Extracapsular cataract extraction with posterior chamber intraocular lens implantation at the Rawalpindi general hospital

ABSTRACT

Out of a total of 220 consecutive patients who underwent extracapsular cataract extraction with posterior chamber intraocular lens implantation at the Rawalpindi General Hospital, Rawalpindi Medical College, Rawalpindi, Pakistan, 135 [61.4%] patients did not keep their appointments for follow-up. This discouraging pattern is universal in Pakistan and makes clinical studies very difficult and less than ideal for drawing reliable conclusions. The following postoperative complications appeared in the 85 patients who did come for follow-up visits anterior uveitis in 17 [20%] patients, after cataract [secondary cataract] in 11 [13.5%], glaucoma in 3 [3.5%], lens implant decentration in 3 [3.5%], and cystoid macular edema in 3 [3.5%]. Intraopera-tively, posterior capsular rupture with or without vitreous loss occurred in three [3.5%] patients and the removal of anterior capsule was not complete in another three [3.5%]. One female diabetic patient totally lost her sight due to postoperative rubeosis iridis and hyphema causing severe thrombotic [neovascular] glaucoma. One man [1.17%] developed bacterial endophthalmitis. The infection was successfully controlled, but the eye developed total corneal decompensation. A partially successful penetrating keratoplasty gave this patient a visual acuity of counting fingers. Of the 11 after cataract [posterior capsule opacification] cases, eight were treated with neodymium YAG laser capsulotomy and three with surgical capsulotomy. Out of a total of 14 eyes which had traumatic cataract, 11 recovered a visual acuity of 6/36 [20/120] or better, two a visual acuity of 6/60 [20/200], and one only light perception