Cataract surgical coverage and outcome in Goro District, Central Ethiopia.

OBJECTIVE

To assess cataract surgical coverage and outcome in Goro District, Central Ethiopia.

METHOD: Systematic random cluster sampling was used to select 30 villages. All persons 50 years of age and older were included from the selected villages. Interviewer administered questionnaire was used to collect data on demography and history of previous eye surgery. Visual acuity (VA) was taken using Snelen 's E chart. All patients with presenting VA of less than 6/18 in one or both eyes were rechecked with pinhole test. Patients. with monocular and bilateral blindness ( VA < 3/60) with pinhole test as well as those with history of previous eye operations were examined by the investigators. Cataract blindness was defined as VA of less than 3/60 in an eye with visible lens opacity.

RESULT: Of the total 1500 persons registered, 1497 (99.8%) were available for examination. The overall prevalence of blindness was 71/1497 (4.7%) while cataract blindness was found to be 3.2% (95% CI: 2.5-3.9). A total of 97 eyes of 59 patients underwent cataract surgery, 73 (75%) with intraocular lens (IOL) implantation and 24 (25%) without IOL. Cataract surgical coverage was 47.8% for persons and 48.7% for eyes. Presenting and corrected visual acuities of 6/18 or better were obtained in 23 (23.7%) and 46 (47.4%) of the operated eyes respectively. Visual outcome of patients with aphakia was significantly lower than those with pseudophakia. The major cause of poor visual outcome was surgery related complications in 61.1% of the case.

CONCLUSION

Cataract surgical coverage found in this survey is reasonably comparable to reports from other developing countries. However, the visual outcome after cataract surgery was significantly lower compared to the WHO recommendations. As the major cause of poor visual acuity was surgery related and also associated with aphakia, improving the quality and type of surgery with IOL implantation is recommend.