{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T08:23:04Z","timestamp":1784276584046,"version":"3.55.0"},"reference-count":58,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2024,12,9]],"date-time":"2024-12-09T00:00:00Z","timestamp":1733702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Cataract, despite being treatable, persists to have a devastating impact on people\u2019s health and livelihoods all over the world. In Sub-Saharan Africa (SSA), 1.7 million people are blind and 6.94 million are visually impaired due to cataract. Also, Cataract surgery outcomes remain below the World Health Organization (WHO) recommendations in SSA. Hence, this review aimed to estimate the pooled prevalence and associated factors of poor post-operative visual outcome in SSA.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Method<\/jats:title>\n<jats:p>An intensive literature search was performed from PubMed, Google Scholar, EMBASE, HINARI, Scopus, and Web of Sciences. Data were extracted by using a pre-tested and standardized data extraction format and analyzed by using STATA 17 statistical software. I<jats:sup>2<\/jats:sup> tests to appraise the heterogeneity across the included studies, a random-effect model to estimate the pooled prevalence, and a sub-group analysis to discern the viable source of heterogeneity were executed. Potential publication bias was also assessed by funnel plot, Egger\u2019s weighted correlation, and Begg\u2019s regression. The odds ratio with its 95% confidence was used to reckon the association between the prevalence and factors.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Result<\/jats:title>\n<jats:p>From 201 identified studies, 25 articles were included. The pooled prevalence of poor post-operative visual outcome of cataract surgery in SSA was 14.56% (95% CI 11.31, 17.81). The presence of intra-operative complications (AOR = 2.99, 95% CI: 1.79, 4.98) and the presence of post-operative complications (AOR = 3.56, 95% CI: 2.86, 4.43) were statistically significant with the pooled poor post-operative visual outcome. According to the subgroup analysis, the pooled prevalence of poor post-operative visual outcome was found lower in phacoemulsification, with a sub-pooled prevalence of 12.32% (95% CI 7.89, 16.74) compared to incisional with a sub-pooled prevalence of 16.28% (95% CI 10.98, 21.59).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>This meta-analysis revealed that a substantial proportion of cataract-operated patients had poor post-operative visual outcome. The presence of intra-operative complications and post-operative complications were independent predictors of poor post-operative visual outcome. Therefore, improvement of post-operative visual outcome through decreasing intra-operative complications, managing post-operative complications, and investing in specialized training and equipment for ophthalmic surgeons are pivotal and need significant emphasis.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0315263","type":"journal-article","created":{"date-parts":[[2024,12,9]],"date-time":"2024-12-09T18:31:42Z","timestamp":1733769102000},"page":"e0315263","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["Through the fog: Systematic review and meta-analysis of the prevalence and associated factors of poor post-operative visual outcome of cataract surgery in Sub-Saharan Africa"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-4003-207X","authenticated-orcid":true,"given":"Zufan Alamrie","family":"Asmare","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9278-6826","authenticated-orcid":true,"given":"Beminate Lemma","family":"Seifu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bezawit Melak","family":"Fente","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1332-670X","authenticated-orcid":true,"given":"Yohannes Mekuria","family":"Negussie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiwot Altaye","family":"Asebe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meklit Melaku","family":"Bezie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamaru","family":"Melkam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angwach Abrham","family":"Asnake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,12,9]]},"reference":[{"issue":"9","key":"pone.0315263.ref001","first-page":"25","article-title":"Vision loss, access to eye care and Quality of cataract surgery in a marginalised population: The Karachi Marine Fishing Communities Eye and General Health Survey.Doctoral dissertation","volume":"110","author":"KS Ahmad","year":"2013","journal-title":"UNSW Sydney"},{"issue":"12","key":"pone.0315263.ref002","first-page":"2377","article-title":"Global prevalence of vision impairment and blindness: magnitude and temporal trends, 1990\u20132010","volume":"120","author":"GA Stevens","year":"2013","journal-title":"Ophthalmology"},{"issue":"11","key":"pone.0315263.ref003","first-page":"2156","article-title":"Global estimates on the number of people blind or visually impaired by cataract: a meta-analysis from 2000 to 2020.Eye","volume":"38","author":"Vision Loss Expert Group of the Global Burden of Disease Study","year":"2024"},{"issue":"3","key":"pone.0315263.ref004","first-page":"204","article-title":"Prevalence and causes of blindness and low vision in Ethiopia.","volume":"21","author":"Y Berhane","year":"2007","journal-title":"Ethiopian Journal of Health Development"},{"issue":"67","key":"pone.0315263.ref005","first-page":"37","article-title":"Changing patterns in global blindness: 1988\u20132008","volume":"21","author":"A Foster","year":"2008","journal-title":"Community Eye Health Journal"},{"issue":"7559","key":"pone.0315263.ref006","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1136\/bmj.333.7559.128","article-title":"Cataract and surgery for cataract","volume":"333","author":"D Allen","year":"2006","journal-title":"British Medical Journal"},{"issue":"2","key":"pone.0315263.ref007","first-page":"146","article-title":"Cataract surgical coverage An important indicator for eye health and for monitoring progress towards Universal Health Coverage","volume":"26","author":"Z Gray","year":"2015","journal-title":"London International Agency for the Prevention of Blindness. Oman Journal of Ophthalmology"},{"issue":"7","key":"pone.0315263.ref008","first-page":"49","article-title":"Visual impairment in the elderly: impact on functional ability and quality of life.","volume":"19","author":"JJ Servat","year":"2011","journal-title":"Clinics in geriatric medicine."},{"issue":"2","key":"pone.0315263.ref009","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1017\/S0959259806002061","article-title":"The aging eye","volume":"16","author":"JJ Ah-Chan","year":"2006","journal-title":"Reviews in Clinical Gerontology"},{"issue":"12","key":"pone.0315263.ref010","doi-asserted-by":"crossref","first-page":"1658","DOI":"10.1136\/bjophthalmol-2019-315217","article-title":"Prevalence and causes of vision loss in sub-Saharan Africa in 2015: magnitude, temporal trends and projections","volume":"104","author":"K Naidoo","year":"2020","journal-title":"British Journal of Ophthalmology"},{"issue":"2","key":"pone.0315263.ref011","first-page":"1409","article-title":"What are the priorities for improving cataract surgical outcomes in Africa?","volume":"38","author":"J Buchan","year":"2018","journal-title":"Results of a Delphi exercise. 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Khanna","year":"2020","journal-title":"PLoS One"},{"key":"pone.0315263.ref033","article-title":"Outcome of Age Related Cataract Surgery at Mbingo Baptist Hospital Eye Unit, North West Region, Cameroon: Doctoral dissertation,","author":"KP Beyiah","year":"2016","journal-title":"University of Nairobi;"},{"issue":"6","key":"pone.0315263.ref034","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1007\/s00417-022-05964-4","article-title":"Assessment of cataract surgery outcomes in Nampula (Mozambique): visual acuity, visual function and quality of life.","volume":"261","author":"DB Sengo","year":"2023","journal-title":"Graefe\u2019s Archive for Clinical and Experimental Ophthalmology"},{"issue":"1","key":"pone.0315263.ref035","doi-asserted-by":"crossref","first-page":"e37","DOI":"10.1016\/S2214-109X(13)70003-2","article-title":"Assessment of cataract surgical outcomes in settings where follow-up is poor: PRECOG, a multicentre observational study","volume":"1","author":"N Congdon","year":"2013","journal-title":"The Lancet Global health"},{"issue":"1","key":"pone.0315263.ref036","doi-asserted-by":"crossref","first-page":"8","DOI":"10.4314\/aipm.v9i1.72428","article-title":"Visual outcome after cataract surgery at the University College Hospital, Ibadan.","volume":"9","author":"O Olawoye","year":"2011","journal-title":"Annals of Ibadan Postgraduate Medicine."},{"issue":"1","key":"pone.0315263.ref037","doi-asserted-by":"crossref","first-page":"25","DOI":"10.4103\/1596-3519.126943","article-title":"Outcome of cataract surgery in rural areas of Kaduna State, Nigeria.","volume":"13","author":"KK Oladigbolu","year":"2014","journal-title":"Annals of African medicine."},{"issue":"1","key":"pone.0315263.ref038","doi-asserted-by":"crossref","first-page":"15","DOI":"10.25259\/GJCSRO_4_2021","article-title":"Visual outcome of cataract surgery from a free outreach camp among rural areas of Southern-Kaduna, Nigeria.","volume":"1","author":"SS 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Umerji","year":"2020","journal-title":"Doctoral dissertation, The University of Zambia"},{"issue":"3","key":"pone.0315263.ref045","first-page":"21","article-title":"Visual outcomes in manual small incision cataract surgery versus phacoemulsification: a prospective comparative data analysis","volume":"14","author":"S Moodley","year":"2019","journal-title":"South African Ophthalmology Journal"},{"issue":"2","key":"pone.0315263.ref046","first-page":"241","article-title":"Visual outcome of cataract surgery in a field hospital of sub-Saharan Africa","volume":"61","author":"S. Ahmad","year":"2011","journal-title":"Pakistan Armed Forces Medical Journal"},{"issue":"5","key":"pone.0315263.ref047","first-page":"22","article-title":"Functional Results and Patient Satisfaction after Cataract Surgery by Phacoemulsification in Gabon: R\u00e9sultats Fonctionnels et Satisfaction des Patients apr\u00e8s Chirurgie de la Cataracte par Phaco\u00e9mulsification au Gabon","volume":"2","author":"P, DA MA Assoumou","year":"2024","journal-title":"HEALTH RESEARCH IN AFRICA"},{"issue":"3","key":"pone.0315263.ref048","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1136\/bjo.87.3.266","article-title":"Sutureless cataract surgery with nucleus extraction: outcome of a prospective study in Nepal","volume":"87","author":"A Hennig","year":"2003","journal-title":"British Journal of Ophthalmology"},{"issue":"9","key":"pone.0315263.ref049","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.1136\/bjo.2004.063479","article-title":"Outcomes of high volume cataract surgeries in a developing country","volume":"89","author":"R Venkatesh","year":"2005","journal-title":"British Journal of Ophthalmology"},{"issue":"2","key":"pone.0315263.ref050","doi-asserted-by":"crossref","first-page":"147","DOI":"10.4103\/1119-3077.183249","article-title":"Refractive aim and visual outcome after phacoemulsification: A 2\u2011year review from a Tertiary Private Eye Hospital in Sub\u2011Saharan Africa.","volume":"20","author":"O Oderinlo","year":"2017","journal-title":"Nigerian Journal of Clinical Practice"},{"issue":"11","key":"pone.0315263.ref051","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1136\/bjophthalmol-2017-310324","article-title":"Management of postoperative inflammation after cataract and complex ocular surgeries: a systematic review and Delphi survey","volume":"101","author":"F Aptel","year":"2017","journal-title":"British Journal of Ophthalmology"},{"issue":"2","key":"pone.0315263.ref052","doi-asserted-by":"crossref","first-page":"385","DOI":"10.54361\/ajmas.2472026","article-title":"Cataract Surgery in Camp Patients; A Study on Visual Outcomes.","volume":"25","author":"H Gaith","year":"2024","journal-title":"AlQalam Journal of Medical and Applied Sciences"},{"issue":"1","key":"pone.0315263.ref053","first-page":"2234","article-title":"Chirurgie de la cataracte chez une population de diab\u00e9tiques alg\u00e9riens","volume":"9","author":"M Naili","year":"2023","journal-title":"Maghrebian Journal of Pure and Applied Science"},{"issue":"4","key":"pone.0315263.ref054","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.1038\/s41433-020-01335-7","article-title":"Ophthalmology training in sub-Saharan Africa: a scoping review","volume":"35","author":"WH Dean","year":"2021","journal-title":"Eye"},{"issue":"11","key":"pone.0315263.ref055","doi-asserted-by":"crossref","first-page":"1849","DOI":"10.1016\/j.jcrs.2010.05.025","article-title":"Phacoemulsification versus manual small-incision cataract surgery for white cataract.","volume":"36","author":"R Venkatesh","year":"2010","journal-title":"Journal of Cataract & Refractive Surgery."},{"issue":"2","key":"pone.0315263.ref056","first-page":"281","article-title":"Visual outcomes after anterior vitrectomy: comparison of ECCE and phacoemulsification.","volume":"97","author":"JC Bobrow","year":"1999","journal-title":"Transactions of the American Ophthalmological Society"},{"issue":"22","key":"pone.0315263.ref057","doi-asserted-by":"crossref","first-page":"120","DOI":"10.21037\/atm-20-845","article-title":"Cataract complications study: an analysis of adverse effects among 14,520 eyes in relation to surgical experience.","volume":"8","author":"A Aaronson","year":"2020","journal-title":"Annals of translational medicine."},{"issue":"2","key":"pone.0315263.ref058","first-page":"525","article-title":"Management of postoperative inflammation and dry eye after cataract surgery","volume":"38","author":"K Kato","year":"2019","journal-title":"Cornea"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0315263","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,9]],"date-time":"2024-12-09T18:32:02Z","timestamp":1733769122000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0315263"}},"subtitle":[],"editor":[{"given":"Ogugua Ndubuisi","family":"Okonkwo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,12,9]]},"references-count":58,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12,9]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0315263","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,9]]}}}