Factors Affecting Cataract Surgical Outcome In The Eastern Region Of Ghana

ABSTRACT Background The 2012 report from the World Health Organization stated that 285 million people have visual impairment and 39 million are blind. Cataract is the main cause of blindness globally, in SubSaharan Africa and in Ghana responsible for 51%, 50%, and 54.8% respectively. Objective The objective of this study was to assess the factors affecting cataract surgical outcome in the Eastern region of Ghana. Methods A cross-sectional study was employed; data was collected quantitatively and qualitatively. For quantitative data collection, hospital records of persons who had cataract surgery in eastern region from 1st January 2017 to 31st December 2017 were reviewed. Hospitals in Eastern Region with ophthalmologists were selected. A systematic random sampling method was used in selecting patient records. In total 384 records were reviewed and data abstracted using a pretested data abstraction form. For key informant interviews, 5 ophthalmologists in the region and one eye nurse from selected hospitals were interviewed for insight on factors affecting cataract surgical outcomes in the region. Cataract surgical outcome was measured using postoperative visual acuity six weeks after surgery. Data were analyzed using Stata I/C statistical package 15 and thematic framework. Regression models were used for detailed analysis to obtain crude and adjusted odds ratio; each present with a 95% confidence interval (CI). v Results Results from this study shows that 71.6% of participants had good surgical outcome, 26.8% had borderline outcome and only 1.6% had poor outcome. Factors identified to affect cataract surgical outcomes include post-surgical complications OR 1.72, CI 1.48-2.01. Results obtained from in-depth interviews showed that co-morbidities, inadequate optical correction, intra-surgical complications and use of traditional eye medicine were the major factors affecting cataract surgical outcome. Conclusions Factors affecting cataract surgical outcome are post-surgical complications, co-morbidities, inadequate optical correction, intra-surgical complications and application of traditional eye medicine. The main cause of poor outcome from cataract surgery was post-surgical complications. Although the study showed that nearly three-quarters of patients with cataract who received surgical intervention had good post-operative visual acuity, the 1.6% with severe visual impairment has serious public health implications. It is imperative thus to put plans in place to reduce poor visual outcomes from complications arising after surgery.