Population-Based Assessment of Visual Outcomes After Cataract Surgery in Four Districts in Telangana, India

To report the visual outcomes, causes and risk factors for poor visual outcomes after cataract surgery among four districts in Telangana, India.

Individuals aged ≥40 years were recruited from Adilabad, Mahbubnagar, Khammam, and Warangal districts. A detailed history of cataract surgery was recorded, followed by eye examinations. Based on the presenting visual acuity, visual outcomes were defined as borderline (<6/18 to 6/60) and poor (<6/60). Multivariable analysis was conducted to identify risk factors for borderline and poor outcomes.

A total of 11,238 participants were examined with a mean age of 54.1 ± 11.2 years. Of these, 54.6% were women, and 72.5% had no formal education. Of the 1850 eyes of 1332 participants operated, 321 (17.4%) and 207 (11.2%) had borderline and poor outcomes, respectively. Of 518 participants who had bilateral cataract surgery, 75 (14.5%) and 19 (11.2%) had borderline and poor outcomes, respectively. Age of 70 years and older (p = 0.01), lack of formal education (p < 0.01), surgery in government hospitals (p < 0.01) and eye camps (p = 0.02, and residence in the Khammam (p = 0.01) and Warangal districts (p < 0.01) were associated with borderline outcomes. No formal education (p = 0.02), free surgeries (p = 0.03), and residence in Mahbubnagar (p < 0.01), Khammam (p = 0.01), and Warangal districts (p = 0.01) were associated with poor outcomes. Posterior segment disease, uncorrected refractive errors, and surgical complications were common causes of borderline and poor outcomes after cataract surgery.

Visual outcomes can be further enhanced through appropriate case selection, after ruling out posterior segment pathology, regular eye examinations, and the provision of spectacles after surgery.