Unilateral versus simultaneous bilateral cataract surgery in a Nigerian eye hospital
Abstract
Objective: To compare the outcome of unilateral versus bilateral simultaneous cataract surgery at the Guinness Eve Center Onitsha, Nigeria.
Materials and Methods: The visual outcome and complications rates in patients who had bilateral simultaneous cataract sungery (BSCS) intraocular lens implant between 01 January, 2014 and 31 December, 2016 and had been followed up for 6 months were compared with those who had unilateral cataract stugery (UCS) within the same period. Information on socio-demographic characteristics, domicile, pre-operative visual acuity, visual acuity on last iöllow up, intra-operative complications, postoperative complications and causes ofpoor vision were analyzed.
Results: Thirty nine patients with bilateral simultaneous surgery and 142 with uniocular surgery were studied. The age range was 6 - 93 years, median — 66years. There were 104 males (57.5%). Preoperatively 62 (79.5%) and 1 34 (94.4%) eyes had visual acuity in bilateral and uniocular surgery patients respectively. Post-operatively, 36 (46.10/0) and 60 (42.3%) eyes of bilateral and uniocular surgery patients respectively had unaided acuity ?6/18. Post-operative acuity significantly improved in both unilateral (X: = 9.626; p<0.05) and bilateral (X! = 9.556; p<0.05) surgeries. However, there was no statistically significant difièrence in the improvement in visual acuity between unilateral and bilateral surgeries (X2 = 0.562; p>0.05).
Intra-operatively, vitreous loss occurred in one ( I .3%) BSCS and 2 ( I .4%) UCS patients. Post-operatively posterior capsule opacification occurred in and 22 (15.5%) eyes of bilateral and uniocular surgery patients respectively. Recurrent uveitis occurred in 8 ( 10.3%) and 13 of bilateral and uniocular surgery patients respecti vely. Post-operative endophthalmitis occurred in one (O. 7%) eye Of a uniocular Surgery patient.
Conclusion: Simultaneous bilateral cataract extraction with intraocular lens implant has visual outcome and complication rate similar to those ofuniocular surgery. It should be recommended för patients who do not want staged surgery and those who cannot aftòrd long hospital admission.
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