Long-term visual outcome among adults availing free cataract surgery in Southern India

Lijiraj Sundararaj; Shajer Shaikh; Rachapalle Reddi Sudhir; Shobhana Chavan; Dhayalan Sunderraj; Ramu Srinivas; Alphones Bhujangrao; Pankaj Vishwakarma; Elizabeth Kurian

doi:10.18203/2394-6040.ijcmph20261787

Authors

Lijiraj Sundararaj Department of Programme Impact and Learning, Mission for Vision, Chennai, Tamil Nadu, India
Shajer Shaikh Department of Programme Impact and Learning, Mission for Vision, Mumbai, Maharashtra, India
Rachapalle Reddi Sudhir Department of Cornea and Refractive Surgery, Sankara Nethralaya, Chennai, Tamil Nadu, India
Shobhana Chavan Department of Programme Impact and Learning, Mission for Vision, Mumbai, Maharashtra, India
Dhayalan Sunderraj Department of Programme Impact and Learning, Mission for Vision, Chennai, Tamil Nadu, India
Ramu Srinivas Department of Programme Impact and Learning, Mission for Vision, Chennai, Tamil Nadu, India
Alphones Bhujangrao Department of Programme Impact and Learning, Mission for Vision, Chennai, Tamil Nadu, India
Pankaj Vishwakarma Department of Programme Impact and Learning, Mission for Vision, Mumbai, Maharashtra, India
Elizabeth Kurian Mission for Vision, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20261787

Keywords:

Cataract surgery, Visual acuity, Long-term follow-up, Low-resource settings, India, Postoperative outcomes

Abstract

Background: Cataract surgery aims to restore vision and independence, yet long-term follow-up in low-resource settings remains low. This study evaluates the sustainability of visual outcomes in patients who received free cataract surgery in South India.

Methods: A multicenter, observational study was conducted among adults who underwent cataract surgery at six tertiary care hospitals in Tamil Nadu and Karnataka. Two cohorts were assessed: individuals operated 2 years prior (n=319) and 4 years prior (n=361). Participants were selected using random-proportional sampling followed by convenience sampling. Data collection included home-based interviews and visual acuity assessment using a Snellen tumbling E chart. Baseline visual acuity obtained from medical records was compared with follow-up measurements. Both uncorrected and pinhole-corrected visual acuity were analyzed in LogMAR units. Paired t-tests and ANOVA were used to assess differences.

Results: In the 2-year cohort, mean uncorrected VA remained stable from baseline (0.34±0.37 LogMAR) to follow-up (0.35±0.30; p=0.08). Pinhole-corrected VA also showed no significant change (0.34±0.36 to 0.25±0.29; p=0.05). In the 4-year cohort, a significant decline in visual acuity was observed. Uncorrected VA worsened from 0.23±0.20 at baseline to 0.31±0.31 at 4 years (p=0.03). Similarly, pinhole-corrected VA declined from 0.17±0.22 to 0.21±0.28 (p=0.01).

Conclusions: While visual outcomes remained stable at 2 years post-surgery, a significant decline was evident at the 4-year follow-up among South Indian patients who underwent free cataract surgery. This underscores the necessity for structured, long-term postoperative care and monitoring systems in resource-limited settings to sustain the initial benefits of cataract intervention and address late complications.

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