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Abstract
Purpose: To determine the refractive outcomes of cataract surgery in Hospital Kuala Lumpur (HKL) and how they compare to international standards. To determine factors associated with it among cataract patients who underwent phacoemulsification surgery and intraocular lens implantation in HKL for quality improvement initiatives.
Study design: This is a retrospective study conducted based on the Malaysian Cataract Surgery Registry (CSR) records from January 1, 2021 to December 31, 2021 by the Department of Ophthalmology in HKL.
Methods: This study included all patients who underwent phacoemulsification during the study period. Poor cataract outcome was classified as spherical equivalent (SE) difference not within 1.0 dioptres (D) of predicted value. SE difference as a dichotomous dependent variable was used in a logistic regression model. Simple logistic regression was performed to determine the association between all risk factors and the outcome. Multiple logistic regression analysis was carried out to determine factors that may affect the probability of poor cataract outcome.
Results: The results showed that phacoemulsification procedures done in HKL achieved the benchmark standards, whereby 87.3% of the patients achieved post-phacoemulsification SE refraction within 1 D of predicted value, while 58.6% were within 0.5 D of predicted value. Female gender (p = 0.015), presence of age-related macular degeneration (ARMD) (p = 0.002), ultrasound biometry technique (p = 0.045), and intraoperative posterior capsule rupture (PCR) (p = 0.018) were associated with poor cataract outcomes. The odds of getting a poor outcome for each factor were 1.73, 6.47, 2.00, and 6.42 times more, respectively.
Conclusion: This study showed that refractive outcomes in HKL are comparable to international standards. Risk factors for poor refractive outcome were female gender, ARMD, ultrasound biometry technique, and PCR.