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Visual outcomes after cataract surgery among the elderly residents in the 'homes for the aged' in South India: the Hyderabad Ocular Morbidity in Elderly Study.

Authors
  • Marmamula, Srinivas1, 2, 3, 4, 5
  • Barrenakala, Navya Rekha6
  • Challa, Rajesh6
  • Kumbham, Thirupathi Reddy6
  • Modepalli, Satya Brahmanandam6
  • Yellapragada, Ratnakar6
  • Bhakki, Madhuri6
  • Reddy, Jagadesh C7
  • Friedman, David S5
  • Khanna, Rohit C6, 4
  • 1 Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India [email protected] , (India)
  • 2 Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, India. , (India)
  • 3 Department of Biotechnology / Wellcome Trust India Alliance, L V Prasad Eye Institute, Hyderabad, India. , (India)
  • 4 School of Optometry and Vision Science, University of New South Wales, Sydney, Australia. , (Australia)
  • 5 Massachusetts Eye and Ear, Harvard Medical School Department of Ophthalmology, Boston, United States of America. , (United States)
  • 6 Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India. , (India)
  • 7 Cataract and Refractive Services, L V Prasad Eye Institute, Hyderabad, India. , (India)
Type
Published Article
Journal
British Journal of Ophthalmology
Publisher
BMJ
Publication Date
Aug 01, 2021
Volume
105
Issue
8
Pages
1087–1093
Identifiers
DOI: 10.1136/bjophthalmol-2020-317167
PMID: 32855164
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To report visual outcomes and factors associated with good visual outcomes after cataract surgery among the elderly residents in 'homes for the aged' in Hyderabad, India. Individuals aged ≥60 years were recruited from 41 'homes for the aged'. All participants had a detailed eye examinations including visual acuity (VA) assessment , refraction, slit-lamp examination and fundus imaging by trained professionals. A detailed history of cataract surgery was recorded. Multivariate logistic regression was used to determine the factors associated with good visual outcomes after cataract surgery which was defined as presenting VA of 6/18 or better in the operated eye. Visual impairment (VI) is defined as presenting VA worse than 6/18 in the operated eye. 1215 eyes of 703 individuals had cataract surgery. The mean age of these participants was 77.5 years (SD: 8.2 years; range: 60-108 years), 66.8% were women, 29.9% reported diabetes and 61% reported hypertension. 406/1215 (33.4%; 95% CI 30.8 to 36.1) eyes had VI after cataract surgery. Posterior capsular opacification (31.8%; n=129) was the leading cause of VI followed by uncorrected refractive error (24.1%; n=98). The prevalence of good outcomes was 66.6% (95% CI 63.8 to 69.2). On applying multivariable analysis, younger age, self-reported hypertension, independent mobility, surgery in a non-government (as opposed to private) hospital and undergoing paid surgery were associated with good outcomes. One-third of the eyes of elderly individuals living in homes for the aged that had previously undergone cataract surgery had VI. Regular eye examinations with the provision of laser capsulotomy and appropriate refractive correction can substantially improve their vision. © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.

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