Predictors of Time to Recovery from Cataract Surgery among Cataract Patients at Menelik II Comprehensive Specialized Hospital: A Retrospective Follow up Study

Predictors of Time to Recovery from Cataract Surgery among Cataract Patients at Menelik II Comprehensive Specialized Hospital: A Retrospective Follow up Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Predictors of Time to Recovery from Cataract Surgery among Cataract Patients at Menelik II Comprehensive Specialized Hospital: A Retrospective Follow up Study Gininu Wendmeneh Tsegaw, Yilma Chisha Dea, Melkamu Merid Mengesha This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5893698/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 25 Apr, 2025 Read the published version in BMC Ophthalmology → Version 1 posted 16 You are reading this latest preprint version Abstract Background Cataracts are the leading cause of reversible blindness globally, disproportionately affecting populations in low- and middle-income countries. In Ethiopia, cataracts remain a significant public health concern. Despite the effectiveness of cataract surgery in restoring vision, information on recovery time and its predictors remain limited. The aim of this study was to assess time to recovery and its predictors among patients undergoing cataract. Methods A retrospective cohort study was conducted on 459 cataract patients who underwent surgery between January 1 and December 31, 2023. Data were randomly extracted from their medical records between June 1 and August 15, 2024. The Kaplan-Meier method was used to estimate the survival probabilities and compare groups, with significant differences tested using the log-rank test. The Weibull regression with the inverse Gaussian frailty was applied following a goodness-of-fit test to identify predictors of time to recovery. Results are presented as adjusted hazard ratios (AHRs) with 95% confidence intervals (CIs). All statistical tests were declared significant at P-value < 0.05. Results we reviewed 459 patient cards, and 368 (80.17%, 95% CI: 76.26–83.58%) had recovered from a cataract surgery over 7,919.28 person-weeks. The overall incidence rate of recovery was at 46.47 per 1,000 persons per week (95% CI: 41.95–51.47). The median recovery time was at 18.14 weeks (IQR: 12.29–24, 95% CI: 17.14–18.86). Age over 60 years (AHR = 0.25, 95% CI: 0.07–0.96), urban residence (AHR = 1.77, 95% CI: 1.15–2.70), preoperative visual acuity (medium: AHR = 1.98, 95% CI: 1.23–3.18; high: AHR = 5.83, 95% CI: 1.72–19.77), comorbidities (ocular: AHR = 0.30, 95% CI: 0.15–0.61; systemic: AHR = 0.41, 95% CI: 0.22–0.75), type of surgery (phacoemulsification: AHR = 1.98, 95% CI: 1.06–3.67; intracapsular cataract extraction: AHR = 0.14, 95% CI: 0.03–0.89), and complications (intraoperative: AHR = 0.29, 95% CI: 0.12–0.71; postoperative: AHR = 0.17, 95% CI: 0.06–0.47), and surgeries performed by an ophthalmologist (AHR = 3.44, 95% CI: 1.80–6.55) were statistically significant predictors of time to recovery from cataract surgery. Conclusion The median recovery time was shorter than in previous local studies but longer than in developed countries. Improved preoperative assessment, effective comorbidity management, minimizing complications, prioritizing phacoemulsification surgery, and involving skilled ophthalmologists are crucial for enhancing recovery outcomes. Personalized care approaches are recommended to optimize postoperative recovery. Cataract surgery time to recovery from cataract surgery predictors of Ethiopia Figures Figure 1 Figure 2 INTRODUCTION Cataracts are a leading cause of visual impairment and blindness worldwide, particularly in low- and middle-income countries, including Ethiopia ( 1 – 3 ). Globally, approximately 94 million people suffer from distance vision impairment or blindness due to cataracts ( 1 ). Nearly 90% of global blindness cases occur in low-income countries, with cataracts accounting for 50% of these cases, making it a significant yet avoidable cause of blindness ( 1 , 3 ). In Ethiopia, cataracts contribute to 42.3% of low vision cases and 49.9% of blindness cases, adding to the national blindness rate of 1.6% and impaired vision prevalence of 3.7%. Remarkably, more than 80% of these cases are potentially preventable or treatable ( 3 ). The burden of untreated cataracts extends beyond visual impairment. In older adults, cataracts increase the risk of dementia ( 5 ), falls, and road accidents ( 6 , 7 ), significantly reduce quality of life, and contribute to increased mortality ( 8 , 9 ). Cataracts also impose a substantial socioeconomic burden on individuals, families, and communities by affecting physical health, emotional well-being, social connectedness, and economic productivity ( 10 ). Globally, an estimated 30% of disability-adjusted life years (DALYs) lost due to blindness and vision problems are attributed to cataracts( 11 ). Currently, there are no approved medications to prevent or treat cataracts, making surgery the only effective and widely used treatment ( 12 – 15 ). Each year, approximately 9.5 million cataract surgeries are performed worldwide ( 14 ). In low- and middle-income countries, including Ethiopia, cataract surgery is essential for restoring vision ( 4 , 16 ). However, access to cataract surgery in Ethiopia remains limited ( 17 , 18 ), contributing to the high burden of cataract-related blindness and visual impairment ( 19 ). Efforts are underway to improve access to essential eye care services, such as increasing the number of ophthalmologists and establishing eye clinics in underserved areas ( 17 ). Cataract surgery involves removing the clouded lens and replacing it with a clear artificial lens ( 20 ). Following the procedure, the eye needs time to heal and adjust to the new lens. Postoperative recovery varies widely among individuals, with most patients experiencing initial improvements within days but requiring weeks to months for full recovery ( 21 , 22 ). Recovery time is influenced by several factors ( 23 ). While cataract surgery is highly effective, gaps remain in understanding the recovery process, particularly in low-resource settings such as Ethiopia. These gaps present challenges for both patients and healthcare providers. Patients often face uncertainty and unrealistic expectations, complicating their postoperative journey and resulting in increased anxiety, disappointment, and frustration ( 24 , 25 ). For healthcare providers, unclear recovery timelines hinder the delivery of optimal care, affecting follow-up scheduling and patient assessment ( 26 , 27 ). Most research on interventions to improve cataract surgery outcomes has been conducted in high-income countries, leaving significant gaps in evidence from low- and middle-income settings ( 28 ). A retrospective study in northern Ethiopia reported a median recovery time of 23 weeks (IQR: 16–35 weeks) following cataract surgery ( 23 ). However, the full range of factors influencing recovery, including marital status, intraocular lens (IOL) site, operated eye type, ocular comorbidities, intraoperative and postoperative complications, and surgeon status, remains unclear. Therefore, this study aimed to investigate recovery time and its predictors among cataract surgery patients at Menelik II Comprehensive Specialized Hospital. By addressing knowledge gaps in this area, the findings will help patients set realistic recovery expectations and support healthcare providers and policymakers in improving personalized care, planning, and policy development. MATERIALS AND METHODS Study area The study was conducted at Menelik II Comprehensive Specialized Hospital, a public tertiary health facility located in Addis Ababa, the capital of Ethiopia. Established in 1910, the hospital is the country's first and largest ophthalmology center. Managed by the Addis Ababa Health Bureau, it provides specialized eye care services to critically ill patients referred from across Ethiopia. The ophthalmology department is staffed by 22 specialists and 6 subspecialists and is equipped with 60 beds, 45 examination rooms, 4 operating theaters, and dedicated teaching facilities. The hospital offers a range of cataract treatments, including both standard and complex surgeries, and performs between 2,000 and 2,500 cataract surgeries annually on average. Study design and period A one-year facility-based retrospective cohort study was conducted at Menelik II Comprehensive Specialized Hospital. Secondary data were obtained from the electronic medical records system and medical charts of cataract patients treated with cataract surgery between January 1, 2023, and December 31, 2023, which served as the study period. Data were extracted from June 1, 2024, to August 15, 2024. Population Source population All cataract patients were treated with cataract surgery at Menelik II Comprehensive Specialized Hospital Study population All cataract patients were treated with cataract surgery at Menelik II Comprehensive Specialized Hospital from January 1, 2023, to December 31, 2023. Inclusion and exclusion criteria Inclusion criteria The medical records of cataract patients treated with different types of cataract surgery at Menelik II Comprehensive Specialized Hospital between January 1, 2023, and December 31, 2023, were included in the study. Exclusion criteria Cataract patients who had undergone cataract surgery but whose medical records were incomplete were excluded from the study. Incomplete records were defined as missing data on surgery date, patient baseline data, or other important predictors or if the medical charts themselves were unavailable. Sample size and sampling procedure Sample size determination To ensure adequate statistical power for analyzing recovery time from cataract surgery and its predictors, the sample size was calculated using the stpower log-rank test in Stata version 17. The estimation was based on significant predictors of recovery time identified in a previous study conducted in northern Ethiopia, including place of residence (AHR = 1.59), visual acuity (medium: AHR = 4.14; high: AHR = 5.23), type of cataract (traumatic: AHR = 1.75; secondary: AHR = 2.59), and type of surgical procedure (AHR = 1.43) ( 23 ). Assumptions of 80% power, a 5% α error, and a 10% allowance for incomplete data were incorporated into the calculation. The sample sizes estimated for each predictor were compared, and the largest one was selected as the final minimum sample size. This was determined to be 494. Details of these calculations are summarized in Table 1 . Table 1 Sample size calculation for predictors of time to recovery from cataract surgery among cataract patients at Menelik II Comprehensive Specialized Hospital, 2024 Variables Adjusted hazard ratio (AHR) Probability of withdrawal Event Sample size Reference Resident(Urban) 1.59 0.1 152 288 ( 23 ) Medium Visual Acuity 4.14 0.1 22 34 High Visual Acuity 5.23 0.1 18 26 Type of cataract(traumatic) 1.75 0.1 106 196 Type of cataract (Secondary Cataract) 2.59 0.1 42 68 Type of surgery(ECCE + PCIOL) 1.43 0.1 252 494 Note: ECCE: Extracapsular cataract extraction; PCIOL: Posterior chamber intraocular lens Sampling procedures The year 2023 was chosen for record review as it offered the most recent and comprehensive data on the problem under investigation. Medical record numbers (MRNs) of cataract patients who underwent surgery between January 1, 2023, and December 31, 2023, were obtained from the ophthalmic operation room registry to create a sampling frame. A total of 494 MRNs were selected using a computer-generated random sampling technique. The medical records attached to these MRNs were reviewed, and records with missing data were excluded using listwise deletion, as incomplete data could compromise analysis reliability. Ultimately, 459 eligible records meeting the study's inclusion criteria were included in the analysis. Figure 1 summarizes the sampling process. Variables Dependent variable The dependent variable was the time to recovery from cataract surgery, defined as the duration (in weeks) from the date of cataract surgery until recovery was achieved. Independent variables Independent variables included the following: Sociodemographic variables age, sex, and residence Preoperative factors cataract type (e.g., age-related, traumatic, congenital), level of visual acuity, ocular comorbidities (e.g., age-related macular degeneration (AMD), glaucoma, diabetic retinopathy), and systemic comorbidities (e.g., diabetes mellitus, hypertension, cardiovascular diseases). Intraoperative factors Cataract surgery type (e.g., phacoemulsification, manual small-incision cataract surgery), type of anesthesia (e.g., local, general), site of lenses inserted (IOL), intraoperative complications (e.g., intraocular lens dislocation, posterior capsule rupture, vitreous loss) and surgeon status. Postoperative factors postoperative complications (e.g., infection, inflammation, cystoid macular edema, secondary glaucoma, or retinal detachment). Operational definition Recovered In this research, recovery from cataract surgery was defined as the process of restoring a person’s sight, minimizing discomfort, and completing eye healing after the successful removal of a cataract through surgery, as declared by the clinician. Assessment of recovery involves improvements in visual acuity (achieving 6/12 vision or better) and patient satisfaction with their new vision, enabling them to perform daily activities after cataract extraction with lens replacement or intraocular lens implantation( 29 ). Start time the date when surgery was performed Follow-up period From the date of surgery until either to a point where an event or censorship occurs The time to recovery was defined as the duration in weeks from the date of cataract surgery until the patient achieved full recovery. Event the occurrence of full recovery Censored A cataract patient who was treated with cataract surgery but whose outcome was out of follow-up (> 26 weeks), who was lost to follow-up, or who was transferred to other health facilities. Loss to follow-up refers to patients who visited the ophthalmic outpatient department (OPD) three times, were scheduled for a subsequent visit, but did not attend that visit, and whose final outcomes were not recorded. Transferred-out Patients who moved to another health facility with a confirmed written documentation of a transfer out Visual acuity ability to resolve detail at 6 m on a Snellen chart(30). In this study, the participants were categorized as having low acuity (worse than 6/60), medium acuity (6/18 to 6/60), or high acuity (6/12 to 6/18). Ocular comorbidity፡ refers to the presence of one or more additional eye conditions or diseases alongside cataracts in a patient, including age-related macular degeneration (AMD), glaucoma, diabetic retinopathy, retinal detachment, corneal diseases, refractive errors (e.g., myopia, hyperopia, astigmatism),and optic nerve disorders. Systemic comorbidity refers to the presence of other medical conditions or diseases that a cataract patient may have in addition to cataracts, including diabetes mellitus, hypertension, cardiovascular diseases, respiratory disorders, neurological conditions, autoimmune diseases, renal and liver diseases, cancer, and metabolic disorders. Intraoperative complications were assessed by ‘Yes’ or ‘No’ questions and were considered present if the cataract patients experienced adverse events or issues that occurred during the surgical procedure itself, such as intraocular lens dislocation, posterior capsule rupture, corneal edema, or vitreous loss. Postoperative complications were assessed by ‘Yes’ or ‘No’ questions and were considered present if the cataract patients had adverse events that occurred after the surgical procedure was completed, typically within the immediate recovery period or during the healing process, such as infection, inflammation, delayed wound healing, cystoid macular edema, secondary glaucoma, or retinal detachment. Data collection and quality assurance Data were extracted from the electronic medical records system and patient cards of the hospital using a structured checklist adapted from a previous study ( 23 ). Before data collection, the tool was pretested on 5% of the sample size. Two health management information system (HMIS) officers collected the data using the Kobo collection tool under the supervision of an ophthalmic nurse employed at the hospital. Data collectors and supervisor received two days of training on the study purpose, ethical considerations and data extraction protocols. Incomplete follow-up formats were excluded from data extraction. To further ensure data quality, a 10% random sample of the extracted data was re-extracted by the supervisor to verify consistency, and necessary corrections were made. Daily supervision by the supervisor and the principal investigator ensured the completeness, consistency and timely submission of collected data to the Kobo database. Data cleaning was performed post-entry using frequency, cross-tabulation, sorting, and listing to identify missing values and outliers. Any identified errors were corrected by cross-referencing with the original documents. Data processing and statistical analysis Upon completion of the data collection activities, the dataset was exported to Excel and imported into STATA version 17 for analysis. Descriptive statistics summarized baseline characteristics. Continuous variables were assessed for normality using histograms and the Shapiro-Wilk test. Normality was violated (p < 0.001); therefore, the data are presented as medians with interquartile ranges (IQR). Categorical variables are summarized as frequencies and percentages. Recovery time was calculated as the difference between the surgery and recovery dates. Due to the nature of follow-up documentation, it was assumed that some recovery times might be interval-censored, occurring between scheduled visits. To address these potential censoring, a parametric Weibull regression model was used. This model, assuming a Weibull distribution for recovery times, estimated the likelihood of recovery within intervals rather than at specific moments, enabling a more accurate estimation of recovery patterns in the study population. Four-week interval recovery probabilities were estimated using a life table. The Kaplan‒Meier survival estimator was used to determine the median recovery time and to generate survival curves for comparing recovery times across groups. The log-rank test was used to assess significant differences in survival functions between these groups. We assessed the proportional hazards and multicollinearity assumptions to ensure model validity. The proportional hazards assumption was confirmed using the Schoenfeld residuals global test (p = 0.421). Multicollinearity was evaluated using the variance inflation factor (VIF), with all values below the threshold of 10 (highest VIF = 9.54). No multicollinearity violations were detected. Detailed results are provided in Table 7 of Annex I. Survival models were compared on the basis of log-likelihood, Akaike information criterion (AIC), and Bayesian information criterion (BIC) values to identify the best fit. The Weibull regression model with inverse Gaussian frailty was selected as the preferred model, with a log-likelihood of -173.09, an AIC of 398.19, and a BIC of 505.55. This model accounts for individual variation in recovery times and unobserved heterogeneity by incorporating the Weibull distribution and inverse Gaussian frailty. See Table 8 of Annex I for details. Predictors of time to recovery were identified using bivariable and multivariable Weibull regression with inverse Gaussian frailty models. Initially, a bivariable Weibull regression model with a crude hazard ratio was used to identify candidate variables for the multivariable Weibull regression model at a P value < 0.25. All identified candidate variables were subsequently incorporated into the multivariable Weibull regression model. The findings were presented using adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) to measure the strength of the association, and statistical significance was declared at a P value < 0.05. Variables that were statistically significant in the multivariate analysis were considered independent predictors of time to recovery from cataract surgery. RESULTS Sociodemographic characteristics of the study participants The records of 494 cataract patients who underwent surgery in 2023 were reviewed. Of these, 35 patients (7.1%) had incomplete medical records and were excluded, leaving 459 (92.9%) for analysis. Among the included patients, 234 (50.98%) were male, and nearly two-thirds (293/459; 63.83%) resided in urban areas. The participants' ages ranged from 1 to 94 years, with a median age of 60 years (IQR = 21 years). A large proportion of the patients, 207 patients (45.10%), were over 60 years old, whereas 146 (31.81%) were aged 46 to 60 years (Table 2 ). Table 2 Sociodemographic characteristics of cataract patients treated with cataract surgery at Menelik II Comprehensive Specialized Hospital from January 1, 2023, to December 31, 2023(n = 459). Variables Category Frequency Percent (%) Sex Male 234 50.98 Female 225 49.02 Age in years 60 Age 207 45.10 Residence Rural 168 36.60 Urban 291 63.40 Marital status Single 85 18.52 Married 348 75.82 Divorced 11 2.40 Widowed 15 3.27 Preoperative characteristics of the study participants Age-related cataracts were the most prevalent cataract, affecting 316 (68.85%) of the patients. Over two-thirds of the patients (315, 68.63%) had low visual acuity before surgery. Ocular comorbidities were present in 23.97% of patients, with glaucoma being the most common (66.36%). Systemic comorbidities affected 20.70% of the patients, with hypertension being the most prevalent (69.47%), followed by diabetes mellitus (33.68%) (Table 3 ). Table 3 Preoperative characteristics of cataract patients treated with cataract surgery at Menelik II Comprehensive Specialized Hospital from January 1, 2023, to December 31, 2023(n = 459). Variables Category Frequency Percent (%) Types of cataract Age related cataract 316 68.85 Traumatic cataract 61 13.29 Congenital cataract 23 5.01 Secondary cataract 59 12.85 Level of Visual acuity Low 315 68.63 Medium 111 24.18 High 33 7.19 Presences of ocular comorbidities Yes 110 23.97 No 349 76.03 Ocular comorbidity Glaucoma 73 66.36 Age related macular degeneration 14 12.73 Uveitis 13 11.82 Diabetic retinopathy 8 7.27 Other ocular comorbidity 7 6.36 Presences of systemic comorbidities Yes 95 20.70 No 364 79.30 Systemic comorbidity Hypertension 66 69.47 Diabetes mellitus 32 33.68 Asthma 6 6.32 HIV/AIDS 6 6.32 Cardiovascular disease 4 4.21 Other systemic comorbidities 3 3.16 Note: Other ocular comorbidities include myopia, ocular hypertension, conjunctivitis, and disorders of the cornea; other systemic comorbidities include chronic kidney disease and cancer Intraoperative characteristics Small-incision cataract extraction (SICE) was the most common (73.42%) surgical procedure, and local anesthesia was predominantly (92.59%) used. The majority (91.50%) of lens insertions occurred in the posterior chamber. A greater proportion of surgeries were performed by ophthalmologists (54.47%) than by ophthalmology residents (45.53%). Intraoperative complications occurred in 8.71% of the patients, with capsular tears being the most commonly observed, accounting for 50% of those with complications. See Table 4 for details. Table 4 Intraoperative characteristics of cataract patients treated with cataract surgery at Menelik II Comprehensive Specialized Hospital from January 1, 2023, to December 31, 2023(n = 459) Variables Category Frequency Percent (%) Types of cataract surgery Intracapsular Cataract Extraction 8 1.74 Extracapsular Cataract Extraction 74 16.12 Small Incision Cataract Extraction 337 73.42 Phacoemulsification (Phaco) 40 8.71 Type of anesthesia Local anesthesia 425 92.59 General anesthesia 34 7.41 Site of lens inserted Posterior chamber 420 91.50 Sulcus fixated 25 5.45 Anterior chamber 14 3.05 Eye operated Oculus Dexter (OD) 237 51.63 Oculus Sinister (OS) 217 47.28 Oculus Uterque (OU) 5 1.09 Presences of intraoperative complication Yes 40 8.71 No 419 91.29 Intraoperative complication Capsular tears 20 50.00 Vitreous loss 7 17.50 Iris prolapse 6 15.00 Corneal edema 4 10.00 Intraocular lens dislocation 3 7.5 Others 3 7.5 Surgeon status Ophthalmologist 250 54.47 Ophthalmology resident 209 45.53 Note: Other intraoperative complications include posterior capsule rupture, iris tear, and uveal prolapse. Postoperative characteristics Among the 459 patients, 53 (11.55%) experienced postoperative complications. The most common complications were inflammation 12 (22.64% of cases) and increased intraocular pressure (IOP) 11 (20.75% of cases). Other notable complications included posterior capsular opacification (PCO) in 8 patients (15.09% of cases) and infection in 7 patients (13.21% of cases). The less frequent complications were retinal detachment (6, 11.32%), secondary glaucoma (5, 9.43%) and others (cystoid macular edema and cataract lens fragments) (5, 9.43%). Overall, the majority of patients (406; 88.45%) did not experience any postoperative complications. 5.5. Time to recovery of patients who underwent cataract surgery Overall, 459 cataract patients were followed for a total of 7,919.28 person-weeks. At the end of the study period, 368 (80.17%) patients had recovered after cataract surgery. The overall incidence rate of recovery was 46.47 (95% CI: 41.95–51.47) per 1000 persons per week. The overall median recovery time of patients was 18.14 weeks (IQR = 12.29–24), with (95% CI = 17.14–18.86) (Fig. 2 ). The life table showed a gradual decrease in survival probability (i.e., not yet recovered) after cataract surgery, from 0.9978 at 4 weeks to 0.7665 at 8–12 weeks, 0.4150 at 16–20 weeks, and 0.1209 at 24–28 weeks, indicating that most recoveries occurred between 8 and 20 weeks (Table 5 ). Table 5 Life table of patient survival probabilities at 4-week intervals for the time to recovery from cataract surgery at Menelik II Comprehensive Specialized Hospital from January 1, 2023, to December 31, 2023 Interval Total at the beginning Recovery Lost Survival [95% CI] 0–4 459 1 11 0.9978 0.9845–0.9997 4–8 447 22 3 0.9485 0.9235–0.9655 8–12 422 81 0 0.7665 0.7243–0.8030 12–16 341 73 1 0.6021 0.5550–0.6459 16–20 267 83 0 0.4150 0.3689–0.4603 20–24 184 68 6 0.2591 0.2191–0.3007 24–28 110 40 70 0.1209 0.0887–0.1584 Time to recovery among different groups of cataract patients Kaplan–Meier survival curves and log-rank tests were used to assess differences in recovery times across categorical variables. Shorter recovery was observed among younger patients (31–45 years: 13.43 weeks, P = 0.0007), married individuals (17.71 weeks, P < 0.0246), urban residents (16.85 weeks, P = 0.0004), patients with secondary cataracts (12.43 weeks, P < 0.0001), those undergoing phacoemulsification (13.43 weeks), patients with high preoperative visual acuity (12.43 weeks, P < 0.0001), and surgeries performed by ophthalmologists (14.29 weeks, P < 0.0001). Patients without comorbidities or complications also had significantly shorter recovery times (P < 0.001). No significant differences were found by sex, anesthesia type, lens insertion site, or the eye operated on. Kaplan–Meier curves (Fig. 3 , Annex I) and log-rank test results (Table 9 , Annex I) provide further details. Predictors of time to recovery from cataract surgery In the initial analysis, a bivariable Weibull regression with inverse Gaussian frailty was used to determine the effect of each covariate on the time-to-recovery before proceeding to the multivariable analysis; at a value of p < 0.25 relaxed level of significance. The analysis revealed that age, marital status, residence, level of visual vacuity, type of cataract, presence of ocular comorbidities, presence of systemic comorbidities, type of cataract surgery, site of lens insertion, presence of intraoperative complications, status of the surgeon and presence of postoperative complications had significant effects on recovery time at this significance level. After the first analysis, a multivariable Weibull regression model with an inverse Gaussian frailty component was employed at a significance level of p < 0.05 to adjust for confounding variables while accounting for unobserved heterogeneity among individuals. The results revealed that patients over 60 years of age had a 75% slower recovery rate than did those under 16 years (AHR = 0.25, 95% CI: 0.07–0.96), whereas cataract patients living in urban areas recovered 77% faster than those in rural areas (AHR = 1.77, 95% CI: 1.15–2.70). Patients with a medium level of preoperative visual acuity experienced a 98% faster recovery time compared to those with low visual acuity (AHR = 1.98, 95% CI: 1.23–3.18), whereas patients with high visual acuity experienced a more than fivefold faster recovery time (AHR = 5.83, 95% CI: 1.72–19.77). Patients with ocular comorbidities had a 70% slower recovery rate (AHR = 0.30, 95% CI: 0.15–0.61), whereas those with systemic comorbidities had a 59% slower recovery rate (AHR = 0.41, 95% CI: 0.22–0.75). Patients who underwent phacoemulsification surgery achieved a 98% faster recovery time than did those who underwent small-incision cataract extraction (SICE) (AHR = 1.98, 95% CI: 1.06–3.67). In contrast, patients who underwent intracapsular cataract extraction (ICCE) were significantly associated with an 86% slower recovery time (AHR = 0.14, 95% CI: 0.03–0.89). Patients who underwent surgery by ophthalmologists experienced more than three times faster recovery rates (AHR = 3.44, 95% CI: 1.80–6.55) than those who underwent surgery by residents. Patients with intraoperative complications had a 71% slower recovery compared to those without complications (AHR = 0.29, 95% CI: 0.12–0.71), and patients with postoperative complications experienced an 83% slower recovery compared to those without postoperative complications (AHR = 0.17, 95% CI: 0.06–0.47). A significantly high degree of frailty (θ = 2.23) was observed, indicating substantial unobserved heterogeneity in recovery rates among patients. This suggests that unmeasured factors (e.g., patient characteristics not included in the model) contributed significantly to differences in recovery rates between individuals (Table 6 ). Table 6 Weibull regression with an inverse Gaussian frailty analysis of the recovery time after cataract surgery at Menelik II Comprehensive Specialized Hospital, 2024 (n = 459) Variables Category Survival status CHR (95% CI) AHR (95% CI) P value Recovered (N = 368) Censored (N = 91) Age in years 60 Age 157 50 0.54(0.26–1.10) 0.25(0.07–0.96) 0.044* Marital status Single 71 14 1(reference) 1(reference) Married 282 66 0.99(0.62–1.58) 2.09(0.99–4.39) 0.051 Divorced 7 4 0.33(0.08–1.41) 0.85(0.23–3.08) 0.800 Widowed 8 7 0.18(0.05–0.63) 0.49(0.14–1.69) 0.259 Residence Rural 125 43 1(reference) 1(reference) 0.008* Urban 243 48 2.05(1.39–3.02) 1.77(1.15–2.70) Types of cataract Age related cataract 239 77 1(reference) 1(reference) Traumatic cataract 57 4 3.65(2.08–6.39) 1.25(0.69–2.27) 0.461 Congenital cataract 21 2 1.09(0.47–2.52) 0.57(0.19–1.72) 0.320 Secondary cataract 51 8 5.18(2.86–9.40) 1.72(0.98-3.00) 0.058 Level of Visual acuity Low 238 77 1(reference) 1(reference) Medium 104 7 2.64(1.69–4.11) 1.98(1.23–3.18) 0.005* High 26 7 7.29(3.52–15.1) 5.83(1.72–19.77) 0.005* Presences of ocular comorbidities Yes 70 40 0.22(0.13–0.34) 0.30(0.15–0.61) 0.001* No 298 51 1(reference) 1(reference) Presences of systemic comorbidities Yes 70 25 0.41(0.25–0.65) 0.41(0.22–0.75) 0.004* No 298 66 1(reference) 1(reference) Types of cataract surgery ICCE 4 4 0.14(0.02–0.87) 0.14(0.03–0.89) 0.037* ECCE 48 26 0.45(0.26–0.78) 0.71(0.43–1.17) 0.180 SICE 278 59 1(reference) 1(reference) Phaoc 38 2 2.49(1.29–4.81) 1.98(1.06–3.76) 0.032* Site lens inserted Posterior chamber 339 81 1(reference) 1(reference) Sulcus fixated 19 6 0.65(0.28–1.48) 0.53(0.24–1.19) 0.124 Anterior chamber 10 4 0.35(0.11–1.10) 0.43(0.15–1.21) 0.109 Presences of intraoperative complication Yes 25 15 0.26(0.13–0.55) 0.29(0.12–0.71) 0.007* No 343 76 1(reference) 1(reference) Surgeon status Ophthalmologist 222 28 4.09(2.90–7.59) 3.44(1.80–6.55) < 0.001* Resident 146 63 1(reference) 1(reference) Presences of postoperative complication Yes 26 27 0.16(0.08–0.32) 0.17(0.06–0.47) 0.001* No 342 64 1(reference) 1(reference) P 5.13(3.18–8.27) 1/p 0.19(0.12–0.31) Theta(θ) 2.23(0.08–64.71) Note: 1 = reference category, * significant at p value < 0.05, ICCE = intracapsular cataract extraction, ECCE = extracapsular cataract extraction, SICE = small-incision cataract extraction, Phaco = phacoemulsification DISCUSSION In this study we assessed the time to recovery following a cataract surgery and its predictors among patients. The overall median recovery time was 18.14 weeks, with 80.17% of patients recovering, and an incidence rate of 46.47 per 1000 person-weeks. Age, residence, preoperative visual acuity, the presence of comorbidities, the type of cataract surgery, the presence of complications, and the surgeon status were independent predictors of recovery time. The median recovery time observed in this study was longer than the recovery periods reported in developed countries, where guidelines suggest that recovery typically occurs between 4 and 12 weeks ( 31 , 32 ). Similarly, the American Academy of Ophthalmology reported that full recovery is usually achieved within 4–8 weeks ( 33 ). This difference can be attributed to variations in patient demographics, surgical techniques, and complication rates between the populations studied ( 34 ). Compared to a previous study conducted in Northern Ethiopia, which reported a median recovery time of 23 weeks ( 23 ), this study observed a shorter recovery period. The difference may be explained by the setting of this study, which was conducted at a tertiary national referral facility in Ethiopia, where severe cases are more commonly managed, potentially leading to prolonged recovery times. However, the use of advanced surgical techniques, such as phacoemulsification, and the expertise of the surgeons may have mitigated the impact of case complexity, resulting in relatively faster recovery compared to other local studies. Patients over 60 years old had a 75% slower recovery compared to those younger than 60. This finding aligns with those of previous studies that have consistently shown that older age is associated with slower recovery after cataract surgery ( 35 , 36 ). Age-related physiological changes, such as reduced wound healing capacity and the presence of multiple comorbidities, are more common in older adults and may contribute to slower recovery. This highlights the importance of tailored clinical approaches for older patients to address their unique needs during the postoperative period. Compared with rural residents, urban residents had a 77% faster recovery. This finding is consistent with studies conducted in other areas, which suggest that urban residents generally have better access to healthcare services, including follow-up care, which likely contributed to their faster recovery ( 23 , 37 ). Furthermore, urban residents may benefit from less physically demanding jobs, making it easier to adhere to postoperative restrictions and their proximity to healthcare facilities allows for regular monitoring and timely interventions. This study indicates that preoperative visual acuity significantly influences recovery time. Patients with medium preoperative visual acuity recovered 98% faster than those with low acuity do, whereas those with high acuity recover more than five times faster. The supporting literature reinforces these findings, suggesting that initial visual acuity is a crucial determinant of recovery time. Studies conducted in Ethiopia and Malaysia link better preoperative acuity to improved postoperative outcomes and faster recovery ( 23 , 38 ). Similarly, studies from China have shown that patients with high preoperative visual acuity are more likely to achieve favorable postsurgery vision ( 39 , 40 ). These insights underscore the critical need for preoperative evaluations to optimize surgical outcomes and recovery trajectories. Cataract patients with systemic comorbidities had a 59% slower recovery rate than did those without comorbidities, a finding consistent with studies from Malaysia, which reported similar impacts of comorbidities on postsugary recovery ( 38 ). Similarly, ocular comorbidities were associated with a 70% reduction in the recovery rate, which aligns with studies from Ethiopia ( 41 ), and The Review of Ophthalmology, which highlighted the challenges posed by glaucoma and other eye conditions to recovery ( 42 ). The slower recovery of these patients may be attributed to the additional burden of managing multiple health issues, complicating the recovery process. These findings emphasize the need for clinicians to address both systemic and ocular comorbidities when planning and managing postoperative care to optimize recovery outcomes. Patients who underwent phacoemulsification recovered 98% faster than those who underwent small-incision cataract surgery (SICS), consistent with studies from Japan and India, which reported fewer complications and less trauma with phacoemulsification ( 43 , 44 ). However, a study on diabetic retinopathy patients indicated that visual improvement might not depend on the surgical technique used ( 45 ). Patients who underwent intracapsular cataract extraction (ICCE) experienced an 86% slower recovery rate than did those who underwent small-incision cataract surgery (SICS), aligning with studies linking intracapsular cataract extraction (ICCE) to higher complication rates and delayed recovery ( 46 ). The faster recovery with phacoemulsification may be attributed to its less invasive nature, minimizing trauma and promoting faster healing. In contrast, slower recovery following intracapsular cataract extraction (ICCE) may be due to larger incisions and sutures, leading to complications like corneal edema and delayed wound healing. Patients who undergo cataract surgery by ophthalmologists recover more than three times faster than those treated by residents do. This highlights the importance of the surgeon’s expertise in ensuring optimal recovery. Studies from the United States, Nigeria, and Israel have revealed that greater surgical experience leads to fewer complications, reduced postoperative corneal edema, and faster recovery ( 47 – 49 ). This emphasizes the need for prioritizing experienced surgeons in cataract surgery to enhance patient recovery and surgical outcomes. This study also revealed that intraoperative and postoperative complications significantly affect recovery times. Intraoperative complications led to a 71% slower recovery, and postoperative complications caused an 83% slower recovery than in patients without complications. These findings align with studies from Spain and India, which reported delayed recovery due to intraoperative events, such as posterior capsule rupture ( 50 , 51 ). Similarly, postoperative complications have been associated with poorer outcomes and prolonged recovery in regions like Finland and the United Kingdom ( 52 , 53 ). The slower recovery may result from the need for additional interventions to manage complications, prolonging the healing process. The delayed recovery may be due to the need for additional interventions to address complications, which prolong the healing process. These findings highlight the importance of adopting meticulous surgical techniques and vigilant postoperative care to minimize complications and improve recovery outcomes. Strengths and Limitations of the study The strength of this study lies in the use of a Weibull survival model with an inverse Gaussian frailty component, which allowed for the assessment of both observed and unobserved factors affecting recovery time. The use of Kobo Collect enhanced data accuracy and quality through built-in validation rules. However, the retrospective nature of data collection from medical records led to the exclusion of important variables, such as socioeconomic status, lifestyle habits, family meals, and surgery duration, which may have affected the accuracy of the findings. Inconsistent documentation and missing data further limited the study's accuracy. Interval-censored data, where recovery times were unknown between follow-up visits, introduced uncertainty into the analysis. Additionally, the single-facility data source limits representativeness and generalizability. These limitations should be considered in future research and clinical practice. Conclusions and recommendations The median recovery time from cataract surgery in this study was longer than in developed countries. Recovery time was significantly influenced by patient age, residence, preoperative visual acuity, comorbidities, surgical techniques, surgeon expertise, and complications. Older patients, those with comorbidities or complications, and those undergoing less advanced surgeries like intra capsular cataract extraction had slower recovery rates. To improve recovery times, enhancing preoperative assessments, improving healthcare access for rural populations, and prioritizing advanced surgical techniques like phacoemulsification are recommended. Strengthening surgeon expertise and minimizing complications will also improve outcomes and narrow the gap between local and developed settings. Abbreviations and acronyms AHR, Adjusted hazard ratio; CI, Confidence Interval; ECCE, Extracapsular cataract extraction; ECCE, Extracapsular cataract extraction; ICCE, Intracapsular cataract extraction; IOL, Intraocular lens; IOP, Intraocular pressure; IQR, Interquartile range; OD, Oculus Dexter; OS, Oculus Sinister; OU, Oculus uterque; PCIOL, Posterior chamber intraocular lens; PCO, Posterior capsular opacification; PCR, Posterior capsule rupture; Phaco, Phacoemulsification; SICE, Small incision cataract extraction Declarations Ethics Approval and Consent to Participate Ethical approval was granted by the Institutional Research Ethics Review Board (IRB) of Arba Minch University, College of Medicine and Health Science, on May 7, 2024 (Protocol number: GW23147). Written authorization was obtained from the Addis Ababa City Administration Health Bureau and the research office of Menelik II Comprehensive Specialized Hospital to access medical records. Informed consent was waived due to the retrospective nature of the study. Patient data were anonymized by using medical record numbers, ensuring that no identifiable information was accessed. Data collection adhered to strict ethical and confidentiality standards. Consent for publication Not applicable Availability of data and material The dataset supporting this research is available from the corresponding author upon reasonable request. This research is original and has not been submitted to or published in any journal. Competing interests The authors declare no competing interests related to this work. Funding This research was financially supported by Arba Minch University, which covered the per diem costs of data collectors and supervisors. The funder had no role in the design, data collection, analysis, interpretation, manuscript preparation, or decision to publish. Authors contributions Gininu Wendmeneh (G.W.), Yilma Chisha (Y.C.) and Melkamu Merid (M.M.) made significant contributions to the conception, design, execution, analysis, and interpretation of the study. G.W. was responsible for data acquisition and management and drafted the initial manuscript. G.W. and M.M. collaboratively conducted a critical review and revision of the manuscript. Y.C. and M.M. supervised the research and managed project administration. All authors read and approved the final manuscript. Corresponding authors Correspondence to Gininu Wendmeneh or Yilma Chisha Acknowledgments We thank Arba Minch University for providing financial support and ethical approval. We also acknowledge the Addis Ababa City Administration Health Bureau for granting ethical approval and facilitating access to the health facility. Our gratitude extends to Menelik II Comprehensive Specialized Hospital for permitting access to patient records. Special gratitude goes to Dr. Getu Jufar, ophthalmologist, for his expert guidance and invaluable assistance. We also acknowledge the data collectors and supervisor for their dedication. Author details 1 Department of Health Service Quality Improvement, Menelik II Comprehensive Specialized Hospital, Addis Ababa, Ethiopia 2 School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia 3 Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden References Bourne RRA, Steinmetz JD, Saylan M, Mersha AM, Weldemariam AH, Wondmeneh TG, et al. Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: The Right to Sight: An analysis for the Global Burden of Disease Study. Lancet Glob Heal. 2021 Feb 1;9(2):e144–60. Kohli T. To end extreme poverty, we must also end blindness | World Economic Forum. 2021. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5893698","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":407662326,"identity":"2d55e2b0-e544-40e0-b27d-6cfaece10210","order_by":0,"name":"Gininu Wendmeneh Tsegaw","email":"data:image/png;base64,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","orcid":"","institution":"Arba Minch University","correspondingAuthor":true,"prefix":"","firstName":"Gininu","middleName":"Wendmeneh","lastName":"Tsegaw","suffix":""},{"id":407662327,"identity":"e23562bc-3980-4a8b-a56c-e29755514414","order_by":1,"name":"Yilma Chisha Dea","email":"","orcid":"","institution":"Arba Minch University","correspondingAuthor":false,"prefix":"","firstName":"Yilma","middleName":"Chisha","lastName":"Dea","suffix":""},{"id":407662328,"identity":"25e27ad0-9634-4e2d-8609-d6f3e02fafe8","order_by":2,"name":"Melkamu Merid Mengesha","email":"","orcid":"","institution":"Arba Minch University","correspondingAuthor":false,"prefix":"","firstName":"Melkamu","middleName":"Merid","lastName":"Mengesha","suffix":""}],"badges":[],"createdAt":"2025-01-24 08:08:26","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5893698/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5893698/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12886-025-04053-4","type":"published","date":"2025-04-25T15:56:55+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":75312401,"identity":"617cb16e-ab1c-42d7-ad26-7de203438f5f","added_by":"auto","created_at":"2025-02-03 09:13:55","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":67662,"visible":true,"origin":"","legend":"\u003cp\u003eA schematic representation of the sampling procedure for the study predictors of time to recovery from cataract surgery among cataract patients at Menelik II Comprehensive Specialized Hospital, 2024\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-5893698/v1/59faf3fe111f6bf203246b04.jpg"},{"id":75312402,"identity":"be216878-1e7a-45cd-a459-aacd53ac6249","added_by":"auto","created_at":"2025-02-03 09:13:55","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":43062,"visible":true,"origin":"","legend":"\u003cp\u003eKaplan–Meier estimator curve for the recovery time of cataract patients at Menelik II Comprehensive Specialized Hospital from January 1, 2023, to December 31, 2023\u003c/p\u003e","description":"","filename":"2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-5893698/v1/a6e73331be8e0e2bee9a7f56.jpg"},{"id":81569801,"identity":"59db0a98-0d81-4994-bbf4-1d3c37ab6564","added_by":"auto","created_at":"2025-04-28 16:11:23","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1684522,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5893698/v1/4b1ba7ba-5616-4df8-adc7-78a8088d11b4.pdf"},{"id":75312407,"identity":"b69a2e79-2af8-46fb-bb8a-d9722fe53bfe","added_by":"auto","created_at":"2025-02-03 09:13:55","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":333288,"visible":true,"origin":"","legend":"","description":"","filename":"AnnexI.docx","url":"https://assets-eu.researchsquare.com/files/rs-5893698/v1/8a430204295c1d5e1218cc74.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Predictors of Time to Recovery from Cataract Surgery among Cataract Patients at Menelik II Comprehensive Specialized Hospital: A Retrospective Follow up Study","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eCataracts are a leading cause of visual impairment and blindness worldwide, particularly in low- and middle-income countries, including Ethiopia (\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Globally, approximately 94\u0026nbsp;million people suffer from distance vision impairment or blindness due to cataracts (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Nearly 90% of global blindness cases occur in low-income countries, with cataracts accounting for 50% of these cases, making it a significant yet avoidable cause of blindness (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). In Ethiopia, cataracts contribute to 42.3% of low vision cases and 49.9% of blindness cases, adding to the national blindness rate of 1.6% and impaired vision prevalence of 3.7%. Remarkably, more than 80% of these cases are potentially preventable or treatable (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe burden of untreated cataracts extends beyond visual impairment. In older adults, cataracts increase the risk of dementia (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e), falls, and road accidents (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e), significantly reduce quality of life, and contribute to increased mortality (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Cataracts also impose a substantial socioeconomic burden on individuals, families, and communities by affecting physical health, emotional well-being, social connectedness, and economic productivity (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Globally, an estimated 30% of disability-adjusted life years (DALYs) lost due to blindness and vision problems are attributed to cataracts(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eCurrently, there are no approved medications to prevent or treat cataracts, making surgery the only effective and widely used treatment (\u003cspan additionalcitationids=\"CR13 CR14\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). Each year, approximately 9.5\u0026nbsp;million cataract surgeries are performed worldwide (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). In low- and middle-income countries, including Ethiopia, cataract surgery is essential for restoring vision (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). However, access to cataract surgery in Ethiopia remains limited (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e), contributing to the high burden of cataract-related blindness and visual impairment (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). Efforts are underway to improve access to essential eye care services, such as increasing the number of ophthalmologists and establishing eye clinics in underserved areas (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eCataract surgery involves removing the clouded lens and replacing it with a clear artificial lens (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). Following the procedure, the eye needs time to heal and adjust to the new lens. Postoperative recovery varies widely among individuals, with most patients experiencing initial improvements within days but requiring weeks to months for full recovery (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). Recovery time is influenced by several factors (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). While cataract surgery is highly effective, gaps remain in understanding the recovery process, particularly in low-resource settings such as Ethiopia. These gaps present challenges for both patients and healthcare providers. Patients often face uncertainty and unrealistic expectations, complicating their postoperative journey and resulting in increased anxiety, disappointment, and frustration (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). For healthcare providers, unclear recovery timelines hinder the delivery of optimal care, affecting follow-up scheduling and patient assessment (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eMost research on interventions to improve cataract surgery outcomes has been conducted in high-income countries, leaving significant gaps in evidence from low- and middle-income settings (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). A retrospective study in northern Ethiopia reported a median recovery time of 23 weeks (IQR: 16\u0026ndash;35 weeks) following cataract surgery (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). However, the full range of factors influencing recovery, including marital status, intraocular lens (IOL) site, operated eye type, ocular comorbidities, intraoperative and postoperative complications, and surgeon status, remains unclear.\u003c/p\u003e \u003cp\u003eTherefore, this study aimed to investigate recovery time and its predictors among cataract surgery patients at Menelik II Comprehensive Specialized Hospital. By addressing knowledge gaps in this area, the findings will help patients set realistic recovery expectations and support healthcare providers and policymakers in improving personalized care, planning, and policy development.\u003c/p\u003e"},{"header":"MATERIALS AND METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy area\u003c/h2\u003e \u003cp\u003eThe study was conducted at Menelik II Comprehensive Specialized Hospital, a public tertiary health facility located in Addis Ababa, the capital of Ethiopia. Established in 1910, the hospital is the country's first and largest ophthalmology center. Managed by the Addis Ababa Health Bureau, it provides specialized eye care services to critically ill patients referred from across Ethiopia. The ophthalmology department is staffed by 22 specialists and 6 subspecialists and is equipped with 60 beds, 45 examination rooms, 4 operating theaters, and dedicated teaching facilities. The hospital offers a range of cataract treatments, including both standard and complex surgeries, and performs between 2,000 and 2,500 cataract surgeries annually on average.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStudy design and period\u003c/h3\u003e\n\u003cp\u003eA one-year facility-based retrospective cohort study was conducted at Menelik II Comprehensive Specialized Hospital. Secondary data were obtained from the electronic medical records system and medical charts of cataract patients treated with cataract surgery between January 1, 2023, and December 31, 2023, which served as the study period. Data were extracted from June 1, 2024, to August 15, 2024.\u003c/p\u003e\n\u003ch3\u003ePopulation\u003c/h3\u003e\n\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eSource population\u003c/h2\u003e \u003cp\u003eAll cataract patients were treated with cataract surgery at Menelik II Comprehensive Specialized Hospital\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStudy population\u003c/h3\u003e\n\u003cp\u003eAll cataract patients were treated with cataract surgery at Menelik II Comprehensive Specialized Hospital from January 1, 2023, to December 31, 2023.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eInclusion and exclusion criteria\u003c/h2\u003e \u003cdiv id=\"Sec9\" class=\"Section3\"\u003e \u003ch2\u003eInclusion criteria\u003c/h2\u003e \u003cp\u003eThe medical records of cataract patients treated with different types of cataract surgery at Menelik II Comprehensive Specialized Hospital between January 1, 2023, and December 31, 2023, were included in the study.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e\n\u003ch3\u003eExclusion criteria\u003c/h3\u003e\n\u003cp\u003eCataract patients who had undergone cataract surgery but whose medical records were incomplete were excluded from the study. Incomplete records were defined as missing data on surgery date, patient baseline data, or other important predictors or if the medical charts themselves were unavailable.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eSample size and sampling procedure\u003c/h2\u003e \u003cdiv id=\"Sec12\" class=\"Section3\"\u003e \u003ch2\u003eSample size determination\u003c/h2\u003e \u003cp\u003eTo ensure adequate statistical power for analyzing recovery time from cataract surgery and its predictors, the sample size was calculated using the stpower log-rank test in Stata version 17. The estimation was based on significant predictors of recovery time identified in a previous study conducted in northern Ethiopia, including place of residence (AHR\u0026thinsp;=\u0026thinsp;1.59), visual acuity (medium: AHR\u0026thinsp;=\u0026thinsp;4.14; high: AHR\u0026thinsp;=\u0026thinsp;5.23), type of cataract (traumatic: AHR\u0026thinsp;=\u0026thinsp;1.75; secondary: AHR\u0026thinsp;=\u0026thinsp;2.59), and type of surgical procedure (AHR\u0026thinsp;=\u0026thinsp;1.43) (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). Assumptions of 80% power, a 5% α error, and a 10% allowance for incomplete data were incorporated into the calculation. The sample sizes estimated for each predictor were compared, and the largest one was selected as the final minimum sample size. This was determined to be 494. Details of these calculations are summarized in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSample size calculation for predictors of time to recovery from cataract surgery among cataract patients at Menelik II Comprehensive Specialized Hospital, 2024\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAdjusted hazard ratio (AHR)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eProbability of withdrawal\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eEvent\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSample size\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eReference\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eResident(Urban)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e152\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e288\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e(\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedium Visual Acuity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh Visual Acuity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eType of cataract(traumatic)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e106\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e196\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eType of cataract (Secondary Cataract)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e68\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eType of surgery(ECCE\u0026thinsp;+\u0026thinsp;PCIOL)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e252\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e494\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003eNote: ECCE: Extracapsular cataract extraction; PCIOL: Posterior chamber intraocular lens\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eSampling procedures\u003c/h2\u003e \u003cp\u003e The year 2023 was chosen for record review as it offered the most recent and comprehensive data on the problem under investigation. Medical record numbers (MRNs) of cataract patients who underwent surgery between January 1, 2023, and December 31, 2023, were obtained from the ophthalmic operation room registry to create a sampling frame. A total of 494 MRNs were selected using a computer-generated random sampling technique. The medical records attached to these MRNs were reviewed, and records with missing data were excluded using listwise deletion, as incomplete data could compromise analysis reliability. Ultimately, 459 eligible records meeting the study's inclusion criteria were included in the analysis. Figure\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e summarizes the sampling process.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eVariables\u003c/h2\u003e \u003cdiv id=\"Sec15\" class=\"Section3\"\u003e \u003ch2\u003eDependent variable\u003c/h2\u003e \u003cp\u003eThe dependent variable was the time to recovery from cataract surgery, defined as the duration (in weeks) from the date of cataract surgery until recovery was achieved.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eIndependent variables\u003c/h2\u003e \u003cp\u003eIndependent variables included the following:\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eSociodemographic variables\u003c/strong\u003e \u003cp\u003eage, sex, and residence\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003ePreoperative factors\u003c/strong\u003e \u003cp\u003ecataract type (e.g., age-related, traumatic, congenital), level of visual acuity, ocular comorbidities (e.g., age-related macular degeneration (AMD), glaucoma, diabetic retinopathy), and systemic comorbidities (e.g., diabetes mellitus, hypertension, cardiovascular diseases).\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eIntraoperative factors\u003c/strong\u003e \u003cp\u003eCataract surgery type (e.g., phacoemulsification, manual small-incision cataract surgery), type of anesthesia (e.g., local, general), site of lenses inserted (IOL), intraoperative complications (e.g., intraocular lens dislocation, posterior capsule rupture, vitreous loss) and surgeon status.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003ePostoperative factors\u003c/strong\u003e \u003cp\u003epostoperative complications (e.g., infection, inflammation, cystoid macular edema, secondary glaucoma, or retinal detachment).\u003c/p\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eOperational definition\u003c/h2\u003e \u003cp\u003e \u003cstrong\u003eRecovered\u003c/strong\u003e \u003cp\u003eIn this research, recovery from cataract surgery was defined as the process of restoring a person\u0026rsquo;s sight, minimizing discomfort, and completing eye healing after the successful removal of a cataract through surgery, as declared by the clinician. Assessment of recovery involves improvements in visual acuity (achieving 6/12 vision or better) and patient satisfaction with their new vision, enabling them to perform daily activities after cataract extraction with lens replacement or intraocular lens implantation(\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e).\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eStart time\u003c/strong\u003e \u003cp\u003ethe date when surgery was performed\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eFollow-up period\u003c/strong\u003e \u003cp\u003eFrom the date of surgery until either to a point where an event or censorship occurs\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eThe time to recovery\u003c/b\u003e was defined as the duration in weeks from the date of cataract surgery until the patient achieved full recovery.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eEvent\u003c/strong\u003e \u003cp\u003ethe occurrence of full recovery\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eCensored\u003c/strong\u003e \u003cp\u003eA cataract patient who was treated with cataract surgery but whose outcome was out of follow-up (\u0026gt;\u0026thinsp;26 weeks), who was lost to follow-up, or who was transferred to other health facilities.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eLoss to follow-up\u003c/b\u003e refers to patients who visited the ophthalmic outpatient department (OPD) three times, were scheduled for a subsequent visit, but did not attend that visit, and whose final outcomes were not recorded.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eTransferred-out\u003c/strong\u003e \u003cp\u003ePatients who moved to another health facility with a confirmed written documentation of a transfer out\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eVisual acuity\u003c/strong\u003e \u003cp\u003eability to resolve detail at 6 m on a Snellen chart(30). In this study, the participants were categorized as having low acuity (worse than 6/60), medium acuity (6/18 to 6/60), or high acuity (6/12 to 6/18).\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eOcular comorbidity፡\u003c/b\u003e refers to the presence of one or more additional eye conditions or diseases alongside cataracts in a patient, including age-related macular degeneration (AMD), glaucoma, diabetic retinopathy, retinal detachment, corneal diseases, refractive errors (e.g., myopia, hyperopia, astigmatism),and optic nerve disorders.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eSystemic comorbidity\u003c/strong\u003e \u003cp\u003erefers to the presence of other medical conditions or diseases that a cataract patient may have in addition to cataracts, including diabetes mellitus, hypertension, cardiovascular diseases, respiratory disorders, neurological conditions, autoimmune diseases, renal and liver diseases, cancer, and metabolic disorders.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eIntraoperative complications\u003c/b\u003e were assessed by \u0026lsquo;Yes\u0026rsquo; or \u0026lsquo;No\u0026rsquo; questions and were considered present if the cataract patients experienced adverse events or issues that occurred during the surgical procedure itself, such as intraocular lens dislocation, posterior capsule rupture, corneal edema, or vitreous loss.\u003c/p\u003e \u003cp\u003e \u003cb\u003ePostoperative complications\u003c/b\u003e were assessed by \u0026lsquo;Yes\u0026rsquo; or \u0026lsquo;No\u0026rsquo; questions and were considered present if the cataract patients had adverse events that occurred after the surgical procedure was completed, typically within the immediate recovery period or during the healing process, such as infection, inflammation, delayed wound healing, cystoid macular edema, secondary glaucoma, or retinal detachment.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eData collection and quality assurance\u003c/h2\u003e \u003cp\u003eData were extracted from the electronic medical records system and patient cards of the hospital using a structured checklist adapted from a previous study (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). Before data collection, the tool was pretested on 5% of the sample size. Two health management information system (HMIS) officers collected the data using the Kobo collection tool under the supervision of an ophthalmic nurse employed at the hospital. Data collectors and supervisor received two days of training on the study purpose, ethical considerations and data extraction protocols. Incomplete follow-up formats were excluded from data extraction. To further ensure data quality, a 10% random sample of the extracted data was re-extracted by the supervisor to verify consistency, and necessary corrections were made. Daily supervision by the supervisor and the principal investigator ensured the completeness, consistency and timely submission of collected data to the Kobo database. Data cleaning was performed post-entry using frequency, cross-tabulation, sorting, and listing to identify missing values and outliers. Any identified errors were corrected by cross-referencing with the original documents.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003eData processing and statistical analysis\u003c/h2\u003e \u003cp\u003eUpon completion of the data collection activities, the dataset was exported to Excel and imported into STATA version 17 for analysis. Descriptive statistics summarized baseline characteristics. Continuous variables were assessed for normality using histograms and the Shapiro-Wilk test. Normality was violated (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001); therefore, the data are presented as medians with interquartile ranges (IQR). Categorical variables are summarized as frequencies and percentages.\u003c/p\u003e \u003cp\u003eRecovery time was calculated as the difference between the surgery and recovery dates. Due to the nature of follow-up documentation, it was assumed that some recovery times might be interval-censored, occurring between scheduled visits. To address these potential censoring, a parametric Weibull regression model was used. This model, assuming a Weibull distribution for recovery times, estimated the likelihood of recovery within intervals rather than at specific moments, enabling a more accurate estimation of recovery patterns in the study population. Four-week interval recovery probabilities were estimated using a life table. The Kaplan‒Meier survival estimator was used to determine the median recovery time and to generate survival curves for comparing recovery times across groups. The log-rank test was used to assess significant differences in survival functions between these groups.\u003c/p\u003e \u003cp\u003eWe assessed the proportional hazards and multicollinearity assumptions to ensure model validity. The proportional hazards assumption was confirmed using the Schoenfeld residuals global test (p\u0026thinsp;=\u0026thinsp;0.421). Multicollinearity was evaluated using the variance inflation factor (VIF), with all values below the threshold of 10 (highest VIF\u0026thinsp;=\u0026thinsp;9.54). No multicollinearity violations were detected. Detailed results are provided in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e7\u003c/span\u003e of Annex I. Survival models were compared on the basis of log-likelihood, Akaike information criterion (AIC), and Bayesian information criterion (BIC) values to identify the best fit. The Weibull regression model with inverse Gaussian frailty was selected as the preferred model, with a log-likelihood of -173.09, an AIC of 398.19, and a BIC of 505.55. This model accounts for individual variation in recovery times and unobserved heterogeneity by incorporating the Weibull distribution and inverse Gaussian frailty. See Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e8\u003c/span\u003e of Annex I for details.\u003c/p\u003e\u003cp\u003ePredictors of time to recovery were identified using bivariable and multivariable Weibull regression with inverse Gaussian frailty models. Initially, a bivariable Weibull regression model with a crude hazard ratio was used to identify candidate variables for the multivariable Weibull regression model at a P value\u0026thinsp;\u0026lt;\u0026thinsp;0.25. All identified candidate variables were subsequently incorporated into the multivariable Weibull regression model. The findings were presented using adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) to measure the strength of the association, and statistical significance was declared at a P value\u0026thinsp;\u0026lt;\u0026thinsp;0.05. Variables that were statistically significant in the multivariate analysis were considered independent predictors of time to recovery from cataract surgery.\u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003eSociodemographic characteristics of the study participants\u003c/h2\u003e \u003cp\u003e The records of 494 cataract patients who underwent surgery in 2023 were reviewed. Of these, 35 patients (7.1%) had incomplete medical records and were excluded, leaving 459 (92.9%) for analysis. Among the included patients, 234 (50.98%) were male, and nearly two-thirds (293/459; 63.83%) resided in urban areas. The participants' ages ranged from 1 to 94 years, with a median age of 60 years (IQR\u0026thinsp;=\u0026thinsp;21 years). A large proportion of the patients, 207 patients (45.10%), were over 60 years old, whereas 146 (31.81%) were aged 46 to 60 years (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSociodemographic characteristics of cataract patients treated with cataract surgery at Menelik II Comprehensive Specialized Hospital from January 1, 2023, to December 31, 2023(n\u0026thinsp;=\u0026thinsp;459).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e234\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e50.98\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e225\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e49.02\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eAge in years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;16 Age\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.19\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16\u0026ndash;30 Age\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31\u0026ndash;45 Age\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10.89\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e46\u0026ndash;60 Age\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e146\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e31.81\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;60 Age\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e207\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e45.10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eResidence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e168\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e36.60\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e291\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e63.40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18.52\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e348\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e75.82\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.27\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003e\u003cb\u003ePreoperative characteristics of the study participants\u003c/b\u003e\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAge-related cataracts were the most prevalent cataract, affecting 316 (68.85%) of the patients. Over two-thirds of the patients (315, 68.63%) had low visual acuity before surgery. Ocular comorbidities were present in 23.97% of patients, with glaucoma being the most common (66.36%). Systemic comorbidities affected 20.70% of the patients, with hypertension being the most prevalent (69.47%), followed by diabetes mellitus (33.68%) (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePreoperative characteristics of cataract patients treated with cataract surgery at Menelik II Comprehensive Specialized Hospital from January 1, 2023, to December 31, 2023(n\u0026thinsp;=\u0026thinsp;459).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eTypes of cataract\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAge related cataract\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e316\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e68.85\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTraumatic cataract\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13.29\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCongenital cataract\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSecondary cataract\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12.85\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eLevel of Visual acuity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e315\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e68.63\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMedium\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e111\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e24.18\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHigh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.19\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePresences of ocular comorbidities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e110\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23.97\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e349\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e76.03\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eOcular comorbidity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGlaucoma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e66.36\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAge related macular degeneration\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12.73\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUveitis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11.82\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDiabetic retinopathy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.27\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther ocular comorbidity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.36\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePresences of systemic comorbidities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20.70\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e364\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e79.30\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003eSystemic comorbidity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHypertension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e69.47\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDiabetes mellitus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e33.68\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAsthma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.32\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHIV/AIDS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.32\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCardiovascular disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.21\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther systemic comorbidities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.16\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eNote: Other ocular comorbidities include myopia, ocular hypertension, conjunctivitis, and disorders of the cornea; other systemic comorbidities include chronic kidney disease and cancer\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003eIntraoperative characteristics\u003c/h2\u003e \u003cp\u003eSmall-incision cataract extraction (SICE) was the most common (73.42%) surgical procedure, and local anesthesia was predominantly (92.59%) used. The majority (91.50%) of lens insertions occurred in the posterior chamber. A greater proportion of surgeries were performed by ophthalmologists (54.47%) than by ophthalmology residents (45.53%). Intraoperative complications occurred in 8.71% of the patients, with capsular tears being the most commonly observed, accounting for 50% of those with complications. See Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e4\u003c/span\u003e for details.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eIntraoperative characteristics of cataract patients treated with cataract surgery at Menelik II Comprehensive Specialized Hospital from January 1, 2023, to December 31, 2023(n\u0026thinsp;=\u0026thinsp;459)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eTypes of cataract surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntracapsular Cataract Extraction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.74\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExtracapsular Cataract Extraction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16.12\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSmall Incision Cataract Extraction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e337\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e73.42\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePhacoemulsification (Phaco)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8.71\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eType of anesthesia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLocal anesthesia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e425\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e92.59\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGeneral anesthesia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.41\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eSite of lens inserted\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePosterior chamber\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e420\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e91.50\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSulcus fixated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.45\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAnterior chamber\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eEye operated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOculus Dexter (OD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e237\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e51.63\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOculus Sinister (OS)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e217\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e47.28\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOculus Uterque (OU)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.09\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePresences of intraoperative complication\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8.71\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e419\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e91.29\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003eIntraoperative complication\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCapsular tears\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e50.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVitreous loss\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17.50\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIris prolapse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCorneal edema\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntraocular lens dislocation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSurgeon status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOphthalmologist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e250\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e54.47\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOphthalmology resident\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e209\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e45.53\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eNote: Other intraoperative complications include posterior capsule rupture, iris tear, and uveal prolapse.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cdiv id=\"Sec23\" class=\"Section3\"\u003e \u003ch2\u003ePostoperative characteristics\u003c/h2\u003e \u003cp\u003eAmong the 459 patients, 53 (11.55%) experienced postoperative complications. The most common complications were inflammation 12 (22.64% of cases) and increased intraocular pressure (IOP) 11 (20.75% of cases). Other notable complications included posterior capsular opacification (PCO) in 8 patients (15.09% of cases) and infection in 7 patients (13.21% of cases). The less frequent complications were retinal detachment (6, 11.32%), secondary glaucoma (5, 9.43%) and others (cystoid macular edema and cataract lens fragments) (5, 9.43%). Overall, the majority of patients (406; 88.45%) did not experience any postoperative complications.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec24\" class=\"Section2\"\u003e \u003ch2\u003e5.5. Time to recovery of patients who underwent cataract surgery\u003c/h2\u003e \u003cp\u003e Overall, 459 cataract patients were followed for a total of 7,919.28 person-weeks. At the end of the study period, 368 (80.17%) patients had recovered after cataract surgery. The overall incidence rate of recovery was 46.47 (95% CI: 41.95\u0026ndash;51.47) per 1000 persons per week. The overall median recovery time of patients was 18.14 weeks (IQR\u0026thinsp;=\u0026thinsp;12.29\u0026ndash;24), with (95% CI\u0026thinsp;=\u0026thinsp;17.14\u0026ndash;18.86) (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThe life table showed a gradual decrease in survival probability (i.e., not yet recovered) after cataract surgery, from 0.9978 at 4 weeks to 0.7665 at 8\u0026ndash;12 weeks, 0.4150 at 16\u0026ndash;20 weeks, and 0.1209 at 24\u0026ndash;28 weeks, indicating that most recoveries occurred between 8 and 20 weeks (Table\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eLife table of patient survival probabilities at 4-week intervals for the time to recovery from cataract surgery at Menelik II Comprehensive Specialized Hospital from January 1, 2023, to December 31, 2023\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInterval\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal at the beginning\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRecovery\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLost\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSurvival\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e[95% CI]\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e0\u0026ndash;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e459\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.9978\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.9845\u0026ndash;0.9997\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4\u0026ndash;8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e447\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.9485\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.9235\u0026ndash;0.9655\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8\u0026ndash;12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e422\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.7665\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.7243\u0026ndash;0.8030\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e12\u0026ndash;16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e341\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.6021\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.5550\u0026ndash;0.6459\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e16\u0026ndash;20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e267\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.4150\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.3689\u0026ndash;0.4603\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e20\u0026ndash;24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e184\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.2591\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.2191\u0026ndash;0.3007\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e24\u0026ndash;28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e110\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.1209\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.0887\u0026ndash;0.1584\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cdiv id=\"Sec25\" class=\"Section3\"\u003e \u003ch2\u003eTime to recovery among different groups of cataract patients\u003c/h2\u003e \u003cp\u003eKaplan\u0026ndash;Meier survival curves and log-rank tests were used to assess differences in recovery times across categorical variables. Shorter recovery was observed among younger patients (31\u0026ndash;45 years: 13.43 weeks, P\u0026thinsp;=\u0026thinsp;0.0007), married individuals (17.71 weeks, P\u0026thinsp;\u0026lt;\u0026thinsp;0.0246), urban residents (16.85 weeks, P\u0026thinsp;=\u0026thinsp;0.0004), patients with secondary cataracts (12.43 weeks, P\u0026thinsp;\u0026lt;\u0026thinsp;0.0001), those undergoing phacoemulsification (13.43 weeks), patients with high preoperative visual acuity (12.43 weeks, P\u0026thinsp;\u0026lt;\u0026thinsp;0.0001), and surgeries performed by ophthalmologists (14.29 weeks, P\u0026thinsp;\u0026lt;\u0026thinsp;0.0001). Patients without comorbidities or complications also had significantly shorter recovery times (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). No significant differences were found by sex, anesthesia type, lens insertion site, or the eye operated on. Kaplan\u0026ndash;Meier curves (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, Annex I) and log-rank test results (Table\u0026nbsp;\u003cspan refid=\"Tab8\" class=\"InternalRef\"\u003e9\u003c/span\u003e, Annex I) provide further details.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec26\" class=\"Section3\"\u003e \u003ch2\u003ePredictors of time to recovery from cataract surgery\u003c/h2\u003e \u003cp\u003eIn the initial analysis, a bivariable Weibull regression with inverse Gaussian frailty was used to determine the effect of each covariate on the time-to-recovery before proceeding to the multivariable analysis; at a value of p\u0026thinsp;\u0026lt;\u0026thinsp;0.25 relaxed level of significance. The analysis revealed that age, marital status, residence, level of visual vacuity, type of cataract, presence of ocular comorbidities, presence of systemic comorbidities, type of cataract surgery, site of lens insertion, presence of intraoperative complications, status of the surgeon and presence of postoperative complications had significant effects on recovery time at this significance level.\u003c/p\u003e \u003cp\u003eAfter the first analysis, a multivariable Weibull regression model with an inverse Gaussian frailty component was employed at a significance level of p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 to adjust for confounding variables while accounting for unobserved heterogeneity among individuals. The results revealed that patients over 60 years of age had a 75% slower recovery rate than did those under 16 years (AHR\u0026thinsp;=\u0026thinsp;0.25, 95% CI: 0.07\u0026ndash;0.96), whereas cataract patients living in urban areas recovered 77% faster than those in rural areas (AHR\u0026thinsp;=\u0026thinsp;1.77, 95% CI: 1.15\u0026ndash;2.70). Patients with a medium level of preoperative visual acuity experienced a 98% faster recovery time compared to those with low visual acuity (AHR\u0026thinsp;=\u0026thinsp;1.98, 95% CI: 1.23\u0026ndash;3.18), whereas patients with high visual acuity experienced a more than fivefold faster recovery time (AHR\u0026thinsp;=\u0026thinsp;5.83, 95% CI: 1.72\u0026ndash;19.77). Patients with ocular comorbidities had a 70% slower recovery rate (AHR\u0026thinsp;=\u0026thinsp;0.30, 95% CI: 0.15\u0026ndash;0.61), whereas those with systemic comorbidities had a 59% slower recovery rate (AHR\u0026thinsp;=\u0026thinsp;0.41, 95% CI: 0.22\u0026ndash;0.75).\u003c/p\u003e \u003cp\u003ePatients who underwent phacoemulsification surgery achieved a 98% faster recovery time than did those who underwent small-incision cataract extraction (SICE) (AHR\u0026thinsp;=\u0026thinsp;1.98, 95% CI: 1.06\u0026ndash;3.67). In contrast, patients who underwent intracapsular cataract extraction (ICCE) were significantly associated with an 86% slower recovery time (AHR\u0026thinsp;=\u0026thinsp;0.14, 95% CI: 0.03\u0026ndash;0.89). Patients who underwent surgery by ophthalmologists experienced more than three times faster recovery rates (AHR\u0026thinsp;=\u0026thinsp;3.44, 95% CI: 1.80\u0026ndash;6.55) than those who underwent surgery by residents. Patients with intraoperative complications had a 71% slower recovery compared to those without complications (AHR\u0026thinsp;=\u0026thinsp;0.29, 95% CI: 0.12\u0026ndash;0.71), and patients with postoperative complications experienced an 83% slower recovery compared to those without postoperative complications (AHR\u0026thinsp;=\u0026thinsp;0.17, 95% CI: 0.06\u0026ndash;0.47). A significantly high degree of frailty (θ\u0026thinsp;=\u0026thinsp;2.23) was observed, indicating substantial unobserved heterogeneity in recovery rates among patients. This suggests that unmeasured factors (e.g., patient characteristics not included in the model) contributed significantly to differences in recovery rates between individuals (Table\u0026nbsp;\u003cspan refid=\"Tab9\" class=\"InternalRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab9\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eWeibull regression with an inverse Gaussian frailty analysis of the recovery time after cataract surgery at Menelik II Comprehensive Specialized Hospital, 2024 (n\u0026thinsp;=\u0026thinsp;459)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eSurvival status\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCHR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAHR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRecovered (N\u0026thinsp;=\u0026thinsp;368)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCensored (N\u0026thinsp;=\u0026thinsp;91)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eAge in years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;16 Age\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(reference)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1(reference)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16\u0026ndash;30 Age\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.68(0.61\u0026ndash;4.60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.75(0.26\u0026ndash;2.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.59\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31\u0026ndash;45 Age\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.70(0.73\u0026ndash;3.93)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.61(0.21\u0026ndash;1.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.36\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e46\u0026ndash;60 Age\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e155\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.73(0.35\u0026ndash;1.51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.34(0.10\u0026ndash;1.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.084\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;60 Age\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e157\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.54(0.26\u0026ndash;1.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.25(0.07\u0026ndash;0.96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.044*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(reference)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1(reference)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e282\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.99(0.62\u0026ndash;1.58)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.09(0.99\u0026ndash;4.39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.051\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.33(0.08\u0026ndash;1.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.85(0.23\u0026ndash;3.08)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.800\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.18(0.05\u0026ndash;0.63)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.49(0.14\u0026ndash;1.69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.259\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eResidence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e125\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(reference)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1(reference)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.008*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e243\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.05(1.39\u0026ndash;3.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.77(1.15\u0026ndash;2.70)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eTypes of cataract\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAge related cataract\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e239\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(reference)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1(reference)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTraumatic cataract\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.65(2.08\u0026ndash;6.39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.25(0.69\u0026ndash;2.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.461\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCongenital cataract\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.09(0.47\u0026ndash;2.52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.57(0.19\u0026ndash;1.72)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.320\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSecondary cataract\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.18(2.86\u0026ndash;9.40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.72(0.98-3.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.058\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eLevel of Visual acuity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e238\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(reference)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1(reference)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMedium\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e104\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.64(1.69\u0026ndash;4.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.98(1.23\u0026ndash;3.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.005*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHigh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7.29(3.52\u0026ndash;15.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5.83(1.72\u0026ndash;19.77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.005*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePresences of ocular comorbidities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.22(0.13\u0026ndash;0.34)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.30(0.15\u0026ndash;0.61)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.001*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e298\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(reference)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1(reference)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePresences of systemic comorbidities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.41(0.25\u0026ndash;0.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.41(0.22\u0026ndash;0.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.004*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e298\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(reference)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1(reference)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eTypes of cataract surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eICCE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.14(0.02\u0026ndash;0.87)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.14(0.03\u0026ndash;0.89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.037*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eECCE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.45(0.26\u0026ndash;0.78)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.71(0.43\u0026ndash;1.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.180\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSICE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e278\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(reference)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1(reference)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePhaoc\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.49(1.29\u0026ndash;4.81)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.98(1.06\u0026ndash;3.76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.032*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eSite lens inserted\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePosterior chamber\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e339\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(reference)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1(reference)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSulcus fixated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.65(0.28\u0026ndash;1.48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.53(0.24\u0026ndash;1.19)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.124\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAnterior chamber\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.35(0.11\u0026ndash;1.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.43(0.15\u0026ndash;1.21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.109\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePresences of intraoperative complication\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.26(0.13\u0026ndash;0.55)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.29(0.12\u0026ndash;0.71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.007*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e343\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(reference)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1(reference)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSurgeon status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOphthalmologist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e222\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.09(2.90\u0026ndash;7.59)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.44(1.80\u0026ndash;6.55)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eResident\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e146\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(reference)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1(reference)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePresences of postoperative complication\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.16(0.08\u0026ndash;0.32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.17(0.06\u0026ndash;0.47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.001*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e342\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(reference)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1(reference)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5.13(3.18\u0026ndash;8.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1/p\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.19(0.12\u0026ndash;0.31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTheta(θ)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.23(0.08\u0026ndash;64.71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003eNote: 1\u0026thinsp;=\u0026thinsp;reference category, * significant at p value\u0026thinsp;\u0026lt;\u0026thinsp;0.05, ICCE\u0026thinsp;=\u0026thinsp;intracapsular cataract extraction, ECCE\u0026thinsp;=\u0026thinsp;extracapsular cataract extraction, SICE\u0026thinsp;=\u0026thinsp;small-incision cataract extraction, Phaco\u0026thinsp;=\u0026thinsp;phacoemulsification\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003c/div\u003e "},{"header":"DISCUSSION","content":"\u003cp\u003eIn this study we assessed the time to recovery following a cataract surgery and its predictors among patients. The overall median recovery time was 18.14 weeks, with 80.17% of patients recovering, and an incidence rate of 46.47 per 1000 person-weeks. Age, residence, preoperative visual acuity, the presence of comorbidities, the type of cataract surgery, the presence of complications, and the surgeon status were independent predictors of recovery time.\u003c/p\u003e \u003cp\u003eThe median recovery time observed in this study was longer than the recovery periods reported in developed countries, where guidelines suggest that recovery typically occurs between 4 and 12 weeks (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). Similarly, the American Academy of Ophthalmology reported that full recovery is usually achieved within 4–8 weeks (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e). This difference can be attributed to variations in patient demographics, surgical techniques, and complication rates between the populations studied (\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e). Compared to a previous study conducted in Northern Ethiopia, which reported a median recovery time of 23 weeks (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e), this study observed a shorter recovery period. The difference may be explained by the setting of this study, which was conducted at a tertiary national referral facility in Ethiopia, where severe cases are more commonly managed, potentially leading to prolonged recovery times. However, the use of advanced surgical techniques, such as phacoemulsification, and the expertise of the surgeons may have mitigated the impact of case complexity, resulting in relatively faster recovery compared to other local studies.\u003c/p\u003e \u003cp\u003ePatients over 60 years old had a 75% slower recovery compared to those younger than 60. This finding aligns with those of previous studies that have consistently shown that older age is associated with slower recovery after cataract surgery (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e). Age-related physiological changes, such as reduced wound healing capacity and the presence of multiple comorbidities, are more common in older adults and may contribute to slower recovery. This highlights the importance of tailored clinical approaches for older patients to address their unique needs during the postoperative period. Compared with rural residents, urban residents had a 77% faster recovery. This finding is consistent with studies conducted in other areas, which suggest that urban residents generally have better access to healthcare services, including follow-up care, which likely contributed to their faster recovery (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e). Furthermore, urban residents may benefit from less physically demanding jobs, making it easier to adhere to postoperative restrictions and their proximity to healthcare facilities allows for regular monitoring and timely interventions.\u003c/p\u003e \u003cp\u003eThis study indicates that preoperative visual acuity significantly influences recovery time. Patients with medium preoperative visual acuity recovered 98% faster than those with low acuity do, whereas those with high acuity recover more than five times faster. The supporting literature reinforces these findings, suggesting that initial visual acuity is a crucial determinant of recovery time. Studies conducted in Ethiopia and Malaysia link better preoperative acuity to improved postoperative outcomes and faster recovery (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e). Similarly, studies from China have shown that patients with high preoperative visual acuity are more likely to achieve favorable postsurgery vision (\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e). These insights underscore the critical need for preoperative evaluations to optimize surgical outcomes and recovery trajectories.\u003c/p\u003e \u003cp\u003eCataract patients with systemic comorbidities had a 59% slower recovery rate than did those without comorbidities, a finding consistent with studies from Malaysia, which reported similar impacts of comorbidities on postsugary recovery (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e). Similarly, ocular comorbidities were associated with a 70% reduction in the recovery rate, which aligns with studies from Ethiopia (\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e), and The Review of Ophthalmology, which highlighted the challenges posed by glaucoma and other eye conditions to recovery (\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e). The slower recovery of these patients may be attributed to the additional burden of managing multiple health issues, complicating the recovery process. These findings emphasize the need for clinicians to address both systemic and ocular comorbidities when planning and managing postoperative care to optimize recovery outcomes.\u003c/p\u003e \u003cp\u003ePatients who underwent phacoemulsification recovered 98% faster than those who underwent small-incision cataract surgery (SICS), consistent with studies from Japan and India, which reported fewer complications and less trauma with phacoemulsification (\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e). However, a study on diabetic retinopathy patients indicated that visual improvement might not depend on the surgical technique used (\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e). Patients who underwent intracapsular cataract extraction (ICCE) experienced an 86% slower recovery rate than did those who underwent small-incision cataract surgery (SICS), aligning with studies linking intracapsular cataract extraction (ICCE) to higher complication rates and delayed recovery (\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e). The faster recovery with phacoemulsification may be attributed to its less invasive nature, minimizing trauma and promoting faster healing. In contrast, slower recovery following intracapsular cataract extraction (ICCE) may be due to larger incisions and sutures, leading to complications like corneal edema and delayed wound healing.\u003c/p\u003e \u003cp\u003ePatients who undergo cataract surgery by ophthalmologists recover more than three times faster than those treated by residents do. This highlights the importance of the surgeon’s expertise in ensuring optimal recovery. Studies from the United States, Nigeria, and Israel have revealed that greater surgical experience leads to fewer complications, reduced postoperative corneal edema, and faster recovery (\u003cspan additionalcitationids=\"CR48\" citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e–\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e). This emphasizes the need for prioritizing experienced surgeons in cataract surgery to enhance patient recovery and surgical outcomes.\u003c/p\u003e \u003cp\u003eThis study also revealed that intraoperative and postoperative complications significantly affect recovery times. Intraoperative complications led to a 71% slower recovery, and postoperative complications caused an 83% slower recovery than in patients without complications. These findings align with studies from Spain and India, which reported delayed recovery due to intraoperative events, such as posterior capsule rupture (\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e). Similarly, postoperative complications have been associated with poorer outcomes and prolonged recovery in regions like Finland and the United Kingdom (\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e, \u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e). The slower recovery may result from the need for additional interventions to manage complications, prolonging the healing process. The delayed recovery may be due to the need for additional interventions to address complications, which prolong the healing process. These findings highlight the importance of adopting meticulous surgical techniques and vigilant postoperative care to minimize complications and improve recovery outcomes.\u003c/p\u003e \u003cdiv id=\"Sec28\" class=\"Section2\"\u003e \u003ch2\u003eStrengths and Limitations of the study\u003c/h2\u003e \u003cp\u003eThe strength of this study lies in the use of a Weibull survival model with an inverse Gaussian frailty component, which allowed for the assessment of both observed and unobserved factors affecting recovery time. The use of Kobo Collect enhanced data accuracy and quality through built-in validation rules. However, the retrospective nature of data collection from medical records led to the exclusion of important variables, such as socioeconomic status, lifestyle habits, family meals, and surgery duration, which may have affected the accuracy of the findings. Inconsistent documentation and missing data further limited the study's accuracy. Interval-censored data, where recovery times were unknown between follow-up visits, introduced uncertainty into the analysis. Additionally, the single-facility data source limits representativeness and generalizability. These limitations should be considered in future research and clinical practice.\u003c/p\u003e \u003c/div\u003e "},{"header":"Conclusions and recommendations","content":"\u003cp\u003eThe median recovery time from cataract surgery in this study was longer than in developed countries. Recovery time was significantly influenced by patient age, residence, preoperative visual acuity, comorbidities, surgical techniques, surgeon expertise, and complications. Older patients, those with comorbidities or complications, and those undergoing less advanced surgeries like intra capsular cataract extraction had slower recovery rates.\u003c/p\u003e\u003cp\u003eTo improve recovery times, enhancing preoperative assessments, improving healthcare access for rural populations, and prioritizing advanced surgical techniques like phacoemulsification are recommended. Strengthening surgeon expertise and minimizing complications will also improve outcomes and narrow the gap between local and developed settings.\u003c/p\u003e"},{"header":"Abbreviations and acronyms","content":"\u003cp\u003eAHR, Adjusted hazard ratio; CI, Confidence Interval; ECCE, Extracapsular cataract extraction; ECCE, Extracapsular cataract extraction; ICCE, Intracapsular cataract extraction; IOL, Intraocular lens; IOP, Intraocular pressure; IQR, Interquartile range; OD, Oculus Dexter; OS, Oculus Sinister; OU, Oculus uterque; PCIOL, Posterior chamber intraocular lens; PCO, Posterior capsular opacification; PCR, Posterior capsule rupture; Phaco, Phacoemulsification; SICE, Small incision cataract extraction\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eEthics Approval and Consent to Participate\u003c/p\u003e\n\u003cp\u003eEthical approval was granted by the Institutional Research Ethics Review Board (IRB) of Arba Minch University, College of Medicine and Health Science, on May 7, 2024 (Protocol number: GW23147). Written authorization was obtained from the Addis Ababa City Administration Health Bureau and the research office of Menelik II Comprehensive Specialized Hospital to access medical records. Informed consent was waived due to the retrospective nature of the study. Patient data were anonymized by using medical record numbers, ensuring that no identifiable information was accessed. Data collection adhered to strict ethical and confidentiality standards.\u003c/p\u003e\n\u003cp\u003eConsent for publication\u003c/p\u003e\n\u003cp\u003eNot applicable\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAvailability of data and material\u003c/p\u003e\n\u003cp\u003eThe dataset supporting this research is available from the corresponding author upon reasonable request. This research is original and has not been submitted to or published in any journal.\u003c/p\u003e\n\u003cp\u003eCompeting interests\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests related to this work.\u003c/p\u003e\n\u003cp\u003eFunding\u003c/p\u003e\n\u003cp\u003eThis research was financially supported by Arba Minch University, which covered the per diem costs of data collectors and supervisors. The funder had no role in the design, data collection, analysis, interpretation, manuscript preparation, or decision to publish.\u003c/p\u003e\n\u003cp\u003eAuthors contributions\u003c/p\u003e\n\u003cp\u003eGininu Wendmeneh (G.W.), Yilma Chisha (Y.C.) and Melkamu Merid (M.M.) made significant contributions to the conception, design, execution, analysis, and interpretation of the study. G.W. was responsible for data acquisition and management and drafted the initial manuscript. G.W. and M.M. collaboratively conducted a critical review and revision of the manuscript. Y.C. and M.M. supervised the research and managed project administration. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCorresponding authors\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCorrespondence to Gininu Wendmeneh or Yilma Chisha\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe thank Arba Minch University for providing financial support and ethical approval. We also acknowledge the Addis Ababa City Administration Health Bureau for granting ethical approval and facilitating access to the health facility. Our gratitude extends to Menelik II Comprehensive Specialized Hospital for permitting access to patient records. Special gratitude goes to Dr. Getu Jufar, ophthalmologist, for his expert guidance and invaluable assistance. We also acknowledge the data collectors and supervisor for their dedication.\u003c/p\u003e\n\u003cp\u003eAuthor details\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e1\u003c/sup\u003eDepartment of Health Service Quality Improvement, Menelik II Comprehensive Specialized Hospital, Addis Ababa, Ethiopia\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e2\u003c/sup\u003eSchool of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e3\u003c/sup\u003eDepartment of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eBourne RRA, Steinmetz JD, Saylan M, Mersha AM, Weldemariam AH, Wondmeneh TG, et al. Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: The Right to Sight: An analysis for the Global Burden of Disease Study. 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The Impact of Preoperative Patient Education on Postoperative Pain, Opioid Use, and Psychological Outcomes: A Narrative Review. Can J Pain. 2023;7(2). \u003c/li\u003e\n\u003cli\u003eAla A, Alsaadi FE, Ahmadi M, Mirjalili S. Optimization of an appointment scheduling problem for healthcare systems based on the quality of fairness service using whale optimization algorithm and NSGA-II. Sci Rep. 2021 Dec 1;11(1). \u003c/li\u003e\n\u003cli\u003eFikrie A, Mariam YG, Amaje E, Bekele H. Knowledge about cataract and associated factors among adults in Yirgalem town, Sidama National Regional State, southern Ethiopia, 2020: a community based cross sectional study design. BMC Ophthalmol. 2021;21(1):79. \u003c/li\u003e\n\u003cli\u003eYoshizaki M, Ramke J, Zhang JH, Aghaji A, Furtado JM, Burn H, et al. How can we improve the quality of cataract services for all? A global scoping review. Clin Exp Ophthalmol. 2021 Jul 21;49(7):672\u0026ndash;85. \u003c/li\u003e\n\u003cli\u003eWHO. Report of the 2030 targets on effective coverage of eye care [Internet]. 2022. Available from: http://apps.who.int/\u003c/li\u003e\n\u003cli\u003eTedros Adhanom 2019. World report on vision. World Heal Organ. 2019;214(14):180\u0026ndash;235. \u003c/li\u003e\n\u003cli\u003eCentre SNE. A patient guide - Cataract and Cataract Surgery. 2017; \u003c/li\u003e\n\u003cli\u003eArmadale eye clinic. How Long Does It Take to Recover from Cataract Surgery? Time of Healing [Internet]. 2021 [cited 2024 Sep 9]. Available from: https://armadale-eye.com.au/how-long-does-take-recover-from-cataract-surgery/\u003c/li\u003e\n\u003cli\u003eAshley Behrens M. Cataract Surgery | Johns Hopkins Medicine. 2024. \u003c/li\u003e\n\u003cli\u003eAmerican Academy of Ophthalmology. 10 Cataract Surgery Side Effects, and How to Cope [Internet]. 2023 [cited 2025 Jan 20]. Available from: https://www.aao.org/eye-health/tips-prevention/side-effects-cataract-surgery-complications-cope\u003c/li\u003e\n\u003cli\u003eWong TY. Effect of increasing age on cataract surgery outcomes in very elderly patients. BMJ. 2001 May 5;322(7294):1104\u0026ndash;6. \u003c/li\u003e\n\u003cli\u003eMin Jung Ji, Sang Kim M, Jun Lee S, Beom Han S. Evaluation of Visual Outcome after Cataract Surgery in Patients Aged 85 Years or Older. J Korean Ophthalmol Soc. 2016 Feb 1;57(2):214\u0026ndash;20. \u003c/li\u003e\n\u003cli\u003eVijaya L, George R, Rashima A, Raju P, Arvind H, Baskaran M, et al. Outcomes of cataract surgery in a rural and urban south Indian population. Indian J Ophthalmol. 2010 May 1;58(3):223\u0026ndash;8. \u003c/li\u003e\n\u003cli\u003eYong GY, Mohamed-Noor J, Salowi MA, Adnan TH, Zahari M. Risk factors affecting cataract surgery outcome: The Malaysian cataract surgery registry. PLoS One. 2022 Sep 1;17(9). \u003c/li\u003e\n\u003cli\u003eZhu X, Ye H, He W, Yang J, Dai J, Lu Y. Objective functional visual outcomes of cataract surgery in patients with good preoperative visual acuity. Eye. 2017;31(3):452\u0026ndash;9. \u003c/li\u003e\n\u003cli\u003eRongrong Z, Fu L, Yan Y, Tiantian W, Changfan W. Factors Affecting Early Postoperative Visual Acuity in Cataract Patients with High Myopia. Int J Ophthalmol Clin Res. 2020 Aug 22;7(3):117. \u003c/li\u003e\n\u003cli\u003eMarkos CM, Tamrat LT, Asferaw MA. Outcomes and Associated Factors of Cataract Surgery Among Adults Attending a Tertiary Hospital in Addis Ababa, Ethiopia. Patient Relat Outcome Meas. 2020;Volume 11:231\u0026ndash;9. \u003c/li\u003e\n\u003cli\u003eJames D. Brandt, MD, Sacramento C. When Glaucoma Patients Have Cataract Surgery. 2014;(May):1\u0026ndash;68. \u003c/li\u003e\n\u003cli\u003eBissen-Miyajima H, Weikert MP, Koch DD. Cataract Surgery: Maximizing Outcomes Through Research. Cataract Surg Maximizing Outcomes Through Res. 2014 Jan 1;1\u0026ndash;211. \u003c/li\u003e\n\u003cli\u003eMadhumallika Pathak, Annamalai Odayappan, Manas Nath, Ramalakshmi Raman SB, Nachiappan S. Comparison of the outcomes of phacoemulsification and manual small-incision cataract surgery in posterior polar cataract - A retrospective study. BMC Ophthalmol. 2017;17(1):1. \u003c/li\u003e\n\u003cli\u003eChaudhary A, Kumari S. A Comparative study of post-operative results with different grades of diabetic retinopathy after phacoemulsification and small incision cataract surgery (SICS) [with various types of IOLs]. IP Int J Ocul Oncol Oculoplasty. 2021;6(4):232\u0026ndash;6. \u003c/li\u003e\n\u003cli\u003eCenter for sight. Types Of Cataract Surgery: Which Is Right For You? 2023. \u003c/li\u003e\n\u003cli\u003eLhuillier L, Jeancolas AL, Renaudin L, Goetz C, Ameloot F, Premy S, et al. Impact of Ophthalmic Surgeon Experience on Early Postoperative Central Corneal Thickness After Cataract Surgery. Cornea. 2017 May 1;36(5):541\u0026ndash;5. \u003c/li\u003e\n\u003cli\u003eOdugbo O, Babalola O, Morgan R. Influence Of Rank Of Surgeon On The Outcome Of Cataract surgery in Plateau State Nigeria. Jos J Med. 2011 Oct 13;5(2):21\u0026ndash;6. \u003c/li\u003e\n\u003cli\u003eCnaany Y, Goldstein A, Lavy I, Halpert M, Chowers I, Ben-Eli H. Ophthalmology Residents\u0026rsquo; Experience in Cataract Surgery: Preoperative Risk Factors, Intraoperative Complications, and Surgical Outcomes. Ophthalmol Ther. 2024;13(6):1783\u0026ndash;98. \u003c/li\u003e\n\u003cli\u003eGonz\u0026aacute;lez N, Quintana JM, Bilbao A, Vidal S, De Larrea NF, D\u0026iacute;az V, et al. Factors affecting cataract surgery complications and their effect on the postoperative outcome. Can J Ophthalmol. 2014 Feb 1;49(1):72\u0026ndash;9. \u003c/li\u003e\n\u003cli\u003eVajpayee RB, Sharma N, Dada T, Gupta V, Kumar A, Dada VK. Management of posterior capsule tears. Surv Ophthalmol. 2001;45(6):473\u0026ndash;88. \u003c/li\u003e\n\u003cli\u003ePorela-Tiihonen S, Kokki H, Kaarniranta K, Kokki M. Recovery after cataract surgery. Acta Ophthalmol. 2016 Apr 1;94(5):1\u0026ndash;34. \u003c/li\u003e\n\u003cli\u003eFouad YA, Jabbehdari S, Neuhouser A, Soliman MK, Chandra A, Yang YC, et al. Visual outcomes and postoperative complications of eyes with dropped lens fragments during cataract surgery: multicenter database study. J Cataract Refract Surg. 2023 Jan 9;49(5):485\u0026ndash;91. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-ophthalmology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"boph","sideBox":"Learn more about [BMC Ophthalmology](http://bmcophthalmol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/boph","title":"BMC Ophthalmology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Cataract surgery, time to recovery from cataract surgery, predictors of, Ethiopia","lastPublishedDoi":"10.21203/rs.3.rs-5893698/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5893698/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eCataracts are the leading cause of reversible blindness globally, disproportionately affecting populations in low- and middle-income countries. In Ethiopia, cataracts remain a significant public health concern. Despite the effectiveness of cataract surgery in restoring vision, information on recovery time and its predictors remain limited. The aim of this study was to assess time to recovery and its predictors among patients undergoing cataract.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA retrospective cohort study was conducted on 459 cataract patients who underwent surgery between January 1 and December 31, 2023. Data were randomly extracted from their medical records between June 1 and August 15, 2024. The Kaplan-Meier method was used to estimate the survival probabilities and compare groups, with significant differences tested using the log-rank test. The Weibull regression with the inverse Gaussian frailty was applied following a goodness-of-fit test to identify predictors of time to recovery. Results are presented as adjusted hazard ratios (AHRs) with 95% confidence intervals (CIs). All statistical tests were declared significant at P-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003ewe reviewed 459 patient cards, and 368 (80.17%, 95% CI: 76.26\u0026ndash;83.58%) had recovered from a cataract surgery over 7,919.28 person-weeks. The overall incidence rate of recovery was at 46.47 per 1,000 persons per week (95% CI: 41.95\u0026ndash;51.47). The median recovery time was at 18.14 weeks (IQR: 12.29\u0026ndash;24, 95% CI: 17.14\u0026ndash;18.86). Age over 60 years (AHR\u0026thinsp;=\u0026thinsp;0.25, 95% CI: 0.07\u0026ndash;0.96), urban residence (AHR\u0026thinsp;=\u0026thinsp;1.77, 95% CI: 1.15\u0026ndash;2.70), preoperative visual acuity (medium: AHR\u0026thinsp;=\u0026thinsp;1.98, 95% CI: 1.23\u0026ndash;3.18; high: AHR\u0026thinsp;=\u0026thinsp;5.83, 95% CI: 1.72\u0026ndash;19.77), comorbidities (ocular: AHR\u0026thinsp;=\u0026thinsp;0.30, 95% CI: 0.15\u0026ndash;0.61; systemic: AHR\u0026thinsp;=\u0026thinsp;0.41, 95% CI: 0.22\u0026ndash;0.75), type of surgery (phacoemulsification: AHR\u0026thinsp;=\u0026thinsp;1.98, 95% CI: 1.06\u0026ndash;3.67; intracapsular cataract extraction: AHR\u0026thinsp;=\u0026thinsp;0.14, 95% CI: 0.03\u0026ndash;0.89), and complications (intraoperative: AHR\u0026thinsp;=\u0026thinsp;0.29, 95% CI: 0.12\u0026ndash;0.71; postoperative: AHR\u0026thinsp;=\u0026thinsp;0.17, 95% CI: 0.06\u0026ndash;0.47), and surgeries performed by an ophthalmologist (AHR\u0026thinsp;=\u0026thinsp;3.44, 95% CI: 1.80\u0026ndash;6.55) were statistically significant predictors of time to recovery from cataract surgery.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThe median recovery time was shorter than in previous local studies but longer than in developed countries. Improved preoperative assessment, effective comorbidity management, minimizing complications, prioritizing phacoemulsification surgery, and involving skilled ophthalmologists are crucial for enhancing recovery outcomes. Personalized care approaches are recommended to optimize postoperative recovery.\u003c/p\u003e","manuscriptTitle":"Predictors of Time to Recovery from Cataract Surgery among Cataract Patients at Menelik II Comprehensive Specialized Hospital: A Retrospective Follow up Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-02-03 09:13:50","doi":"10.21203/rs.3.rs-5893698/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-03-10T06:32:33+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-03-07T23:04:26+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-02-27T19:42:21+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"300426055067143279115055244201206811272","date":"2025-02-26T15:44:53+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-02-26T10:17:50+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"153517202030754108215884484707366679145","date":"2025-02-23T15:59:38+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"298006098968500448032274336325171164317","date":"2025-02-19T18:12:40+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"174242441027880441517114140117679635541","date":"2025-02-19T14:03:27+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"219675430207794465301923523828030072653","date":"2025-02-19T11:34:10+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"324671538432622426686864417677914266450","date":"2025-02-18T16:06:46+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"144311251969654446498074850342572483805","date":"2025-02-18T09:16:02+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-02-18T09:10:42+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-01-30T07:18:54+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-01-27T12:28:38+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-01-27T12:27:37+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Ophthalmology","date":"2025-01-24T08:01:18+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-ophthalmology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"boph","sideBox":"Learn more about [BMC Ophthalmology](http://bmcophthalmol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/boph","title":"BMC Ophthalmology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"fd7d0ab9-f641-4e99-9503-74f9cdbdcac3","owner":[],"postedDate":"February 3rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-04-28T16:05:04+00:00","versionOfRecord":{"articleIdentity":"rs-5893698","link":"https://doi.org/10.1186/s12886-025-04053-4","journal":{"identity":"bmc-ophthalmology","isVorOnly":false,"title":"BMC Ophthalmology"},"publishedOn":"2025-04-25 15:56:55","publishedOnDateReadable":"April 25th, 2025"},"versionCreatedAt":"2025-02-03 09:13:50","video":"","vorDoi":"10.1186/s12886-025-04053-4","vorDoiUrl":"https://doi.org/10.1186/s12886-025-04053-4","workflowStages":[]},"version":"v1","identity":"rs-5893698","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5893698","identity":"rs-5893698","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}