Nur Aisyah Rahmawati1, Randy Sarayar2, Annisa Nindiana Pertiwi3, Herdanti Rahma Putri1, Arnes Tasya Citra Anggini4, Nizma Permaisuari1, Andrew John Widya Sieman4, Cynthia Viryawan5, Gabriella Chandra2, Dyah Astri Paramaramya4, Muhammad Khoirul Huda6, Yeni Dwi Lestari7
1General Practitioner, Hadji Boejasin Pelaihari General Hospital, Tanah Laut, South Kalimantan, Indonesia.
2General Practitioner, Surya Husadha Nusa Dua Hospital, Badung, Bali, Indonesia.
3General Practitioner, Bhakti Rahayu Tabanan General Hospital, Tabanan, Bali, Indonesia.
4General Practitioner, Dr. Suyoto Hospital, Jakarta, Indonesia.
5General Practitioner, Tani dan Nelayan General Hospital, Boalemo, Gorontalo, Indonesia.
6General Practitioner, dr. Loekmono Hadi General Hospital, Kudus, Central Java, Indonesia.
7Department of Ophthalmology, Faculty of Medicine, Cipto Mangunkusumo HospitalKirana, Universitas Indonesia, Jakarta, Indonesia.
Objective: Cataract is the leading cause of blindness worldwide and its only treatment is surgery, which is intended to restore the visual function; the expected outcomes are improved visual acuity (VA) and elimination of blindness. Therefore, evaluation of the outcomes of cataract surgery is needed to improve the quality of treatment programs. Materials and Methods: This was a cross-sectional study of 193 postcataract surgery eyes from August 2017 to March 2018 in six hospitals in Indonesia. Convenience sampling was used. Bivariate and multivariate analyses were performed on the medical records of pre- and postoperative VA, types of surgery, and complications. Results: Of the 193 eyes, 170 were analyzed. Phacoemulsification, manual small-incision cataract surgery, and extracapsular cataract extraction with intraocular lens (IOL) implantation were performed in 45.3%, 51.2%, and 3.5% of eyes, respectively. Preoperatively, 70% were blind, 8.8% had severe visual impairment (SVI), 17.1% had moderate visual impairment (MVI), and 4.1% were normal. Postoperatively, 78.2% were normal, 15.3% had MVI, 2.4% had SVI, and 4.1% were still blind. There were 93.5% of eyes with visual improvement; the blindness conversion rate was 95%. The overall complication rate was 15.3%, mostly from corneal edema (7.1%), followed by IOL dislocation (1.8%) and endophthalmitis (1.2%). There was no statistically significant difference in the postoperative visual outcome between groups treated with or without phacoemulsification (P = 0.870), but complications from corneal edema were statistically significantly higher with phacoemulsification (P = 0.003). Conclusion: All types of cataract surgery significantly improved VA, but the complication rate was higher with phacoemulsification, mostly from corneal edema.
Keywords: Cataract, complication, surgery, visual outcome