Bilateral Pediatric Cataract Surgery: Outcomes of 390 Children From Nepal and Northern India

Abstract

Even in a setting with limited resources, successful, cost-effective, high-volume surgery for pediatric cataract is possible. Despite late presentation and limited follow-up, more than half achieved good outcomes after more than 1 year. Only 5.6% remained blind due to amblyopia or eye anomalies. Bilateral surgery during one hospital stay, IOL implantation with undercorrection according to age, aggressive surgery to prevent secondary cataract, intensive anti-inflammatory therapy, and provision of durable, high-quality spectacles to take home all proved beneficial because many children cannot attend for regular follow-up.

Outcome of paediatric cataract surgery in Northwest Ethiopia: a retrospective case series

“…Our results for good outcome in the better eye (62%) among bilateral cases are comparable to studies in Tanzania (62%),10 Nepal and Northern India (43%),4 Kenya (44%),9 South India (39.5%),17 UK (40.6%)18 and USA (46.6%),19 but much better than in studies from Zambia (29.7%)13 and South Africa (24.7%) 14. Good visual outcome was achieved more often in bilateral cases compared with unilateral non-traumatic cases.…”

Barriers, Costs, and Attitudes Toward Pediatric Cataract Surgery at Two Large Facilities in China and India

“…Other studies provide similar reports of delay in presentation for cataract surgery in India and nearby Nepal in children with bilateral cataract. 8,24 As in the current study, factors associated with late care-seeking behavior in India include lower socioeconomic status, 25 and lower education levels. 9 Though evidence regarding cataract service uptake is less prevalent in China, a study from Shandong, Shanxi's neighbor to the east, revealed that nearly half of pediatric patients with bilateral cataract was recognized by 6 months of age.…”

“…7 However, meticulous surgery can lead to fewer post-operative complications. 8 Although there is a considerable body of evidence on why adults with cataract do not access surgery, there are fewer studies on children, which requires community-based studies of children with unoperated cataract. A study in Malawi showed that not accessing services was associated with low socioeconomic status and low education of mothers, with low levels of awareness of cataract and its causes and treatment.…”

Pediatric cataract surgery with hydrophilic acrylic intraocular lens implantation in Nepalese children

“…11 The rigid gas permeable PMMA lens has also been used by many surgeons, especially in developing countries. [12][13][14][15] The most important reason being the cost and easy availability. There are studies on the use of PMMA lenses in pediatric cataract surgeries with postoperative outcomes comparable with the foldable acrylic lenses.…”