Outcome after Small Incision Cataract Surgery (Sics) and Phacoemulsification at Kigali University Teaching Hospital

Purpose: To determine the visual outcome and complications related to small incision cataract surgery and phacoemulsification at Kigali University Teaching Hospital. Methods: A retrospective study carried out on 644 eyes of 390 patients from January 2008 to January 2014 at KUTH. All patients with senile cataract operated with SICS or phacoemulsification at KUTH were included. Records on all examinations including visual acuity; refraction; biometry; slit lamp biomicroscopy and fundoscopy from the period before surgery up to 6 months post-operatively were obtained. Results: The final BCVA of 6/18 or more at 6-months after surgery was 90 on the RE and 82.6 on LE as compared to the pre-operative BCVA of 14.2 on the RE and 12.5 on the LE. Both types of surgery had similar post-operative outcome; respectively at 1; 3 and 6 months post-operatively (p=0.09; 0.19 and 0.12). The most common treatable complications were minimal hyphema and corneal edema; with a complete healing during the fist week of steroid treatment. There was no statistically significant difference in the complications rate between both types of surgery (P=0.28). Conclusion: Small incision cataract surgery and phacoemulsification had similar visual outcomes post-operatively; however phacoemulsification provided better UCVA at 3 months after surgery. Hyphema and corneal edema were the most common treatable complications that healed at the fist week after cataract surgery

Patterns of Ocular Trauma at the Main Referral Hospital in Rwanda: Kigali University Teaching Hospital

Background: Eye injuries are the most common cause of referral to the Ophthalmology department; KUTH. No research data is available on ocular trauma in Rwanda. To understand the impact of eye injuries in KUTH and to plan for preventive strategies; it is important to understand the magnitude of this problem. Aim: The aim of this study was to identify the patterns of ocular trauma at Kigali University Teaching Hospital. Methods: In this retrospective study; 352 reviewed patients were referred to KUTH; from January 1st; 2007 to January 1st; 2013. Patient's ocular trauma details were recorded and analyzed. Patients' demographic data; medical history; diagnosis; treatment and possible complication were retrieved from files in archive and recorded on a questionnaire for further analysis. Results: Out of the 352 patient's files; 72.7 were males and 27.3 were females. The male to female ratio was 2.7. Majority of patients were of age group between 11 and 40 years. Among files reviewed; 75.2 sustained blunt ocular injuries whereas 22.1 sustained penetrating injuries. Main risk factors for those injured patients were work place injuries (37); road traffic accident (21) and assault (15). Most frequent offending agents were pieces of wood (21.5); foreign bodies (16.4) and vehicle crush (16.1). However; metal objects; motorbike and stone missile represented important causes of ocular trauma at KUTH respectively 13.9; 13.06 and 11.07. A big number of patients were found to have corneo-limbal perforation (29.2); corneal abrasions (18.4); corneal abrasions (18.4); sub-conjunctival hemorrhage (17.8) and peri-orbital injuries (17.6). The common visual acuity observed on the affected eye on admission was (6/60-3/60) (38) and below 3/60 (30). The main post-traumatic complication at KUTH was corneal scaring (42.04). Conclusion: Males and young patients were more affected by ocular injuries because of their involvement in high risk activities in their daily life. Blunt and penetrating ocular injuries were two main types of ocular trauma recorded. Work place ocular injuries; road traffic accident and assaults were the main risk factors of ocular trauma at KUTH. Piece of wood; ocular foreign bodies and vehicle crush were the main offending agents causing ocular injuries. Main diagnoses in ocular trauma were corneo-limbal perforation; corneal abrasion and sub-conjunctival hemorrhage. On admission; most of injured patients had visual acuity (6/60-3/60) and below 3/60. Management of ocular trauma mainly described at KUTH was antibiotherapy and steroid therapy; however surgery was performed for penetrating trauma and conservative treatment for few cases. The most common complication due to ocular trauma at KUTH was corneal scaring

Normal Conjunctival Flora as Seen in Adult Patients at Kigali University Teaching Hospital

The aim of this study was to assess the pattern of normal ocular bacterial flora isolated from patients attending the Department of ophthalmology at the Kigali University Teaching Hospital and to evaluate their in vitro susceptibility to common antimicrobial agents. From June to October 2011; collection of specimen was performed by rotating a sterile cotton swab on the lower conjunctival sac from the temporal to the medial fornix. Gram stain and culture was performed and antibiotic sensitivity determined in case of bacterial growth. Of the 120 collected samples; 74 (61.6) showed bacterial growth and all were gram positive. 48.6 were Staphylococcus aureus ; while 51.4 were Staphylococcus epidermidis. There was high sensitivity of Staphylococcus aureus to chloramphenicol (100); clindamycine (92); oxacilline (86.7); ciprofloxacine (76.7) and norfloxacine (71.9). However; there was a high resistance of Staphylococcus aureus to penicilline G (11.1) and tetracycline (52.8). Staphylococcus epidermidis was highly sensitive to chloramphenicol (71.9) and oxacilline (71.1) while it was resistant to erythromycine (28.6); norfloxacine (35.3) and penicilline G (40.6 In this study; all of the isolated pathogens were revealed to be gram-positive bacteria. Chloramphenicol; clindamycine and oxacilline showed good activity against normal flora of the ocular surface and should be used in prevention of post-operative end ophtalmitis