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Year : 2014  |  Volume : 6  |  Issue : 2  |  Page : 54-56

Causes of poor visual outcome of extracapsular cataract extraction with posterior chamber intraocular lens implantation

1 Assistant Professor, Kordofan University, Elobied, Khartoum State, Sudan
2 Associate Professor, Alnileen University, Khartoum State, Sudan
3 Professor Sudan Medical Specialization Board, Khartoum State, Khartoum, Sudan

Correspondence Address:
Khalil Ali Ibraheim
Kordofan University, Faculty of Medicine, Elobied
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1858-540X.150995

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Aims: To detect the causes of poor visual outcome among patients who had extracapsular cataract extraction and intraocular lens (IOL) implantation. Materials and Methods: All patients who had ECCE and IOL implantation 6 weeks or more following surgery and who come for regular follow-up were picked from the Statistical Department and assessed for visual acuity, and for those with poor vision uncorrectable with glasses or any other mean of correction, complete ophthalmic examination including pupillary reactions measurement of intraocular presser (IOP) and direct and indirect ophthalmoscopy was performed. Results: Most of the patients were elderly (74%) and females were slightly more than males. The predominant type of cataract was senile cataract, 89% of patients complained of poor vision, 35% with visual acuity after operation less than 6/60 represent the biggest group with poor vision. Concerning intraocular pressure, the majority of pseudophakic eyes had normal range of IOP (75%), while 25% of the study group had raised intraocular pressure, although some of the patients with normal tension showed signs of advanced glaucomatous optic neuropathy. The most common causes of poor vision in the anterior segment were: Posterior capsule opacification (24%), corneal edema, opacity, pannus and bullous keratopathy (23%), amblyopia (6%), IOL decentration (5%), squint (4%), intraocular scarring (3%), nystagmus (2%), shrunken eyes (2%) and epithelial down-growth (1%). The most common causes of low vision in the media and posterior segment were glaucomatous optic neuropathy (28%), vitreous opacities (23%), macular edema (19%) and optic atrophy non-glaucomatous (19%), age-related macular degeneration (11%), toxoplasmic choroidoretinitis (6%), retinal detachment (6%), vitro-retinal bands (2%) and organized macular hemorrhage (1%); in some eyes, more than one cause was detected. Conclusion: The most common contributory factors for poor vision were incomplete ophthalmic examination before surgery, poor case selection and incomplete and irregular follow-up besides the above-mentioned causes.

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