DETERMINANTS OF VISUAL OUTCOMES AFTER PHACOEMULSIFICATION: A COMPARATIVE STUDY IN A SEMI-RURAL HOSPITAL-BASED POPULATION

To determine the demographic, systemic, and ocular factors that influence visual outcomes after phacoemulsification in patients at a semi-rural population-based hospital.

Department of Ophthalmology, RSU Allam Medica, Indonesia, 2024.

A retrospective comparative study included 194 eyes undergoing phacoemulsification with posterior chamber intraocular lens implantation in 2024. Patients were divided into two groups: those with good vision after surgery (≥6/18) and those with bad vision (<6/18). Demographic variables, systemic comorbidities, ocular biometry (intraocular pressure, anterior chamber depth, lens thickness, intraocular lens power), surgical duration, and postoperative complications were examined through t-tests and chi-square tests.

Out of 194 patients, 165 (85.1%) achieved good visual outcomes, while 29 (14.9%) had suboptimal results. The group with suboptimal outcomes was predominantly female (55.2%) and aged 60–79 years (69%). Most (90%) experienced preoperative blindness (<3/60). There was no significant difference in ocular biometric parameters between the two groups (p>0.05). Postoperative complications were significantly associated with poor visual outcomes (82.8% vs 10.9%, p<0.001), with mild corneal oedema being the most frequent occurrence, which improved with conservative therapy.

Postoperative complications are a significant factor influencing less-than-optimal visual recovery after phacoemulsification. Ocular biometry and systemic comorbidities did not significantly affect the final outcome. Early surgical intervention, meticulous surgical technique, and strict postoperative monitoring are crucial for minimising visual impairment due to complications in healthcare facilities in semi-rural areas.