Visual outcome of cataract surgery in three regions of the Philippines / Evangeline O. Olivar-Santos, Jose David Marin, Matabai Lim. Marhil Cadiz, Rasalita V. Tan, Oliver Villaflores

Cataract remains the number one cause of blindness in third world countries. In the Philippines, it accounted for 77 percent of blindness in 1995 with a prevalence rate of 0.70 percent, and 62 percent in 2002 with a prevalence of 0.58 percent. Surgery is still the only treatment for cataract blindness. The two main kinds of cataract extraction are intracapsular and extracapsular. A third procedure, phakoemulsification, is being performed by highly trained ophthalmologists. Laser surgery as a primary procedure for cataract is still considered experimental and is not being performed on cataract patients in the Philippines. The main objective of this study was to determine the percentage of visual rehabilitation and prevention of blindness; and the percentage of complications after cataract surgery. Results were compared versus the different surgical procedures, and the health facility where the procedure was performed. Comparative studies on the different surgical procedures for cataract abound in the literature. However, this is the first report in the Philippines of a community-based study on the visual outcome after each kind of cataract surgery on Filipino patients. The results may also provide important information for the training of cataract surgeons as well as measures for the evaluation of facilities for cataract surgery in the country.This report is a retrospective study of the data gathered in 1999. After randomly sampling municipalities in each province in the 3 selected regions, all cases who had undergone cataract surgery were tracked down, interviewed, and examined especially for visual outcome. A total of 995 post-operative cases were included in this study: 95 in the National Capital Region, 330 in Western Visayas and 530 in Southern Mindanao.The study showed the following findings:.Visual rehabilitation (pre-operative low vision that improved to 20/70 or better after surgery)=90.67 percent. Blindness prevention (pre-op blindness that improved to Counting Fingers more than 3 meters or better)=92.82 percent.Over-all complication rate = 2.20 percent. Some complications after surgery may be surgeon-related or technique-related.

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