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

Asferaw, Mulusew; Mekonen, Sisay Yoseph; Woodruff, Geoffrey; Gilbert, Clare; Tesfaye, Samson

doi:10.1136/bjophthalmol-2017-311513

Cited by 12 publications

(8 citation statements)

References 28 publications

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“…Only 5.6% of children with more than 1 year follow-up were still blind. Our results compared in the Tables 3 and 4 are somewhere in between these two series and go in line with other case series from Shandong, China 13 and Gondar, Ethiopia 14 indicating that there is a good chance that a prospective study in Kinshasa (or a similar situation) could further improve the results in the near future.…”

Section: Discussionsupporting

confidence: 89%

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

Ngoy

Stahnke²,

Dinkulu

et al. 2020

Afr H. Sci.

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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.

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Section: Discussionsupporting

confidence: 89%

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

Ngoy

Stahnke²,

Dinkulu

et al. 2020

Afr H. Sci.

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“…Mean postoperative VA was 0.613 LogMAR, excluding seven patients with “PoL” vision, with 58.1% of the patients with postoperative VA recorded achieving 6/18 vision or better. Although the reliability of this rate is limited by incomplete data collection, it is comparable with the findings of other papers measuring the visual outcomes following pediatric cataract surgery in Africa: Tanzania, 58% achieving ≥6/18;[8] Kenya, 44%;[9] Northwest Ethiopia, 37%;[10] Zambia, 29.7%;[11] and KwaZulu-Natal province of South Africa, 24.7%. [12]…”

Section: Discussionsupporting

confidence: 77%

Establishing a pediatric ophthalmology service in malawi: Developments in childhood cataract surgery

Jamison¹,

MacKinnon²,

Lavy³

et al. 2019

Middle East Afr J Ophthalmol

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PURPOSE:The purpose of this study is to report on the establishment of a Pediatric Ophthalmology Service for Malawi using childhood cataract surgery as a surrogate measure of its effectiveness.MATERIALS AND METHODS:A retrospective review of pediatric cataract surgery at Lions Sight First Eye Hospital, Blantyre, between 2011 and 2016. The paucity of comprehensive records allowed for the sampling of a maximum of 25 cases/year (n = 150) for comparison. Theatre records and population statistics were used to calculate childhood cataract surgical rates (CCSR).RESULTS:A total of 949 cataract operations were performed during the six years studied – 55.8% of these were boys. The number of operations per year remained generally stable. Of the 150 cases reviewed, the mean age at presentation was 6.01 years, with a trend toward a slightly younger age over the period. Over the years studied, the geographical distribution of referrals became more reflective of the population's distribution. Where the logarithm of the minimum angle of resolution (LogMAR) visions were available, these demonstrated a mean improvement from 2.008 (n = 43) preoperatively to 0.613 (n = 51) postoperatively. The mean follow-up was 106 days (0 days–3.25 years). Complication rates were low. The CCSR was 9.2/million population.CONCLUSIONS:A Pediatric Ophthalmology Service has been established in Malawi delivering safe, effective surgery on a country-wide scale for childhood cataract. Over the period studied, the age at presentation reduced, and there was an improvement in the geographical distribution of patients, likely due to an improvement in referral systems throughout Malawi.

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“…Consistent with other studies, unilateral cataracts in the NBDPS were often associated with IEDs, and with persistent fetal vasculature in particular (Lim et al, 2010; Wirth et al, 2002). Compared to bilateral cases, surgeries on unilateral cataracts have worse outcomes (Asferaw et al, 2019), especially when associated with persistent fetal vasculature often leading to retinal detachment or glaucoma (Jinagal et al, 2018). The most common IED associated with bilateral cataracts was microphthalmia, which also can create surgical challenges, such as postoperative corneal edema due to the small surgical space (Hoffman et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

Descriptive and risk factor analysis of infantile cataracts: National Birth Defects Prevention Study, 2000–2011

Nalbandyan

Howley

Cunniff

et al. 2021

American J of Med Genetics Pt A

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Using National Birth Defects Prevention Study (NBDPS) data, we sought to estimate birth prevalence, describe clinical characteristics, and examine risk factors for infantile cataracts. We calculated birth prevalence using the numbers of NBDPS-eligible cataract cases and live births in the study area. We described case infants by the presence of associated ipsilateral eye defects (IEDs) and non-eye-related major birth defects. Using maternal exposure information collected via telephone interview, we conducted logistic regression analyses among the interviewed cases and controls.Birth prevalence of infantile cataracts was 1.07/10,000 live births. Unilateral cataracts were more often associated with IEDs, while infants with bilateral cataracts were more often preterm, full-term with low birth weight, or had non-eye-related major birth defects. Unilateral cataracts were positively associated with maternal nulliparity (adjusted odds ratio [aOR] = 1.61, 95% confidence interval [CI] = 1.18, 2.20; reference: multiparity), whereas bilateral cataracts were positively associated with maternal education <12 years (aOR = 2.08, 95% CI = 1.13, 3.82; reference: education >12 years), and foreign-born nativity (aOR = 1.92, 95% CI = 1.04, 3.52; reference: U.S.-born nativity). The current analysis can inform future epidemiological studies aimed at identifying mechanisms underlying the associations between infantile cataracts and complex maternal exposures, such as lower levels of education and foreign-born nativity.

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

Abstract: Visual acuity improved significantly after surgery, with better outcomes in bilateral cases. Early detection and surgery by a trained surgeon with good follow-up and postoperative rehabilitation can lead to better visual outcomes.

Cited by 12 publications

References 28 publications

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

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

Establishing a pediatric ophthalmology service in malawi: Developments in childhood cataract surgery

Descriptive and risk factor analysis of infantile cataracts: National Birth Defects Prevention Study, 2000–2011

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