regions of the Gilan Province in Iran. A representative sample of residents in the province was recruited into the study through door-to-door visiting, and baseline data were collected by questionnaire. All participants were referred to the medical center for comprehensive ophthalmic examination, laboratory tests, and blood pressure measurement. RESULTS Among the population, 2,588 (86.99%) subjects were eligible to be included in this study, categorized either into the cataract or the non-cataract group. The mean age of participants was 62.59 ± 8.92 years, and 57.5% were female. Higher prevalence of cataract was found in individuals of older ages (odds ratio (OR) = 1.13; 95% confidence interval (CI) = 1.10 to 1.16; P < 0.001) and a history of previous ocular surgery (OR = 5.78; 95% CI = 2.28 to 14.63; P < 0.001). At the same time, a lower prevalence of cataract was seen in patients exposed to sunlight for more than 4 h per day (OR = 0.49; 95% CI = 0.32 to 0.73; P = 0.001). CONCLUSION Cataract affects 50.50% of the study population, especially those over 80. The mildest form of cataract, grade zero, is the most common. Surgery for cataract has good outcomes. The risk of cataract is higher for those older or who have had eye surgeries. People not affected by cataract tend to be exposed to more sunlight.
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Affiliation(s)
- Amirreza Ramezani
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- School of Medicine, Shahid Beheshti University of Medical Sciences, Velenjak Street, Tehran, 198353-5511, Iran
| | - Hamideh Sabbaghi
- Ophthalmic Epidemiology Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Optometry, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Marzieh Katibeh
- Center for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Hamid Ahmadieh
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahareh Kheiri
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | - Siamak Moradian
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yousef Alizadeh
- Department of Ophthalmology, Guilan University of Medical Sciences, Namjoo Avenue, Rasht, Gilan, Iran
| | - Reza Soltani Moghadam
- Department of Ophthalmology, Guilan University of Medical Sciences, Namjoo Avenue, Rasht, Gilan, Iran
| | - Abdolreza Medghalchi
- Department of Ophthalmology, Guilan University of Medical Sciences, Namjoo Avenue, Rasht, Gilan, Iran
| | - Koorosh Etemad
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Hassan Behboudi
- Department of Ophthalmology, Guilan University of Medical Sciences, Namjoo Avenue, Rasht, Gilan, Iran.
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Mohammed J, Assegid S, Fekadu L, Kabeta T. Cataract Surgery Visual Outcome and Associated Factors Among Adults Attended Jimma University Medical Center, Jimma, Southwest Ethiopia. Clin Ophthalmol 2023; 17:3341-3351. [PMID: 37941776 PMCID: PMC10629348 DOI: 10.2147/opth.s434453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 10/24/2023] [Indexed: 11/10/2023] Open
Abstract
Background Cataract is the leading cause of blindness and the second leading cause of visual impairment worldwide, accounting for 51% and 33% of all cases, respectively, in low- and medium-income countries bearing a disproportionately high burden. Hence, this study aimed to assess the visual outcome of age-related cataract surgery and identify factors associated with patients' postoperative visual outcomes in Jimma University Medical Center, Southwest Ethiopia. Methods An institution-based cross-sectional study design was conducted among 386 cataract surgery patients from January 1, 2016, to December 30, 2017. The study participants were selected using a systematic random sampling technique. Data were collected by reviewing the selected patients' medical records using a pre-tested checklist, entered into EpiData version 3.1, and exported to SPSS 20 for analysis. Proportions, summary statistics, and tables were used for presentations of the findings. Binary logistic regression was carried out to identify independent predictors of visual outcome. Findings were presented with adjusted odds ratios and their 95% confidence interval. A p-value <0.05 was used to declare a statistically significant association. Results About 231 individuals (59.8%) had poor visual results following cataract surgery. Furthermore, age >70 (AOR = 3.64; 95% CI [1.35-9.82]), preoperative ocular co-morbidities (AOR = 2.34; [1.32-4.15]), incision-based cataract surgery (AOR = 7.11; [3.16-16.02]), compared phacoemulsification operated by resident surgeons (AOR = 2.19; [1.23-3.89]), presence of intraoperative complication (AOR = 3.41; [1.47-7.92]), lens remnant (AOR = 2.91; [1.11-4.92]), ocular inflammation (OR = 2.56; [1.34-4.92]), and striate keratopathy/corneal edema (AOR = 1.91; [1.07-3.44]) were significantly associated with poor visual outcome. Conclusion The visual outcome following cataract surgery fall below WHO recommendation. In this study, age, ocular co-morbidities, surgical method, surgeon status, intraoperative complication, SK, and ocular inflammation associated with post-operative Uveitis and anterior chamber reaction were associated with a poor visual outcome.
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Affiliation(s)
- Jemmal Mohammed
- Department of Ophthalmology, Faculty of Medical Science, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Sahilu Assegid
- Department of Epidemiology, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Lata Fekadu
- Department of Epidemiology, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Teshome Kabeta
- Department of Epidemiology, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
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Shehata M, Aly MOM, Saleh MGA, Abdel-Radi M. Twelve month outcome of manual small-incision cataract surgery in Assiut, Egypt: A retrospective study with a large sample size. Oman J Ophthalmol 2022; 15:326-330. [PMID: 36760935 PMCID: PMC9905918 DOI: 10.4103/ojo.ojo_1_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 06/11/2022] [Accepted: 07/04/2022] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND To assess the visual outcome of manual small-incision cataract surgery (MSICS) as well as safety, cost, and time of the procedure. PATIENTS AND METHODS A retrospective study involving candidates for cataract surgery with baseline-corrected distance visual acuity (CDVA) ≤20/120. Visual acuity (VA) was the primary outcome measure while surgical complications, cost, and time of surgery were the secondary outcome measures. Follow-up visits were scheduled at 1 day, 1 week, 1 month, and at 6 and 12 months following surgery. RESULTS The study enrolled 3007 patients with a mean age of 66.45 ± 17.3 years. Out of 3007 patients, 2774 (92.2%) were legally blind before surgery (CDVA <20/200) which was significantly reduced to 55 patients (1.9%) by 1 month following surgery. Uncorrected distance visual acuity was 20/60 or better in 2098 eyes (69.8%) at 1 month, in 2035 eyes (67.7%) at 6 months, and in 2017 eyes (67.1%) at 12 months. The posterior capsular rupture was the most common intraoperative complication. Corneal edema was the most common immediate postoperative complication while the development of posterior capsular opacification was the leading cause for later impaired VA. The mean cost was approximately equivalent to 20 US dollars. The median duration of surgery was 10 min. CONCLUSION MSICS is a safe, cost-effective, and time-saving technique for improving the vision of cataract patients in areas with high cataract surgery volume and limited facilities.
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Affiliation(s)
- Mohamed Shehata
- Department of Ophthalmology, Assiut University, Assiut, Egypt
| | | | | | - Mahmoud Abdel-Radi
- Department of Ophthalmology, Assiut University, Assiut, Egypt,Address for correspondence: Dr. Mahmoud Abdel-Radi, Department of Ophthalmology, 6th Floor, Assiut University Hospital, Assiut University, Assiut, Egypt. E-mail:
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Mengistu M, Admassu F, Wondale T, Tsegaw A. Refractive Outcome of Cataract Surgery Done at University of Gondar Tertiary Eye Care and Training Center, North West Ethiopia. Patient Relat Outcome Meas 2021; 12:173-179. [PMID: 34140819 PMCID: PMC8203275 DOI: 10.2147/prom.s308816] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 06/01/2021] [Indexed: 11/13/2022] Open
Abstract
PURPOSE According to World Health Organization (WHO), cataract is the leading cause of blindness and visual impairment throughout the world. Post-operative refractive error is one of the commonest reasons for poor visual outcome after cataract surgery especially in developing countries where the standard modern biometry equipments are not available. The objective of this study was to assess the refractive outcome of cataract surgery done at University of Gondar (UoG) Tertiary Eye Care and Training Center, North West Ethiopia. METHODS A descriptive cross-sectional study was done on 66 patients who had undergone manual small incision cataract surgery (MSICS) and fulfilled the inclusion criteria at UoG Tertiary Eye Care and Training Center from July 15 2019 to October 15 2019. RESULTS From 90 post-operatively refracted eyes, 58 (64.4%) eyes achieved a target refraction of ±1.00 Diopter (D). The right and left eyes achieved mean post-operative refraction SE of -0.073±1.45D and -0.93±1.70 D, respectively. But only 54 (60%) eyes were implanted with the calculated IOL power and for the remaining 40% the calculated IOL was not available at the store. And the target (Good) post-operative uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) was achieved in 66.7% and 82.2% eyes, respectively. CONCLUSION The post-operative refractive outcome after cataract surgery at the center is low. For over one-third of operated eyes, the calculated IOL was not implanted due to the absence of the required IOL power at the store and, therefore, a wide range of IOL power should be available at the center.
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Affiliation(s)
- Masresha Mengistu
- Department of Ophthalmology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fisseha Admassu
- Department of Ophthalmology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Teshager Wondale
- Department of Ophthalmology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Asamere Tsegaw
- Department of Ophthalmology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Markos CM, Tamrat LT, Asferaw MA. Outcomes and Associated Factors of Cataract Surgery Among Adults Attending a Tertiary Hospital in Addis Ababa, Ethiopia. PATIENT-RELATED OUTCOME MEASURES 2020; 11:231-239. [PMID: 33328775 PMCID: PMC7734045 DOI: 10.2147/prom.s280049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 12/04/2020] [Indexed: 12/02/2022]
Abstract
Background Visual outcomes and factors associated with cataract surgery vary from country to country and within countries. This study aimed to evaluate associated factors and visual outcomes following cataract surgery among adults attending Saint Paul’s Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia. Patients and Methods We conducted a prospective, longitudinal study of consecutive adult patients scheduled for cataract surgery between May 2018 and April 2019. Preoperative, intraoperative and postoperative data were collected and analyzed using SPSS version 23.0. Descriptive statistics and binary logistic regressions were used to analyze the data. We used World Health Organization (WHO) criteria for cataract surgery outcome assessment as a reference for comparison. Results Three hundred fourteen eyes of 314 participants (mean age 64.16±8.83 SD, 52% females, 44% from rural location) were included in the study. Most, 283 (90.1%) had preoperative visual acuity less than 6/60. At final follow-up visit (6 to 8 weeks), best-corrected visual acuity (BCVA) was good (≥6/18) in 215 (68.5%), borderline (<6/18–6/60) in 63 (20.1%) and poor (<6/60) in 36 (11.5%) eyes. Age-related macular degeneration (AMD) [OR = 4.57, 95% CI [1.12–17.24], p=0.03] and preoperative astigmatism [OR = 3.22, 95% CI [1.25–8.33], p=0.01] were significantly associated with poor postoperative visual outcome. Conclusion While the majority of patients had good postoperative BCVA following cataract surgery, the percentage of patients with poor visual outcomes was higher than the WHO standard. Greater attention to pre-existing co-morbidities such as retinal disease and high astigmatism could improve outcomes by optimizing patient selection and surgical approach.
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Affiliation(s)
- Cherinet M Markos
- Department of Ophthalmology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Lemlem T Tamrat
- Department of Ophthalmology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Mulusew A Asferaw
- Department of Ophthalmology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Kongsap P. Central corneal thickness changes following manual small incision cataract surgery versus phacoemulsification for white cataract. Rom J Ophthalmol 2019; 63:61-67. [PMID: 31198899 PMCID: PMC6531777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Aim: To assess the central corneal thickness (CCT) and endothelial cell loss after manual small-incision cataract surgery and phacoemulsification in patients with white cataract. Material and methods: This is a comparative, prospective, non-randomized study on 42 patients with white cataract, who underwent cataract surgery. The patients were divided into manual small-incision cataract surgery (21 eyes, MSICS group) and phacoemulsification cataract surgery group (21 eyes, phaco group). The endothelial cell density (ECD), central cornea thickness (CCT), and corrected distance visual acuity (CDVA) were evaluated at 1 day, 1 week, 4 weeks, and 3 months postoperatively. The results of 20 cases of nuclear sclerosis grade II-III (LOCS III) who underwent phacoemulsification by the same surgeon were also compared. Propensity scoring was used to adjust for confounding by selection bias. Results: The CCT increased after surgery in both groups. The thickness was greater in the phaco group on first day postoperatively (73 µ increase in MSICS group and 138 µ in phaco group, p=0.008) and it returned to preoperative levels 1 month postoperatively. The endothelial cell loss was lower in the MSICS group at 3 months postoperatively (11.8% in MSICS group and 15.8% in phaco group, p=0.111). The CDVA was not different in both groups at 1 week and 4 weeks postoperatively (p>0.05). Conclusions: Manual small-incision cataract surgery for white cataract provided less central corneal thickness changes compared to conventional phacoemulsification. Abbreviations: CCT = central corneal thickness; ECD = endothelial cell density; CDVA = corrected distance visual acuity; APT = absolute phacoemulsification time; EPT = effective phacoemulsification time; MSICS = Manual small-incision cataract surgery in white cataract; Phaco II = Phacoemulsification in white cataract; Phaco I = phacoemulsification in NS 2 + Cataract; Phaco = Phacoemulsification in white cataract; APACRS = Asia-Pacific Association of Cataract and Refractive Surgeons.
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Affiliation(s)
- Pipat Kongsap
- Department of Ophthalmology, Prapokklao Hospital, Thailand
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