Intra and post operative complications and visual outcomes following cataract surgery in leprosy patients.

OBJECTIVES: The occurrence of intra and post operative complications was compared in different groups of leprosy patients. The association between post operative and intra operative complications was studied, and how visual outcomes were affected by these complications. We also share our medical management and surgical techniques that might help minimise intra operative complications and improve visual outcomes.

DESIGN: A retrospective analysis of 1024 cataract operations in 786 leprosy patients over an 11 year period from 1995 to 2006 at Kothara Community Hospital, a rural hospital belonging to The Leprosy Mission Trust India, located in the Amravati district of Maharashtra.

RESULTS: 3.5% of eyes had intra operative complications and 22% of eyes had post operative complications, with no appreciable difference in incidence of intra operative complications in the various groups of patients studied. Post operative uveitis was higher in the MB (3.2%), smear positive (6.5%), UT (6%), eyes with leprosy related ocular disease (6.4%) and lepra reaction (12%) groups. Overall, eyes with leprosy related complications and eyes operated on during lepra reactions had more post operative complications compared to the group without. Visual outcomes for eyes with intra and post operative complications were poorer than the groups without.

CONCLUSIONS: Cataract surgery in the hands of a careful and well trained surgeon, who is familiar with ocular leprosy and can modify the surgical technique as necessary, is safe and associated with minimal intra operative and post operative complications.