title: Outcomes of cataract surgery: a population-based developing world study in the Bhaktapur district, Nepal.
abstract: BACKGROUND
  To evaluate the visual outcome after cataract surgery in a population of Nepal.
  
  
  METHODS
  Population-based cross-sectional study.
  
  
  METHODS
  Forty years and above residing in Bhaktapur district.
  
  
  METHODS
  Subjects were selected from 30 clusters using cluster sampling procedure. All underwent a detailed examination at the base hospital, including logarithm of minimal angle of resolution visual acuity, refraction, applanation tonometry, cataract grading, retinal examination and perimetry when indicated.
  
  
  METHODS
  Visual acuity after cataract surgery.
  
  
  RESULTS
  Out of 4003 subjects examined, 151 had undergone cataract surgery. Pseudophakia was present in 142 (94.0%), aphakia in nine (6%). Presenting and best-corrected visual acuity ≥6/18 was achieved in 123 (54.4%) and 164 (72.4%) eyes, respectively. Among the pseudophakic eyes, at presentation 122 (57.5%), 72 (33.9%), 18 (8.5%) and after best correction 162 (76.2%), 33 (15.8%), 17 (8.0%) had visual acuity of ≥6/18, <6/18-≥6/60 and <6/60, respectively. Retinal disease (35.5%), surgical complications (27.4%) and posterior capsular opacification (14.5%) were the principle causes of visual impairment after best correction in all eyes. There was no significant association in visual outcome based on age, sex, literacy and the duration of surgery.
  
  
  CONCLUSIONS
  Correction of refractive errors, preoperative screening of coincidental diseases, reduction in surgical complication rates and monitoring of postoperative follow-up care has to be addressed seriously in order to improve the outcome of cataract surgery to meet standards proposed by the World Health Organization. In the future, longitudinal studies need to be undertaken to provide specific information on the outcomes of cataract surgery in this community.
authors.affiliation: Nepal Glaucoma Eye Clinic, Tilganga Institute of Ophthalmology, Tribhuvan University, Kathmandu, Nepal. ssthapa@tilganga.com.np
authors.forename: Suman S
authors.initials: SS
authors.lastname: Thapa
authors.forename: Shankar
authors.initials: S
authors.lastname: Khanal
authors.forename: Indira
authors.initials: I
authors.lastname: Paudyal
authors.forename: Shankha N
authors.initials: SN
authors.lastname: Twyana
authors.forename: Sanduk
authors.initials: S
authors.lastname: Ruit
authors.forename: Ger H M B
authors.initials: GH
authors.lastname: van Rens
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001036:Aphakia, Postcataract / Q000209:etiology; D001766:Blindness / Q000534:rehabilitation*; D002387:Cataract Extraction; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D009390:Nepal; D019591:Pseudophakia / Q000209:etiology; D012030:Refractive Errors / Q000209:etiology; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*