ABSTRACT
AIM: To report the incidence, risk factors and visual outcomes for postoperative endophthalmitis (POE) based on 7-year data from the Malaysian Ministry of Health Cataract Surgery Registry (MOH CSR). METHODS: Data was collected from the web-based MOH CSR. All consecutive cataract surgery patients from 1st June 2008 to 31st December 2014 were identified. Exclusion criteria were traumatic cataract or previous ocular surgery. Demographic data, ocular co-morbidities, intraoperative details and postoperative visual acuity (VA) at final ophthalmological follow-up were noted. All eyes were taken for analysis. Subjects with POE were compared against subjects with no POE for risk factor assessment using multiple logistic regressions. RESULTS: A total of 163 503 subjects were screened. The incidence of POE was 0.08% (131/163 503). Demographic POE risk factors included male gender (OR: 2.121, 95%CI: 1.464-3.015) and renal disease (OR: 2.867, 95%CI: 1.503-5.467). POE risk increased with secondary causes of cataract (OR: 3.562, 95%CI: 1.740-7.288), uveitis (OR: 11.663, 95%CI: 4.292-31.693) and diabetic retinopathy (OR: 1.720, 95%CI: 1.078-2.744). Intraoperative factors reducing POE were shorter surgical time (OR: 2.114, 95%CI: 1.473-3.032), topical or intracameral anaesthesia (OR: 1.823, 95%CI: 1.278-2.602), posterior chamber intraocular lens (PCIOL; OR: 4.992, 95%CI: 2.689-9.266) and foldable IOL (OR: 2.276, 95%CI: 1.498-3.457). POE risk increased with posterior capsule rupture (OR: 3.773, 95%CI: 1.915-7.432) and vitreous loss (OR: 3.907, 95%CI: 1.720-8.873). Postoperative VA of 6/12 or better was achieved in 15.27% (20/131) subjects with POE. CONCLUSION: This study concurs with other studies regarding POE risk factors. Further strengthening of MOH CSR data collection process will enable deeper analysis and optimization of POE treatment.
ABSTRACT
Introduction: Little is known regarding the extent of visualimpairment amongst pre-school children in Malaysia.Objective: To determine the prevalence of visual impairmentand amblyopia in Malaysian preschool children.Methodology: A cross-sectional, population-based studywas conducted on children aged four to six years from 51participating kindergartens in the district of Segamat, Johor,Malaysia from 20 March 2016 to 6 April 2016. All subjects hadinitial eye screening consisting of LogMar visual acuity,orthoptics examination and Spot vision screenerassessment. Subjects who failed the initial eye screeningwere invited for a formal eye assessment consisting ofcycloplegic refraction and a comprehensive ocularexamination. Definitions of visual impairment and amblyopiawere based on the Multi-Ethnic Pediatric Eye Disease Studycriteria.Results: A total of 1287 children were recruited. Meansubject age was 5.03 (SD:0.77) and males represented 52.3%of subjects. Subjects by ethnicity were Malay (54.8%),Chinese (27.7%), Indian (15.6%) and Orang Asli (1.9%).Formal eye assessment was required for 221 subjects and88.8% required ophthalmic intervention. Refractive error,representing 95.4% of diagnosed ocular disorders,comprised of astigmatism (84%), myopia (9%) andhypermetropia (6.9%). With-the-rule astigmatism waspresent in 93.4% of the subjects with astigmatism. Visualimpairment was present in 12.5% of our subjects, with 61%having bilateral visual impairment. Of the subjects withvisual impairment, 59.1% had moderate visual impairment.The prevalence of amblyopia was 7.53%, and 66% of theamblyopic subjects had bilateral amblyopia.Conclusion: Our study highlights an urgent need forinitiation of preschool vision screening in Malaysia.
