AN OBSERVATIONAL STUDY REGARDING THE IMPROVEMENT OF VISION AFTER EXTRACAPSULAR CATARACT SURGERY

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AN OBSERVATIONAL STUDY REGARDING THE IMPROVEMENT
OF VISION AFTER EXTRACAPSULAR CATARACT SURGERY

• BY
• SMITA NAIR(46)
• ARPIT PANCHAL(49)
• MAYUR PANCHAL(50)
• GUIDED BY
• Dr. TAPASVI PUWAR

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INTRODUCTION

• National Programme for Control of Blindness Eye
  Awareness
• One of the basic Human Right is to see and
  therefore it is to be ensured that no citizen
  goes blind needlessly or being blind does not
  remain so if by reasonable deployment of skill
  and resources his eye sight could be prevented
  from deteriorating and if already lost could be
  restored
• Resolution of the Central Council of Health
  Family Welfare at its meeting in the year 1975.

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Magnitude of Problem

• WORLD
• According to the 1999-2000 statistics ---- 180
  million people are visually impaired out of which
• 
  45 million are blind
• Also 80 of it is falls in the preventable
  category.
• The current prevalence is 0.2 to 1.1
• INDIA
• The current prevalence rate is 1.1
• Cataract is still the leading cause of blindness
  in India contributing to about 50 -90 of the
  cases.
• The major age group affected are between 45 to 50
  yrs.

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RESEARCH QUESTION

• To survey the post operative improvement of
  vision in 100 patients suffering from cataract
  and who underwent extracapsular cataract
  extraction and whether there are any
  complications or not.

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REVIEW OF LITERATURE

• Blindness
• Visual Acuity of less than 3/60 (snellen) or its
  equivalent i.e inability to count fingers at a
  distance of 3 mts. is termed as blindness.
• CATARACT
• Definition Any opacity of crystalline lens of
  eye leading to loss of details and clarity.

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• Barriers To Surgery
• Ignorance of facilities
• Superstitions
• Services too far
• Unaffordable
• No time
• No one to accompany
• Old Age so no need felt
• Other eye in good condition
• Fear
• Contraindication
• Waiting for the cataract to mature

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METHODOLOGY

• Type Of Study Observational Study
• Procedure
• After getting permission from the
  respective HOD of the concerned depts. we went
  to the ophthalmology OPD and collected the data
  from 100 postoperative patients who underwent
  cataract operation by the extracapsular cataract
  extraction technique at Nagri Eye Hospital.
• We collected their personal data and their vision
  before and after the surgery.Also we asked about
  any complications suffered by them.
• After collecting the data we anlaysed it and
  found out the results.

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TIME LINE CHART
Time Period (weekly)
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ANALYSIS
TABLE 1 AGE WISE DISTRIBUTION OF STUDY POPULATION
The mean age is 59.99 yrs the age group 60 -69
yrs has the highest cases.
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TABLE 2 SEX WISE DISTRIBUTION OF STUDY POPULATION
TABLE 3 ADDICTION WISE DISTRIBUTION OF STUDY
POPULATION
No. of persons
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TABLE 4EDUCATION WISE DISTRIBUTION OF STUDY
POPULATION
0 Illiterate 3 11th to 12th standard 1
1st to 7th Standard 4 Graduation 2 8th to
10th Standard 5 Post Graduation
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TABLE 5 DURATION OF DIAGNOSIS AND OPERATION WISE
DISTRIBUTION OF STUDY POPULATION
The mean duration that has elapsed between
diagnosis and operation is 2.2 months.
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TABLE 6SUBJECTIVE VISION IMPROVEMENT WISE
DISTRIBUTION OF STUDY POPULATION
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TABLE 7 VISION BEFORE AND AFTER CATARACT SURGERY
This table shows the vision before and after
the cataract surgery. A 6/6 E 6/24 B
6/9 F 6/36 C 6/12 G 6/60 D
6/18 This classification is according to the
Snellens chart for distant vision.
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Applying the Z TEST to check the significance of
the vision improvement After the cataract surgery.
Z value 18.09 Std error 0.042 . 0.042 x 1.96
0.0823 which is less than z value. So the test
is significant and hence it shows that people
undergoing a cataract Surgery will have an
improvement of vision.
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TABLE 8 COMPLICATION WISE DISTRIBUTION OF STUDY
POPULATION
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CROSS TABLES

• TABLE 1 AGE V/S
• COMPLICATIONS

Applying the CHI SQUARE TEST to check the
significance of age and complication Chi square
value 0.79 which is less than the table
value. So the test is not significant. That means
statistically there is no high risk age group for
postoperative complications.
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TABLE 2EDUCATION V/S COMPLICATIONS
Applying the CHI SQUARE TEST to check the
signifance of this cause and effect relationship
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Applying the CHI SQAURE TEST to check the
significance of this cause and effect
relationship
The chi square value is 4.04 which is more than
the table value. This shows that the test is
significant. This shows that illiterate people
suffer from more complications most probably due
to unhygienic practice and improper care after
surgery.
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SUMMARY AND CONCLUSIONS

• Cataract has constantly been one of the leading
  causes of blindness in India. However recently
  there has been a decline in the number of people
  suffering from blindness due to cataract.
• This is due to the better facilities of surgery
  available to the common man.Also many programmes
  regarding the prevention control and treatment
  modalities have been undertaken by the Govt.Of
  India.
• NPCB Launched in 1976 it has been striving to
  decrease the prevalence of blindness in India.
• VISION 2020 RIGHT TO SIGHT
• Goal -- Elimination of avoidable blindness by
  the year 2020.
• Under this program cataract is one of the
  target disease including other 4 like DR
  Glaucoma Refractive Errors and Childhood
  Blindness.
• According to the survey we conducted and based on
  the cross examination we carried out we came to
  the conclusion that the only modifiable factor
  associated with the prevention of complication is
  EDUCATION.
• The maximum number of complications occurring are
  those among uneducated people either due to
  unawareness or lack of carefulness.
• If we educate the people about the pros and cons
  of cataract we can encourage them to come in for
  a timely surgery and better results of vision and
  probably very minimal complications.

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• Also we need to educate them to remove the
  barriers to surgery as seen above.
• The other less modifiable factor is the duration
  between the diagnosis and operation which is
  largely dependent on again education. Although
  many people have a delay due to medical
  indications but majority of them delay the
  surgery due to unawareness and superstitions.
• But under the study we carried out we have
  thankfully found out that majority of the
  patients have operated within the duration of 1
  to 2 months.