Audit of Ophthalmic Surgical Interventions in a Resource-deficient Tertiary Eye Care Facility in Sub-Saharan Africa

Background. Ophthalmic surgical intervention is a critical component of therapeutic eye care services. Periodic audit of its output and outcome is needed to monitor service effectiveness and inform evidence-based eye health care reforms, in the spirit of VISION 2020-The Right to Sight. Objectives. To investigate the pattern and results of ophthalmic surgical interventions at the University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria. Methods. The UNTH's eye theatre surgical logbook and patients' clinical charts were retrospectively reviewed, from August 2003-July 2008, to obtain patients' relevant demographic and clinical data. Personnel data were obtained from UNTH's human resources department. Descriptive and analytical statistics were performed. A p<.01 was considered statistically significant. Results. Of the 881 eye operations on 676 patients, cataract extraction (45.1%), pterygium excision (18.4%) and trabeculectomy (7.5%) were the main surgeries performed. The yearly surgical output per surgeon was 23.2. The early outcome was satisfactory for trabeculectomy but sub-optimal for cataract surgery. Surgeries were performed mainly to restore or preserve vision (p<.01). Conclusions. The output and outcome of eye operations at UNTH, Enugu, are sub-optimal. Overcoming surgical uptake barriers, improved pre-operative evaluation, and provisions of micro-surgical consumables are instructive.