AN AUDIT OF MINOR OPHTHALMIC SURGICAL INTERVENTIONS IN A TERTIARY EYE CARE FACILITY IN NORTHERN NIGERIA.

BACKGROUND: An estimated 285 million persons are visually impaired globally, and 39 million of them are blind. Majority of the blind population reside in developing countries. Over 60% of blindness is attributable to surgical causes of blindness. A surgical audit reveals areas of performance that require improvement.

AIM: To assess the output and pattern of minor ophthalmic surgeries over a seven year period.

METHOD: The minor ophthalmic surgical records of Jos University Teaching Hospital, Jos, Nigeria were retrospectively reviewed to obtain information on the patients'demographics, diagnosis, indication, type of surgery, type of anaesthesia administered, outcome of management, histology report and the rank of surgeon. The data obtained were analyzed using Epi Info Statistical version 3.4, Atlanta, Georgia USA.

RESULTS: A total of 536 patients had minor ophthalmic operations at the Jos University Teaching Hospital between January 2008 and December 2014. There were 281(52.4%) males and 255(47.6%) females (χ(2)=9.4, p>0.1) with a mean age of 37.2 years (SD:24). Furthermore, 41(7.6%) patients had surgery in both eyes. The main anatomical sites of ocular morbidity were eyelid/lashes, conjunctiva and anterior segment observed in 237 (41.1%), 166(28.8%) and 94(16.3%) eyes respectively. Posterior segment lesions as indication for minor surgery was observed in 11(1.9%) eyes in the year 2013 and increased to 38(6.6%) eyes in 2014. Most (75%) minor surgical procedures were performed by resident doctors under supervision (χ(2)=13.7, p<0.05). A total of 584 procedures were performed comprising over 33 different types of minor surgeries. The main surgical procedures included pterygium excision in 104(17.8%) cases, eyelid repair in 74(12.7%) cases and incision and curettage for chalazion in 65(11.1%) cases (χ2=23.9, p<0.001). A recurrence rate of 31.6% and 6.1% was observed in eyes that had pterygium excision and incision and curretage for chalazion respectively; 83.8% of eyelids repaired had no postoperative sequelae while notching of the eyelid margin was observed in 9.4% of eyelids repaired.

CONCLUSION: Minor ophthalmic surgeries constitute an important aspect of comprehensive eye care delivery with significant impact on control of blindness programmes. Most minor ophthalmic surgeries are performed on the ocular adnexa, hence the need for strengthening of the orbito-oculoplastic sub-specialty in the hospital.