ABSTRACT
BACKGROUND: A good refractive outcome after cataract surgery indicates adequate clinical service provision. Precise immersion biometry is critical to achieve the desired refractive outcome. While the immersion biometry results are good in the tertiary settings, it is of interest to explore the refractive outcome of cataract surgeries in a rural facility using the same technique. METHODS: A retrospective cross-sectional review was conducted on medical records of all cataract surgeries carried out in Hospital Keningau, Sabah. This study used all patients' medical records who had been assessed using immersion biometry pre-operatively, underwent phacoemulsification cataract surgery besides attending a post-operative refraction session within 90 days from the operation date. Clinical details were recorded in the form of standard proformas and analysed. The refractive outcome was evaluated using spherical equivalence (SE) and best-corrected visual acuity (BCVA). The percentage of cases with post-operative SE within ±1.00 diopter (D) and BCVA of '6/12 or better' were determined. The association between demographic factors and surgical-related factors with post-operative SE was evaluated using Fisher's exact test. RESULTS: Of 140 cataract surgeries, 113 fulfilled the inclusion criteria. The average patient age was 66.3 (SD = 10.9) years old. The technique was proven to replicate a good outcome of 84.1% of cases with post-operative SE within ±1.00 D while 90.3% of the cases achieved BCVA of '6/12 or better'. Age and ethnicity were found to be associated with post-operative SE. CONCLUSION: The study proves the reproducibility of good refractive outcome in a rural facility using immersion biometry. The findings provide a benchmark for performance surveillance in rural facilities.
ABSTRACT
Uncorrected refractive error, especially myopia, in young children can cause permanent visual impairment in later life. However, data on the normative development of refractive error in this age group is limited, especially in Malaysia. The aim of this study was to determine the distribution of refractive error in a sample of infants and young children between the ages of 6 to 36 months in a prospective, cross-sectional study. Cycloplegic retinoscopy was conducted on both eyes of 151 children of mean age 18.09 ± 7.95 months. Mean spherical equivalent refractive error for the right and left eyes was +0.85 ± 0.97D and +0.86 ± 0.98D, respectively. The highest prevalence of refractive error was astigmatism (26%), followed by hyperopia (12.7%), myopia (1.3%) and anisometropia (0.7%). There was a reduction of hyperopic refractive error with increasing age. Myopia was seen to emerge at age 24 months. In conclusion, the prevalence of astigmatism and hyperopia in infants and young children was high, but that of myopia and anisometropia was low. There was a significant reduction in hyperopic refractive error towards emmetropia with increasing age. It is recommended that vision screening be conducted early to correct significant refractive error that may cause disruption to clear vision.
