Visual Outcome after Small Incision Cataract Surgery in Southwestern Nigeria

Objective: The aim of this study was to determine the visual outcome of patients who had manual small incision cataract surgery in a high volume secondary eye hospital in southwestern Nigeria, and to identify reasons for poor outcome. Methodology: This is an observational descriptive, longitudinal study of consecutive patients undergoing cataract surgery at St Mary’s Catholic Eye Hospital, Ago Iwoye (SMEH) Nigeria conducted between May and October 2007. A total of 146 patients who presented to the hospital and met the inclusion criteria were recruited for the study. Patients were examined preoperatively, 1st day and 8th week post-operatively. Results were analyzed using the SPSS statistical software. Significant association was taken at 95% confidence interval i.e. < 0.05. Results: A total of 146 patients who met the inclusion criteria were studied. The mean age was 65.3±10.04 years; and the male to female ratio was 1.4:1. Preoperatively, 110 patients (75.3%) were blind in the operated eye, while 33 patients (22.6%) were blind in both eyes at presentation. At 1st day post-operatively, 17 patients (11.6%) had pinhole visual acuity of 6/6-6/18. Out of 137 patients that had refraction, 114 patients (83.2%) had a visual acuity of 6/6-6/18. The number of blind patients also reduced from 33 (22.6%) to 1(0.7%). Uncorrected refractive error was the commonest cause of poor vision post-operatively. Conclusion: This study demonstrates that good results can be obtained with small incision cataract surgery with intraocular lens implantation in the developing world. Increasing cataract surgery with IOL implantation should reduce the number of eyes with poor functional vision after cataract surgery.Key words: cataract, cataract surgery, visual outcom

Visual outcome after cataract surgery at the University College Hospital, Ibadan

Aim: The aim of this study was to determine the visual outcome of patients who had cataract surgery in the University College Hospital Ibadan. Methodology: This is an observational descriptive, longitudinal study of consecutive patients undergoing cataract surgery at the University College Hospital conducted between May and October 2007. A total of 184 patients who presented to the hospital and met the inclusion criteria were recruited into the study. Patients were examined preoperatively, 1st day postoperatively and 8th week postoperatively. Results: The mean age was 66.5 years; and the male to female ratio was 1.2:1. Preoperatively, 137 patients (74.5%) were blind in the operated eye, while 39 patients (23.6%) were blind in both eyes at presentation. At 1st day postoperatively, 87 patients (47.3%) had pinhole visual acuity of 6/6-6/18. Best corrected vision after refraction eight weeks postoperatively showed that 127 patients out of 161 patients (78.8%) had good vision while 28 patients (17.4%) had borderline vision, and six patients (3.8%) had severe visual impairment after refraction. The number of bilaterally blind patients also reduced from 39 (23.6%) to one (0.6%). Uncorrected refractive error was the commonest cause of poor vision prior to refraction. Glaucoma was the commonest ocular co-morbidity accounting for poor vision in 9.1% of patients eight weeks after cataract surgery. Conclusion: This study demonstrates that good results can be obtained with cataract surgery and intraocular lens implantation in the developing world. More attention should be directed towards ensuring that successful outcomes are indeed being realized by continued monitoring of postoperative visual outcomes and prompt refraction for all patients.Keywords: Cataract, Visual outcome, Cataract surger

Presumed Chloroquine Retinopathy in Ibadan

Objective: To review patients with clinical features of chloroquine retinopathy seen during the study period with the view of identifying the trend and creating public awareness for behavioural change. Methods: A retrospective review of case notes of patients seen between 1996 and 2002. Results: 19 patients with features of presumed chloro-quine retinopathy were reviewed: 5 women and 14 (73.7%) men. The age range is: 36-69 years, mean 50.7 years. Approximately 63% were civil servants, health care workers and teachers. Duration of chloroquine use ranged from six months to ten years, with a mean of 4.1 years. Total cumulative dose ranged from 10 gm to 312 gm, with a mean of 108 gm. Best corrected visual acuity of subjects ranged from 6/5-CF, mean 6/18. Conclusion: The majority of people using large amounts of chloroquine over long periods are educated, middle-aged males, whose loss of vision would have far reaching effects on their families. There is, therefore, a need to create public awareness of the danger of long-term chloroquine use. A follow up national survey would be desirable to determine the actual magnitude of the problem [Nig. J. Ophthalmology Vol.11(1) 2003: 24-28

Risk factors for visually disabling age-related cataracts in Ibadan

Objective: To assess the risk factors for visually disabling age related cataracts. Methods: A hospital based case-control study carried out at the university College Hospital Ibadan between May 1996 and March 1997. Three hundred and eighty three cases were matched for age and sex with five hundred and ninety nine controls. Subjects aged 50 years and above were examined for visual disabling central lens opacities, which were graded on a scale of 0-3, through undilated pupil with direct ophthalmoscope set at +2.00 Diopters, and held 1/3 meter away. Grades 2a or more with visual acuity less than 6/18 only were selected as cases. Both cases and controls were examined and the risk for development of cataract determined. Results: The analysis revealed a strong association between uncontrolled diabetes and cataracts (O.R 2.03, P 0.05). Exposure to alcohol was found to be protective (O.R 0.66; P 0.05) and heavy smoking (O.R 0.81; P > 0.05). Conclusion: The study confirms an association between cataract and exposure to diabetes, ultraviolet irradiation, hypertension, corticosteroids, and cigarette smoking. There is therefore a need for introduction of intervention measures aimed at reducing exposure to these risk factors. Keywords: Age-related cataract, visually disabling cataract, cataract risk factors Annals of African Medicine Vol.2(1) 2003: 27-3

Exfoliation syndrome in Northern Nigeria

Ugbede Idakwo,1 Olusola Olawoye,2 Benedictus GK Ajayi,1 Robert Ritch3 1Eleta Eye Institute, Ibadan, Nigeria; 2Department of Ophthalmology, College of Medicine, University of Ibadan, Ibadan, Nigeria; 3Einhorn Clinical Research Center, Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA Purpose: To estimate the frequency of exfoliation syndrome (XFS) and its association with ocular diseases in Northern Nigeria.Materials and methods: Consecutive patients who presented to the outpatient department of ECWA Eye Hospital Kano from February 2015 to May 2015 were included in the study. Each patient had a complete ophthalmic examination. The anterior segment examination included tonometry, gonioscopy, and detailed slit-lamp examination to assess for the presence or absence of exfoliation material, inflammatory cells, and other abnormal findings. Patients with exfoliation material on the anterior lens surface and/or pupillary margin in either or both eyes were considered to have XFS. Statistical analysis was performed using the Statistical Package for the Social Sciences version 16.0.Results: A total of 620 patients living in Northern Nigeria from the 6 geopolitical zones were examined. The majority of them (34.5%) were indigenous Hausas. There was a male preponderance of 56.6%, while the mean age at presentation for examination in all age groups was 55.7±13.7 years. There were 9 patients with XFS; the frequency was 1.5%, with most of the patients being 70–80 years old. In patients who were ≥50 years, the frequency was 2.5%. Patients with XFS had a higher mean age of 68±4.9 years. The frequency of XFS among glaucoma patients was 4.4%, while among cataract patients it was 3.7%. No other associated ocular disease was found in the patients with XFS.Conclusion: This study shows that XFS does exist in Northern Nigeria, as was found in the South. The prevalence of XFS was, however, not reported in the Nigerian National Blindness and Visual Impairment Survey. Therefore, a population-based study is still needed to determine the true prevalence of XFS in Northern Nigeria. Keywords: exfoliation syndrome, glaucoma, cataract, Northern Nigeria, intra-ocular pressur