Visual Impairment and Delay in Presentation for Surgery in Chinese Pediatric Patients with Cataract

You, Caiyun; Xiao-ming, WU; Zhang, Yingying; Dai, Yunhai; Huang, Yusen; Xie, Liping

doi:10.1016/j.ophtha.2010.04.014

Cited by 64 publications

(72 citation statements)

References 22 publications

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“…[4][5][6][7] Previous studies have determined that age at time of cataract extraction, method of postoperative optical correction, and presence of nystagmus are all factors that may help predict postoperative visual outcomes. Preoperative nystagmus has been associated with poor postoperative visual acuity in bilateral cataract cases.…”

Section: Introductionmentioning

confidence: 99%

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

Bonaparte

Trivedi

Ramakrishnan

et al. 2016

Eye

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Purpose The objective of this study was to investigate preoperative factors associated with postoperative visual acuity outcomes and to develop a model to predict visual acuity prognosis. Methods A retrospective study was conducted by reviewing clinical charts of pediatric patients who underwent bilateral cataract surgery by a single surgeon (MEW) at the Storm Eye Institute. A multiple logistic regression model was constructed to predict the odds of poor postoperative visual acuity, that is, worse than 20/40, based on age at surgery, gender, primary intraocular lens (IOL) placement, ethnicity, and preoperative nystagmus. Results A sample size of 157 children (314 eyes) was investigated with median duration of follow-up of 6.4 years. A total of 78% of children with bilateral cataract had postoperative visual acuity of 20/40 or better. The presence of preoperative nystagmus was highly correlated with poor postoperative visual acuity (OR = 6.0; 95% CLs, 2.5-14.1; P-valueo0.0001). Children of age o1 year at time of cataract extraction (OR = 3.2; 95% CLs, 1.4-7.6; P-value = 0.0073), male gender (OR = 2.3; 95% CLs, 1.1-4.5; P-value = 0.02), the absence of primary IOL placement (OR = 3.0; 95% CLs, 1.05-8.4; P-value = 0.04), and non-Caucasian ethnicity (OR = 2.0; 95% CLs, 1.02-4.03; P-value 0.0447) were associated with poor visual acuity postoperatively. Conclusions Satisfactory visual outcomes occurred in 78% of children operated on for bilateral cataracts. Preoperative nystagmus, age o1 year at time of cataract extraction, absence of primary IOL placement, male gender, and non-Caucasian ethnicity, were all factors associated with poor postoperative visual acuity.

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Section: Introductionmentioning

confidence: 99%

“…5,6 Postoperative glaucoma patients also have lower rates of good visual acuity results. 7,8 The presence of systemic disorders have been associated with poor visual acuity in bilateral cases, reflecting additional causes of poor vision. 4 Many previous studies have included both unilateral and bilateral cataracts within the same study.…”

Section: Introductionmentioning

confidence: 99%

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

Bonaparte

Trivedi

Ramakrishnan

et al. 2016

Eye

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“…Another study in the same country verified that only 0.4% of the patients with congenital cataract were submitted to surgery before 12 weeks of age, and no patient was submitted to surgery within the first 8 weeks (8) . The late treatment in our series was directly related to the late diagnosis, considering that 86.5% of the patients were diagnosed after 2 months of age, comparing to the studies conducted in Bra-zil, where 55.5% of the congenital cataracts was diagnosed after 2 months, and in China where 78% was diagnosed after 6 months of life (11,15) . In developed countries such as USA and UK, the diagnosis of the majority of patients with congenital cataract is done during the first month of life (14) .…”

Section: Discussionmentioning

confidence: 54%

“…Our results are comparable to other studies conducted in developing countries such as Brazil, where a study verifies a similar delay in 95.5% of patients with congenital cataract (15) and another study conducted in the same country verified that 88.8% of patients underwent surgery after six months of age (10) . Studies conducted in China showed similar results: one of them reports that 98.8% of patients with unilateral congenital cataract underwent surgery after 6 months, and none of them within the first 12 weeks of age (11) . Another study in the same country verified that only 0.4% of the patients with congenital cataract were submitted to surgery before 12 weeks of age, and no patient was submitted to surgery within the first 8 weeks (8) .…”

Section: Discussionmentioning

confidence: 64%

“…Prevention of blindness caused by congenital cataract depends on early detection and on the availability of specialized equipment and medical staff trained in pediatric ophthalmology. Even though the pediatrician shall make a red reflex examination on all newborns (and it shall be repeated within the first three months of life), many studies conducted at different developing countries pointed to a late diagnostic, which limits the early surgical treatment to succeed in their visual rehabilitation (11)(12)(13)(14) . In many instances, due to the greater familiarity with the infant, it is the mother who first recognizes the leukocoria.…”

Section: Introductionmentioning

confidence: 99%

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Late diagnosis and surgical treatment of patients diagnosed with unilateral congenital cataract at Fundación Visión, in Asuncion, Paraguay

Zegarra¹,

Burga²,

Lansingh³

et al. 2014

Arquivos Brasileiros De Oftalmologia

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Registered with the fundación visión's ethics committee under number: 002/2013. AbsTRACTPurpose: Providing data on the late diagnosis and surgical treatment of patients who underwent surgery for total unilateral congenital cataract. Methods: Systematic retrospective review of the medical record of all patients between 0 and 16 years old with total unilateral congenital cataract who underwent surgery at Fundación Vision between January 2010 and July 2012. Results: Medical records of 37 patients (51 % females) were studied, age was 7.4 (± 4.9) years (average ± SD) and 62% lived on Departamento Central (the most populated region from Paraguay). A total of 97.3% patients underwent late surgical treatment and 86.5% received a late diagnosis. The average time elapsed between the diagnosis and the surgical treatment was one month, and 62.2% of the patients underwent surgery within six months from the diagnosis. Conclusion: This study evidences that most of the patients in our series had a late treatment as a result of a late diagnosis. Based on these results we recommend establishing strategies to improve the early detection and surgical treatment of the newborns.

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Cataract in Pediatric Age Group: A Review

Shah¹,

Shah²

2014

Oxidative Stress in Applied Basic Research and Clinical Practice

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Visual Impairment and Delay in Presentation for Surgery in Chinese Pediatric Patients with Cataract

Cited by 64 publications

References 22 publications

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

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

Late diagnosis and surgical treatment of patients diagnosed with unilateral congenital cataract at Fundación Visión, in Asuncion, Paraguay

Cataract in Pediatric Age Group: A Review

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