Cataract refers to any opacity of the crystalline lens in the eye and its the leading cause of blindness

worlwide. Approximately 1% of Africans are blind and the major cause is cataract. In fact it accounts for about 50% of blindness in the developing countries. The only permanent cure is surgical intervention. Indications for surgery include reduced visual acuity to a level that interferes with patients function and medical conditions like uveitis or secondary glaucoma due to intumescent cataract. The common techniques of cataract surgery include intracapsuler cataract extraction (ICCE), extracapsular cataract extraction (ECCE) and phacoemulsification. Any of the above can usually be combined with intraocular lens implantation (IOL) be it anterior or posterior chamber type. In congenital cataract, ondraaek and lokaj in their paper recommended that surgery and optical correction should be performed at a very early age i.e., in the sensitive period of binocular visual development, especially if dense opacities are present. With late surgery, good outcomes are achieved in the eyes in which opacity is only partial or is low in density. Common complications of cataract surgery include wound leak, corneal oedema (striate keratitis), hyphaema, uveitis, glaucoma, capsular opacification, endophthalmitis, IOL dislocation (sunrise and sunset syndromes), macular oedema, and retinal detachment. In LUTH, cataract surgery started with the advent of ophtalmology unit but IOL implantation started in june 2000. Prior to that, it used to be ICCE/ECCE with aphakic correction. Now the routine procedure is ECCE with posterior chamber IOL implant unless otherwise indicated. Umeh et al in a report of an on-going British Council Prevention of Blindness sponsored cataract surgical outreach in inyl a rural community in oji river local goverment area of enugu state, nigeria reported that 3 out of 35 i.e. 8.6% of patients operated had complications which include soft lens matter (2.3%), wound gape with uveal prolapse (2.3%) and updrawn pupil (2.3%). However all the cases were done as intra-capsular cataract extraction. Sanjay et al in review of cataract surgeries done at mechi eye care centre in nepal between dec. 1996 and may 1998 reported that a total of 783 eyes were operated and ECCE with PC IOL accounted for 91.3%(715), cataract extraction with AC IOL accounting for 5.1%(40) while lens extraction without IOL implant accounted for 3.6%(28). Twenty-one percent of the patients developed posterior capsular opacification at follow up. Eruchalu in her own study in kaduna state discovered that out of 231 eyes, 119 (i.e.53.6%) had complications with striate keratitis accounting for 30.6% and hyphaema accounting for 10.6%. In adejors study also in kaduna state, he reported pigmen deposit on the IOL surface as the commonest complications after surgery (40%) while posterior capsulaar opacity constitutes 4%. Bekibele in his paper titled anterior chamber intra-ocular lens surgery at St Marys hospital, Ago-Iwoye, Ogun State, Nigeria, the observed complications included, vitreous loss (21.4%), iridodialysis (7.1%), corneal striate (14.3%), posterior capsule opacity (21.4%), uveitis (42.9%) and raised intraocular pressure (14.3%).

Desai in The National Cataracat Surgery Survey: II.Clinical outcomes of a sample of all patients under going cataract surgery in the United Kingdom in 1990 discovered that surgically related complications occured in 22% in the immediate post-operative period, in 18% at the first post-operative out-patient assessment and in 20% of patients at 3 months after surgery. Naeser et al i Complications and visual outcome 4 months after extracapsular cataract extraction with implantation of posterior chamber lenses- Aprospective clinical study, the observed complications were one case (1.5%) of acute iritis, one case of pupillary capture and two (3.0%) cases of capsulotomy-requiring early secondary cataract. Yang et al in Cataract surgery by junior ophtalmologists, reported that 21% had postoperative complications an outcome which compared acceptably with the results of the National Cataract Surgery Survey in Britain.

MATERIALS AND METHODS This study was designed as a retrospective and descriptive study. Patients were thosethat have had cataract surgery done at LUTH from Jan. 1998 to Dec. 2002 The patients case notes and operation notes formed the materials. The data collected from the case notes were analyzed using a computer based analysis with Epi-info 2002. The data included the age, sex, occupation, sypmtoms at presentation, type of surgery, admission period and symptoms after discharge at follow up visits. RESULTS The results are presented inform of Tables and Bar Charts. Table 1 (and figure 1) showsthe types of surgical techniques employed in the treatment of cataract durung this 5-year period. A total of 272 eyes (254 patients) were operated. 29(10.7%) had ICCE only, 36(13.2%) had ECCE only, 6(2.2%) had ICCE with AC IOL implant, 183(67.3%) had ECCE with PC IOL implant while 4 each (1.5%) had secondary IOL implant (AC or PC). The number of complications recorded during this period is shown in table II. Out of the 272 eyes operated, 23(ie. 8.5%) developed complications while the remaining 249(ie. 91.5%) were free of complications. Table III (and Figure 3) shows the frequency of the complications seen. Ten of the patients (43.5%) of the total complications had wound gape with uveal prolapse, 7 develop posterior capsular opacity (30.4%), 3(13%) had hyphaema, 2(8.7%) developed infective endophthalmitis, while 1(4.3%) patients had corneal decompensation.