Risk factors for suboptimal visual outcomes after cataract surgery: A retrospective study in Guyana

This study aims to assess visual outcomes following cataract surgery and identify key risk factors contributing to suboptimal postoperative vision in Guyana. This retrospective study included 103 patients who underwent cataract surgery between December 2023 and June 2024. Preoperative and postoperative visual acuity were recorded, and patients were categorized into low vision or normal vision groups based on best-corrected visual acuity (BCVA) at 1 month post-surgery. Logistic regression analysis was conducted to identify factors associated with poor visual outcomes. One month after surgery, 24 patients were classified into the low vision group, while 79 had normal vision according to their BCVA. Preoperatively, 96% of patients in the low vision group had BCVA of 20/200 or worse, significantly higher than the 60.8% observed in the normal vision group (P < .05). Ocular comorbidities were present in 67% of patients in the low vision group, significantly higher than the 12.7% observed in the normal vision group (P < .05). Additionally, zonular abnormalities or posterior capsule rupture were found in 33% of the low vision group, compared to only 5% in the normal vision group (P < .05). No statistically significant differences were observed between the 2 groups concerning age, gender, small pupil presence, iris relaxation, or systemic comorbidities. Multivariate logistic regression identified ocular comorbidities and intraoperative zonular abnormalities or posterior capsule rupture as independent risk factors for poor postoperative vision (P < .05). Coexisting ocular comorbidities and intraoperative zonular laxity or posterior capsule rupture are significant risk factors for suboptimal postoperative vision in resource-limited settings like Guyana. Optimizing preoperative assessment and implementing tailored postoperative care strategies may enhance outcomes for high-risk patients.