Evaluation of a Public Child Eye Health Tertiary Facility for Pediatric Cataract in Southern Nigeria I: Visual Acuity Outcome

Abstract

Purpose:A retrospective study of the outcome of congenital and developmental cataract surgery was conducted in a public child eye health tertiary facility in children <16 years of age in Southern Nigeria, as part of an evaluation.Materials and Method:Manual Small Incision Cataract Surgery with or without anterior vitrectomy was performed. The outcome measures were visual acuity (VA) and change (gain) in visual acuity. The age of the child at onset, duration of delay in presentation, ocular co-morbidity, non ocular co-morbidity, gender, and pre operative visual acuity were matched with postoperative visual acuity. A total of 66 children were studied for a period of six weeks following surgery.Results:Forty eight (72.7%) children had bilateral congenital cataracts and 18 (27.3%) children had bilateral developmental cataracts. There were 38(57.6%) males and 28 (42.4%) females in the study. Thirty Five (53%) children had good visual outcome (normal vision range 6/6/ -6/18) post-operatively. The number of children with blindness (vision <3/60) decreased from 61 (92.4%) pre-operatively to 4 (6.1%) post-operatively. Post operative complication occurred in 6.8% of cases six week after surgery. Delayed presentation had an inverse relationship with change (gain) in visual acuity (r = - 0.342; p-value = 0.005). Pre-operative visual acuity had a positive relationship with post operative change (gain) in visual acuity (r = 0.618; p-value = 0.000).Conclusion: Predictors of change in visual acuity in our study were; delayed presentation and pre-operative VA. Cataract surgery in children showed clinical benefit.

Long-Term Visual Outcome of Paediatric Cataract Surgery at Kitwe Teaching Eye Hospital, Kitwe, Zambia

“…This is consistent with findings from other studies [6,12,14]. Duke on the other hand, reported that congenital cataract was the most common type of cataract in his study [15]. Furthermore, this study established that children's visual outcome was associated with the timing of refraction.…”

“…As for postoperative complications, this study found that they were less post-operative complications (29.1%) with anterior segment being the most common complications (15.4%), followed by posterior segment (9.4%) and a combination of both anterior and posterior segment (4.3%) respectively. Duke [15] also had less postoperative complication of only nine out of hundred and thirty-two participants (6.8%). According to these results, there is less likelihood of children achieving good visual outcomes after surgery if they encountered complications, intraoperatively or postoperatively.…”

The Comparison of Visual Acuity After Congenital Cataract Surgery between Children ≤2 Years and >2-17 Years

“…5,10 The visual acuity results of the vision were not influenced by gender differences, the poor results of visual acuity could be caused by the presence of amblyopia that had exceeded the critical period added by the presence of Nystagmus. 14,15 The average number of operated children in India was 9 years old with a follow-up of 3 to 8 years, 149 children had BCVA >6/18. Many factors influence, among others: cataract type, type of surgery, intraocular lens type, age of operation, presence or absence of postoperative uveitis, and pre-operative visual acuity.…”