Visual acuity at 6 weeks after small incision cataract surgery and role of audit in predicting visual acuity.
OBJECTIVE
We present the best-corrected visual acuity (BCVA) at 6 weeks after small incision cataract surgery (SICS) and review the role of audit in predicting visual acuity (VA).


METHODS
This was a retrospective data analysis of 14,393 SICS performed during 2007-2008 at a hospital in central India. Ophthalmologists noted preoperative, operative, and postoperative details. The BCVA before and 1 day and 6 weeks after surgery were noted. We identified factors associated with BCVA at 1-day and 6-week follow-up.


RESULTS
Six weeks after surgery, 12,522 (87%) and 1473 (10.2%) patients had BCVA > or =6/18 and 6/24-6/60, respectively. Vision improved between 2 follow-ups in 6695 eyes (46.5% (95% confidence interval (CI) 45.7-47.3)), remained the same in 7117 eyes (49.4%), and deteriorated in 544 (3.8%) eyes. BCVA at 6 weeks was negatively associated with blindness (VA <3/60 in the better eye) before surgery (odds ratio (OR) = 0.73, 95% CI 0.58-0.92), surgeon's experience (OR = 0.75, 95% CI 0.71-0.81), and male patients (OR = 0.73, 95% CI 0.67-0.80). BCVA at 6 weeks was positively associated with older age (OR = 1.02, 95% CI 1.01-1.03) and intraoperative complications (OR = 1.44, 95% CI 1.14-1.83). The association of VA <6/60 1 day after surgery with improved vision between the 2 follow-ups was not statistically significant (OR = 0.005, p = 0.98).


CONCLUSIONS
BCVA at 6 weeks after SICS was > or =6/18 in 87% of operated eyes. By performing surgical audit, one can identify high-risk groups that need proactive subsequent follow-ups.
Khandekar
Rajiv B
RB
British Columbia Center for Epidemiologic and International Ophthalmology, University of British Columbia, Canada. rajshpp@omantel.net.com
Jain
Bundhendra K
BK
Sudhan
Anand K
AK
Pandey
Kamta P
KP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001766:Blindness / Q000209:etiology / Q000517:prevention & control*; D002386:Cataract / Q000150:complications / Q000503:physiopathology*; D002387:Cataract Extraction / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000379:methods; D008297:Male; D008485:Medical Audit / Q000379:methods*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D011182:Postoperative Care / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors; D014792:Visual Acuity