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Intermediate-Term Cataract Surgery Outcomes from Rural Provinces in Lao People's Democratic Republic
Melissa Kate Shields1, Robert J Casson, James Muecke
1South Australian Institute of Ophthalmology, University of Adelaide, and Sight for All , Australia and.
Purpose:
Limited data are available about cataract surgery outcomes from developing regions in South-East Asia, but are necessary to monitor the impact of ongoing program delivery as outlined in the World Health Organization Vision 2020 directives.
Methods:
We conducted a retrospective cohort study of 488 eyes of 449 patients who had undergone cataract surgery in 2011 in Luang Prabang and Xayaboury provinces of northwestern Lao People's Democratic Republic (Lao PDR). The study included 400 eyes of 361 subjects (80.4% of the target population). The main outcomes were presenting and pinhole visual acuity (VA).
Results:
Subjects' mean age was 68 years (standard deviation 12.1 years); 52.6% were women. Preoperative presenting VA in the operated eye was <6/60 in all patients where presenting VA data was available (76.4%). Presenting VA in the operated eye was >6/18 in 185/400 eyes (46.3%, 95% confidence interval, CI, 41.4-51.2%), <6/18-6/60 in 177/400 (44.3%, 95% CI 39.4-49.2%) and <6/60 in 38/400 (9.5%, 95% CI 6.6-12.4%). VA improved two or more lines in 61/400 eyes (15.3%, 95% CI 11.7-18.8%) with pinhole. Relative afferent pupillary defect was present in 13/400 eyes (3.3%, 95% CI 1.5-5.0%).
Conclusion:
Presenting postoperative VA did not meet the World Health Organization criteria for good outcomes. Further study is required to determine specific factors contributing to adverse outcomes in this population.