Visual acuity at 6 weeks after small incision cataract surgery and role of audit in predicting visual acuity

PURPOSE. We present the best-corrected visual acuity (BCVA) at 6 weeks after small incision cataract surgery (SICS) and review the role of audit in predicting visual acuity (VA). METHODS. This was a retrospective data analysis of 14,393 SICS performed during 2007-2008 at a hospital in central India. Ophthalmologists noted preoperative, operative, and postoperative details. The BCVA before and 1 day and 6 weeks after surgery were noted. We identified factors associated with BCVA at 1-day and 6-week follow-up. RESULTS. Six weeks after surgery, 12,522 (87%) and 1473 (10.2%) patients had BCVA >= 6/18 and 6/24-6/60, respectively. Vision improved between 2 follow-ups in 6695 eyes (46.5% (95% confidence interval (CI) 45.7-47.3)), remained the same in 7117 eyes (49.4%), and deteriorated in 544 (3.8%) eyes. BCVA at 6 weeks was negatively associated with blindness (VA <3/60 in the better eye) before surgery (odds ratio (OR) = 0.73, 95% CI 0.58-0.92), surgeon's experience (OR = 0.75, 95% CI 0.71-0.81), and male patients (OR = 0.73, 95% CI 0.67-0.80). BCVA at 6 weeks was positively associated with older age (OR = 1.02, 95% CI 1.01-1.03) and intraoperative complications (OR = 1.44, 95% CI 1.14-1.83). The association of VA < 6/60 1 day after surgery with improved vision between the 2 follow-ups was not statistically significant (OR = 0.005, p = 0.98). CONCLUSIONS. BCVA at 6 weeks after SICS was >= 6/18 in 87% of operated eyes. By performing surgical audit, one can identify high-risk groups that need proactive subsequent follow-ups. (Eur J Ophthalmol 2010; 20: 345-52)