VISUAL OUTCOME OF PHACOEMULSIFICATION
Purpose: To determine visual outcome after phacoemulsification in developmental or age related cataracts.
Place and duration: This study was conducted in Ophthalmology department of Hayatabad Medical Complex (HMC),
Peshawar, Pakistan. Duration of study was 8 months. It was carried out from 12th February 2013 to 11th October 2013.
Methods: This descriptive interventional case series included 46 eyes of 46 patients who underwent uncomplicated
phacoemulsification with foldable intraocular lens implantation in the bag. Complete ophthalmological examination
including best corrected visual acuity (BCVA) was performed preoperatively and at each follow up visit. Visual acuity
(VA) was measured using Snellen’s chart which was later converted to logMAR for data analysis. Follow up was done
at 1st postoperative day and at 1st, 2nd and 6th postoperative weeks. Final visual outcome was assessed at 6th postoperative
Results: Mean age was 54.7 years with a minimum age of 38 years and maximum age of 79 years. Male to female
ratio was 28:18. Four (8.7%) patients were diabetics. One (2.2%) eye has no diabetic retinopathy. Two eyes (4.4%)
have diabetic macular edema (DME) who received 1.25mg/0.05 ml of intravitreal injection of bevacizumab 2 weeks
before surgery. One (2.2%) eye has severe nonproliferative diabetic retinopathy (NPDR) who received panretinal photocoagulation
(PRP) 2 weeks before surgery. One (2.2%) eye has early glaucoma controlled with topical antiglaucoma
medications and 1(2.2%) eye has advanced age related macular degeneration (ARMD). Mean preoperative BCVA was
0.9 logMAR (6/48) which improved to a mean BCVA of 0.1 logMAR (6/7.5) at 6th postoperative week. Postoperative
BCVA of 0 to 0.3 logMAR (6/6 to 6/12 on Snellen chart) was achieved in 82.6% of eyes. Rest had BCVA of less than
0.3 logMAR (<6/12). Eyes with age related macular degeneration, diabetic retinopathy and DME were associated with
worse prognosis. All patients had a very minimal inflammation during the first postoperative week. No patient developed
any postoperative complications like endophthalmitis during the 6 weeks follow up.
Conclusion: The final visual outcome was improved in majority of eyes at 6th postoperative week. Eyes with diabetic
retinopathy, DME and advanced ARMD were associated with worst prognosis regarding postoperative BCVA. Early
glaucoma has no effect on visual outcome.
Key words: Developmental and age related cataract, visual outcome, phacoemulsification