Journal of Clinical and Diagnostic Research. 2020 Feb, Vol-14(2): NC04-NC06 4 4 DOI: 10.7860/JCDR/2020/42643.13528 Original Article Ophthalmology Section Visual Outcome after Cataract Surgery in Rural Hospital of Wardha District: A Prospective Study INTRODUCTION Lens is a transparent structure that has evolved to adjust the refraction of light entering into the eye. World Health Organisation estimated that cataract was the most common cause of blindness worldwide, affecting over 17 million people across the globe [1]. In the developed world, cataract surgery is the most common procedure done and cataract blindness is reversible by this surgery [2]. This will help to attain the targets of the VISION 2020 initiative and manage the World Health Organisation (WHO) recommendation that more than 85% of operated eyes should have good outcome that is ≥6/18 vision and less than 5% should have poor outcome (6/60 vision) at 6 weeks following cataract surgery. The WHO categorised the visibility outcome following cataract surgery, as good=6/18, borderline=6/24-6/60, and poor=<6/60 [3]. However it is becoming evident that the outcomes of surgery is not good always as it is previously assumed, and there is much more attention needed to this aspect of surgical services [4]. Kelman introduced Phacoemulsification in 1967, which is one of the most important innovations in ophthalmology and is accepted as gold standard for surgical procedure in treating cataract [5]. The main aim of cataract surgery is to restore their visual acuity which may be helpful in improving their quality of life [6]. The most popular methods of nucleotomy are “Divide and Conquer” and “Chopping”. Among the two Divide-and-conquer technique was described by Gimbel. It was the first nucleofractis cracking technique which was developed [5]. Whereas at the meeting of the American Society of Cataract and Refractive Surgery in 1993, Kunihiro Nagahara, presented a technique known as phaco chop. Phaco chop can be horizontal chopping or vertical chopping [7,8]. An alternative approach is followed by Kunihiro Nagahara for disassembling the nucleus, using a horizontal chopping technique [8]. The benefit of phaco chop over divide and conquer is that the nucleus can be rapidly disassembled, which results in significantly decreased use of ultrasound energy. The sutureless manual Small Incision Cataract Surgery (SICS) is a good alternative to Phacoemulsification which gives visual results equivalent to Phacoemulsification, at lower expenses [9]. The purpose of this study was to study the visual outcome of patients who underwent cataract surgery. MATERIALS AND METHODS This was a hospital based prospective, cross-sectional study and was conducted between April 2018 to March 2019. This study was adhered to the tenets of the declaration of helsinki, and it was approved by an Institutional Ethics Committee (DMIMS(DU)/ IEC/2017-18/6518) of Datta Meghe Institute of Medical Sciences, Wardha. All the surgeries in the study were conducted at the Department of Ophthalmology, Acharya Vinoba Bhave Hospital, Sawangi by a experienced surgeon. Informed consent from all subjects was taken after the nature and possible consequences of the study was explained to them. Inclusion Criteria Patients with uncomplicated senile cataract, having nuclear 1. sclerosis of all grades by LOCS II classification [10], cortical cataracts and posterior Sub-capsular cataract. Patients who were accessible and willing for follow-up. 2. Patients not having any ocular pathology. 3. Patients with age group 41-70 years. 4. MADHUMITA PRASAD 1 , SACHIN DAIGAVANE 2 , VISHAL KALODE 3 Keywords: Eye lens, Phacoemulsification, Visual acuity ABSTRACT Introduction: The most common cause of blindness is cataract, affecting over 17 million people worldwide. Cataract surgery is the most common surgical procedure done in the developed world. Aim: To study visual outcome of patients who underwent cataract surgery. Materials and Methods: It was a prospective study carried out in the Department of Ophthalmology for 1 year and total of 1750 patients with cataract underwent cataract surgery and the pre-operative and post-operative visual acuity was assessed. By using convenient random sampling, all patient who are admitted in the Department of Ophthalmology for cataract extraction surgery were included in this study. Statistical analysis was done by using descriptive and inferential statistics using Chi- square test. Software used was SPSS 17.0 and Graph Pad 6.0 and p<0.05 was considered as level of significance. Results: Total 1750 cases were enrolled and the maximum number of cases were in the age group of 51-60 years (54.86%) whereas the least cases were found in 41-50 years of age group, Out of 1750 cases, 64.28% were males and 35.72% were females. Pre-operative uncorrected visual acuity (UCVA) was <6/60 in maximum 630 cases (36%) cases, Out of 1750 cases surgeries was performed with phacoemulsification in 1120 (64%) cases and Small Incision Cataract surgery (SICS) in 945 (54%) cases, post-operative Best corrected visual acuity was 6/24-6/9 in maximum 1479 (84.51%) cases. Conclusion: The present study identified the factors that affect the visual outcomes such as surgical procedure, pre- operative Visual acuity, post-operative visual acuity. The phacoemulsification can be utilised due to evidence for better cataract surgery outcomes when compared to SICS. There is a need for community-based approach to increase awareness of eye health which is very important.