Manual Small-Incision Cataract Surgery Outcomes at Al Ihsan Specialist Hospital, Mogadishu, Somalia: A Retrospective Electronic Health Record Study

Abstract Background Cataract remains an important cause of avoidable vision loss in Somalia, but routine data on cataract surgical outcomes are limited. We evaluated the volume, follow-up completeness, recorded visual outcomes, and documented early postoperative events after manual small-incision cataract surgery (SICS) at Al Ihsan Specialist Hospital in Mogadishu. Methods We performed a retrospective, single-centre electronic health record study of manual small-incision cataract surgery (SICS) at Al Ihsan Specialist Hospital, Mogadishu, during 2025. For the visual-outcome analysis, completed unilateral SICS procedures performed from 10 August to 31 December 2025 were linked by patient and operated eye to preoperative legacy VA Examination records (1–180 days before surgery) and postoperative EyeGlass Prescription uncorrected distance visual acuity (UCVA; 8–70 days after surgery). For each eligible surgery, the latest valid preoperative VA and postoperative UCVA closest to day 32 were selected; four clinician-confirmed same-day duplicate procedure records were removed. Broad distance-VA categories were compared descriptively. Electronic same-eye diagnosis and reintervention signals arising within 1–30 days of 2025 SICS were separately screened; these were not considered clinically adjudicated complications. Results The full-year surgical record review identified 4,434 SICS-related records in 4,134 patients; 4,422 were recorded as completed. The revised August–December visual-outcome extraction identified 1,862 completed unilateral SICS records and 230 deduplicated paired patient-eyes in 223 patients. Among these 230 eyes, good VA increased from 20 (8.7%) preoperatively to 83 (36.1%) postoperatively, while poor VA decreased from 159 (69.1%) to 41 (17.8%). VA category improved in 141 (61.3%) eyes, was unchanged in 75 (32.6%), and worsened in 14 (6.1%). Five unique 2025 index SICS procedures had an electronic same-eye diagnosis or reintervention signal within 30 days; clinical causality could not be verified. Conclusions Among patients with deterministically linked, documented preoperative measurements and subsequent EyeGlass UCVA, distance-VA categories improved in a majority of eyes after SICS. These results apply to a selected documented subgroup, not to all patients undergoing surgery. Mixed routine and spectacle-related follow-up, historical documentation gaps, and unavailable paper-based records constrain inference about hospital-wide outcomes and postoperative safety.