Bilateral paediatric cataract surgery - outcomes of 298 children from Kinshasa, the Democratic Republic of the Congo

Abstract

Introduction: The leading cause of childhood blindness globally is paediatric cataract. Bilateral cataract surgery can help to improve visual performance and to diminish the burden of childhood blindness.
 Objective: To report in a retrospective observational cohort study the long-term outcomes of 298 children who had bilat- eral cataract surgery with IOL implantation from 2001-2016 in Kinshasa.
 Methods: A standardized surgical treatment of paediatric cataract was practiced on 298 children. Patient’s follow-up, com- plications, and visual outcomes were recorded and analysed.
 Results: The mean age was 5.7 ± 4.3 years and males were predominant (64.9%). Most of children were living mainly in urban poorest areas (96.3%). Strabismus, nystagmus and microcornea were encountered in 20.1%, 25.1% and 8.7% of children, respectively. Using WHO criteria most of patients were classified as blind preoperatively and 81.9% of them had improved visual outcomes after surgery. Main reasons for reduced vision during follow-up were secondary cataract (5.7%), IOL decentration (1.2%), retinal detachment (1.2%), and secondary glaucoma (1.5%).
 Conclusion: In spite of the post conflict challenges, elimination of cataract blindness in children remains a priority. Children present at a late age for surgery and long term follow-up is poor. There is need for program strengthening in these areas.
 Keywords: Paediatric cataract surgery; bilateral cataract; outcomes.

Analysis of age at detection and outcomes of dense unilateral congenital cataract surgery for children on the paediatric cataract register

“… 26 The median age at surgery in a study from the Democratic Republic of Congo, of 298 children, was 5.7 years and no children were operated on before 1.4 years of age. 27 In a 2020 study from Nigeria of 164 cases, the child's mother detected the cataract in 70.7% of the patients and the median age at presentation for patients with congenital cataract was 18 months. 28 …”

Ocular Morbidity—A Critical Analysis to Improve Outpatient Services in an Eye Department in a Sub-Saharan Megacity

“…During the last 20 years, two ophthalmological subspecialties have been developed in cooperation with the Rostock University Eye Hospital, Germany [13,14]. These are paediatric ophthalmology with special emphasis on childhood cataract blindness and a centre for diabetic retinopathy and laser treatment as a part of extensive diabetic care units coordinated by the catholic medical network (Catholic Diocesan Office for Medical Work, BDOM).…”