Efficacy, safety and visual outcomes of cataract surgeries performed during blindness prevention programs in different locations in Kenya

Purpose To determine the visual outcomes achieved in terms of efficacy and safety during high-volume cataract surgery programs in different locations in Kenya. Methods Eight hundred eighty-one eyes of 849 patients underwent extracapsular cataract extraction with intraocular lens implantation in a retrospective, observational, consecutive cohort study on patients who underwent cataract surgery in five programs that a Spanish non-governmental organization conducted between 2013 and 2019 for the prevention of blindness in different geographical areas of Kenya: Thika, Athi River, Kissi, Bagavathi, and Nakuru. The programs were carried out by Spanish and Kenyan surgeons working together. Results Mean age was 66.81 ± 14.47 years. Fifty-one percent of the operated eyes (447 eyes) were women. 94% of patients belonged to six ethnic groups. The mean uncorrected distance visual acuity (UDVA) before surgery was 1.98 ± 0.98 logMAR (20/2000), which changed to 0.82 ± 0.68 logMAR (20/150) 3 months after surgeries. The corrected distance visual acuity (CDVA) was 0.4 ± 0.53 logMAR (20/50) 3 months after surgery, 77.5% of the patients had good visual outcomes, and 6.3% had poor outcomes. Preoperative UDVAs were significantly different with respect to the different geographical areas (Kruskal-Wallis; p < 0.001). The most common intraoperative complication was posterior capsule rupture (incidence, 4.2%, 37 of 881), and the most serious complication was expulsive hemorrhage (incidence, 0.1%, 1 of 881). Conclusions Cataract programs performed in a middle-income country with the proper technique and standardized protocols of action improved the visual outcome of the patients. Dissimilar baseline status was found in different areas regarding preoperative visual acuities. Training programs of local surgeons should be reinforced.