Results of Bilateral Cataract Extraction with Posterior Chamber Intraocular Lens Implantation in Children

Visual acuity and its predictors after surgery for bilateral cataracts in children

“…Several previous studies found that the majority of children with bilateral cataracts had a final BCDVA of 20/60 or better after primary IOL implantation, which is similar to our results. [13][14][15][16][17][18] However, Magli et al 15 determined that there were no significant differences of visual outcome between eyes that underwent primary IOL implantation and those that underwent secondary IOL implantation after simultaneous extraction of bilateral congenital cataracts, which differs from the results of our study. Furthermore, Kim et al 19 demonstrated that secondary IOL at 2 years of age showed better visual outcomes for bilateral congenital cataracts than primary implantation, given postoperative complications, such as secondary glaucoma and strabismus, and required additional surgeries.…”

How should blindness in children be managed?

“…These figures compare favourably to visual results from the region prior to the routine use of IOLs in children, Waddell reporting only 8% of patients achieving this level in Uganda, 3 but compare poorly with results of series of similar aged children from the West in which the published proportions achieving 6/18 or better varies from 72 to 91%. 10,[18][19][20] Reasons for this might include higher complication rates such as fibrinous uveitis being more common in pigmented eyes (30% in Kenya 17 ) and intracapsular fixation being less common (because of CCC difficulties outlined above). This is considered unlikely, however, since our series from Tanzania showed only 15% fibrinous uveitis (because a move towards acrylic lenses resulted in significant reduction), but visual outcome was very similar to the Kenya series.…”

Visual Recovery After Surgical Treatment in Children With Bilateral Congenital Cataract

“…It has been shown that in congenital cataracts, operated earlier in life (Within 1 year), the visual development continues till the age of 10-12 years. 15 Hence, with a long-term follow-up, these children will, expectedly, have further improvement in their visual acuity. Overall, 22.5 % patients achieved visual acuity 6/18 or better in the better eye.…”

“…This outcome is comparable to results from Nepal, 35 and India, 36,30 but poorer than reports from the developed world. 12,15,17,19,20 This could be due to the duration of follow-up being only 6 months or small sample size . It has been shown that in congenital cataracts, operated earlier in life (Within 1 year), the visual development continues till the age of 10-12 years.…”

“…Over the past decade, various studies have looked at the outcome of bilateral congenital cataract, [10][11][12][13][14][15][16][17][18][19][20] but only a few have looked at the outcome of both congenital and developmental cataracts and most of them were small specific series. 11,12,14,17 In View of the anatomical peculiarities of pediatric cataracts like a series of fibres meets the capsule at the equator 21,22 Cells in the germinative equatorial zone are dividing constantly, newly formed cells are forced into the transitional zone where they elongate and differentiate to form the fiber mass of the lens.…”