Small incision cataract surgery at an ophthalmic teaching hospital in the Pacific – three month outcomes

Riyaz Bhikoo

Meeting:  2015 RANZCO


Date:      -

Session Title: Poster

Session Time:      -

Purpose: To describe patient demographics, visual and surgical outcomes of eyes undergoing Small Incision Cataract Surgery (SICS) at a teaching hospital in Fiji.

Method: Prospective longitudinal cohort study of 149 patients that underwent temporal SICS with in-the-bag intraocular lens implantation by consultants and trainees at the Pacific Eye Institute, Fiji between September and December 2014. Patients underwent a complete ophthalmic examination by two independent investigators preoperatively, day one, week four and three months. Patient characteristics, visual outcomes including Surgical Induced Astigmatism (SIA) and complications were analysed.

Results: The mean age at surgery was 63 years (range 44-80) with 51% female. Ethnicity distribution was 57% Fijian and 42% Indo-Fijian. Systemic hypertension and diabetes were noted in 45% and 39% respectively. 33% were pseudophakic in the contralateral eye. Mean pre-operative Best Corrected Visual Acuity (BCVA) was 6/165. At three months, 87% returned for follow up with 75% _6/18 unaided vision. Mean post-operative BCVA was 6/9, 98% achieved _6/18 vision and mean post-operative spherical equivalent -0.78D. The mean SIA was 0.48D. Notable complications included: significant posterior capsular opacity 24%, post-operative macula oedema 9%, displaced intraocular lens causing pigment dispersion 7% and posterior capsular rupture 5%. Surgery related reduction in pre-operative BCVA occurred in 2%. No cases of endophthalmitis.

Conclusion: Our results suggest that SICS is effective for patients in Fiji with 98% achieving the World Health Organisation’s definition of ëGood Vision” (_6/18). Refinements in biometric techniques to minimise post-operative refractive error would allow a greater proportion of patients to achieve better unaided vision.