Evaluating the outcomes of glaucoma surgeries at a tertiary eye hospital in Blantyre, Malawi
| dc.contributor.author | Mhango, Priscilla | |
| dc.date.accessioned | 2021-11-25T10:38:36Z | |
| dc.date.available | 2021-11-25T10:38:36Z | |
| dc.date.issued | 2021-01-13 | |
| dc.description.abstract | Glaucoma is the second commonest cause of blindness and the most common cause of irreversible blindness worldwide. In developing countries, where the treatment options are limited, management of glaucoma is challenging. In Malawi, due to various difficulties, including the lack of availability and affordability of a wide range of medical and laser therapies, surgery is usually advised and planned for within a year of diagnosis for most patients. The success rate of surgery depends on several factors, such as the type of surgery performed and the potential complications during the intra and post-operative period. This success rate is typically measured according to the reduction in intraocular pressure (IOP) as well as the post-operative visual acuity. Type of Study This will be a retrospective case series study. Problem There is a paucity of data showing the success rate of adult glaucoma surgery in the Malawian setting. This study aims to establish a baseline success rate of glaucoma surgeries at a tertiary eye hospital in Blantyre. Objectives Broad To describe the clinical profile and outcomes of adult glaucoma surgeries at LSFEH Blantyre, Malawi in order to generate therapeutic data to inform improved disease management. Specific 1. To establish the severity of glaucoma in patients undergoing glaucoma surgeries at LSFEH Blantyre, Malawi 2. To describe determine pre-operative factors associated with post-operative IOP in adult glaucoma surgeries at LSFEH Blantyre, Malawi. 3. To establish the post-operative factors associated with post-operative IOP outcome in adult glaucoma surgeries at LSFEH Blantyre, Malawi. 4. To determine the proportion of successful glaucoma surgeries by comparing the post-operative to the preoperative IOP. Study location This study will be carried out at Lions Sight First Eye Hospital, a referral and teaching eye institution at the Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi. Methodology Case files of patients who underwent glaucoma surgeries, specifically trabeculectomy, combined trabeculectomy and cataract surgery and Ahmed valve surgery between March 2019 and February 2020 will be examined. The following information will be collected from the hospital records: age, gender and demographic details. Details on pre-operative assessment such as visual acuity, intraocular pressure, optic disc appearance and previous surgery will be recorded. Additionally, details on surgical findings, post-operative visual acuity, IOP and complications will also be recorded. The required information will be filled into the data collection form (see appendix 1) and entered into an excel spreadsheet. The data will then be exported to STATA version 16 for analysis. The primary outcome measure is post-operative IOP reduction. The mean percentage reduction in IOP will be shown as column charts and mean IOP reduction will be compared using Wilcoxon’s sign ranked test. Additionally, the IOP will be categorised into successful and not successful. Descriptive statistics will be used on and clinical presentation parameters. Categorical data such as gender and age group will be summarised as frequency distribution tables. Data showing the proportion of cases with intraoperative and post-operative complications displayed in pie chart form and the various complications will be presented in bar graphs. A multivariate binary logistic regression model will be used to identify the factors affecting the outcome. Hypothesis We hypothesise that greater than 60% of the patients will have successful glaucoma surgeries. This is based on observational studies from other African countries. Results dissemination Results from the study will be presented at the College of Medicine research dissemination conference with the intention of publishing in peer-reviewed journals. Additionally, a written report of the final research project will be submitted to the College of Medicine Research and Ethics Committee (COMREC), College of Medicine Library and LSFEH Clinical Director. | en_US |
| dc.description.sponsorship | Kamuzu University of Health Sciences | en_US |
| dc.identifier.uri | http://rscarchive.kuhes.ac.mw/handle/20.500.12988/467 | |
| dc.language.iso | en | en_US |
| dc.publisher | Kamuzu University of Health Sciences | en_US |
| dc.relation.ispartofseries | Ethics Protocol;P.11/20/3189 | |
| dc.subject | Research Subject Categories::MEDICINE | en_US |
| dc.title | Evaluating the outcomes of glaucoma surgeries at a tertiary eye hospital in Blantyre, Malawi | en_US |
| dc.type | Plan or blueprint | en_US |