Follow-up patterns and associated risk factors after paediatric cataract surgery: observation over a 5-year period

2018 ◽  
Vol 102 (11) ◽  
pp. 1550-1555 ◽  
Author(s):  
Pratik Chougule ◽  
Shamsiya Murat ◽  
Ashik Mohamed ◽  
Ramesh Kekunnaya
Keyword(s):  
Cataract Surgery ◽  
Economic Status ◽  
Socioeconomic Group ◽  
Female Ratio ◽  
Logarithmic Curve ◽  
Age At Surgery ◽  
Developmental Cataract ◽  
Associated Risk Factors ◽  
Paediatric Cataract

PurposeTo study the pattern of compliance to follow-up of children less than 5 years of age undergoing surgery for congenital and developmental cataract over a period of 5 years.MethodsIt is a retrospective study of children less than 5 years of age undergoing cataract surgery between January and December 2010 for congenital or developmental cataract and followed up until 31 December 2015. Age, sex, distance from hospital and urban or rural habitat, delay in presentation, socioeconomic status, laterality, morphology and type of cataract, implantation of intraocular lens and interventions done were noted. Compliance to follow-up at postoperative 1 week, 1 month, 3 months, 6 months, 1 year and then once a year until 5 years were recorded.Results169 patients were included in the study. The median follow-up was 22 months. Median age at surgery was 10 months and had a negative correlation with total follow-up. Male-to-female ratio was 1.82. Logarithmic curve of follow-up was noticed with 85%, 61%, 55%, 52%, 39% and 28% patients attending 1 month, 3 months, 6 months, 1 year, 3 years and 5 years of follow-up, respectively. Low socioeconomic group had poor follow-up compared with higher socioeconomic group (P=0.009), but the curve of follow-up was similar in both groups; multiple interventions group had better follow-up (P<0.0001).ConclusionCurve of loss to follow-up is logarithmic in children undergoing paediatric cataract surgery. Age at surgery and low economic status are the most important factors associated with poor follow-up.

scholarly journals Precision pulse capsulotomy: an automated alternative to manual capsulorhexis in paediatric cataract

2019 ◽  
Vol 4 (1) ◽  
pp. e000255 ◽  
Author(s):  
Pratik Chougule ◽  
Vivekanand Warkad ◽  
Akshay Badakere ◽  
Ramesh Kekunnaya
Keyword(s):  
Adverse Events ◽  
Cataract Surgery ◽  
Anterior Segment ◽  
Surgical Time ◽  
Female Ratio ◽  
Age At Surgery ◽  
Time Required ◽  
Male To Female ◽  
Anterior Capsulotomy ◽  
Paediatric Cataract

ObjectiveTo report our operative experience with precision pulse capsulotomy (PPC) for anterior capsulotomy in a paediatric cataract series.Methods and analysisThis study is a retrospective interventional, descriptive series of consecutive paediatric eyes (≤16 years) undergoing cataract surgery using PPC. Surgical time and the time required to perform PPC was recorded. Any intraoperative and postoperative adverse events were noted. Postoperatively, visual acuity, anterior segment examination and intraocular pressure (IOP) were recorded for all children at day 1, 1 week and 1 month.Results21 eyes of 14 patients were included in the study, with the median age at surgery of 6.0 years (IQR; 5-7.75, range=1–16 years). Male to female ratio was 11:3. 13 eyes had lamellar cataract, 3 eyes had total cataract, 2 had posterior subcapsular cataract, 2 had traumatic cataract, while 1 eye had sutural cataract. Median surgical time was 26 min (IQR 21-32) and median PPC time was 75.0 secs (IQR 56-86.5). The anterior capsulotomy was round and complete in most cases, except in one case due to faulty suction. All patients underwent a successful in the bag implantation of intraocular lens with capsulotomy margins overlapping the optic edges in 19 eyes (90%). Median PPC size was 5.54 mm (n=9, IQR 5.39 -5.75) which was slightly larger than expected. None of the cases had any intraoperative or postoperative adverse events with no radial tears of capsulotomy. Postoperatively, the mean final follow-up was 5.71+3.20 weeks.ConclusionTo conclude PPC can be used as an alternative to manual continuous curvilinear capsulorhexis in paediatric cataract surgery producing round well- centred and strong capsulotomy with an easier learning curve.

scholarly journals Predictive Refractive Error Post Congenital and Developmental Cataract Surgery

2021 ◽  
Vol 17 (2) ◽  
pp. 179
Author(s):  
Eva Imelda ◽  
Feti Karfiati ◽  
Maya Sari Wahyu ◽  
Irawati Irfani ◽  
Primawita Oktarima ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Refractive Error ◽  
Axial Length ◽  
Prediction Error ◽  
Visual Rehabilitation ◽  
Predictive Error ◽  
Age At Surgery ◽  
Significant Difference ◽  
Developmental Cataract

Abstract: Cataract is one of the leading treatable causes of visual impairment in children. Visual rehabilitation is crucial for the development of good visual function after cataract surgery in children. The research aimd to describe post-operative Predictive Refractive Error (PRE) in congenital and developmental cataracts in Cicendo National Eye Hospital from January 2017 to December 2018. This is a retrospective analytic observational study from medical records. We found 107 eyes of 62 children with congenital and developmental cataracts had had cataract surgery and primary implantation of Intraocular Lens (IOL) in Pediatric Ophthalmology and Strabismus Unit, Cicendo National Eye Hospital. The patients were divided into two groups, with axial length (AXL) of ≤ 24 mm and > 24 mm. The paired t-test was used to compare Predictive Error (PE) in SRK/T, SRK II, and Showa SRK formula. Mean age at surgery was 6.7 ± 4.0 years.  Ninety-five eyes had AXL ≤ 24 mm, and 12 eyes had AXL > 24 mm. Prediction Error from patients with AXL ≤ 24 mm was 0.29 D, and from patients with AXL > 24 mm was 2.40 D in SRK/T formula (P < 0.05). There was no significant difference between PE and Absolute Predictive Error (APE) in SRK/T, SRK II, and Showa SRK in patients with AXL > 24 mm (P > 0.05). SRK/T is the most predictable formula in patients with AXL ≤ 24 mm. There is no significant difference in patients with AXL > 24 mm in all formulas. Keywords: congenital and developmental cataract, axial length, Prediction Error, intraocular lens

scholarly journals Congenital and developmental cataract surgery with undercorrected Intraocular lens (IOL) power implantation targeting emmetropia at 8 years of age and post-operative refractive status

2021 ◽  
Vol 12 (9) ◽  
pp. 126-129
Author(s):  
Kabindra Bajracharya ◽  
Anjita Hirachan ◽  
Kriti Joshi ◽  
Bimala Bajracharya
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lens ◽  
Axial Length ◽  
Iol Implantation ◽  
Refractive Status ◽  
Developmental Cataract ◽  
Iol Power ◽  
The Mean ◽  
One Year

Background: In congenital and developmental cataract primary undercorrection of intraocular lens (IOL) power is a common practice. However, long-term refractive status of these children is largely unknown. Aims and Objective: To analyse refractive status after cataract surgery with undercorrected IOL power implantation in congenital and developmental cataract. Materials and Methods: This study was descriptive, retrospective conducted for three years from 1st January 2013 to 31st December 2015. The children (> 6 months to <=7 years of age) who underwent cataract surgery for congenital and developmental cataract with a primary IOL implantation and had reached the age of 8 years were studied. The data were collected in terms of demography, axial length, biometry, IOL implanted, hyperopic correction and postoperative refractive status at 8 years. Results: Total numbers of children operated were 181 with total eyes 288. Unilateral cases were 74 (40.88%) and bilateral 107 (59.12%). Male were 121 (66.85%) and female were 60 (33.15%) with male is to female ratio of 2:1. Right eye was involved in 152 (52.8%) and left eye 136 (47.2%). The mean axial length at the age of one year was 20.75 mm, and gradually increased as age increased which was 22.47 mm at 6 years. The mean biometry was 27.9 diopter (D) at the age of one year which gradually decreased as age increased. Of the total 288 congenital cataract operated, complete follow-up documents were available for 77 (26.74%) eyes up to 8 years which showed emmetropia achieved in 25.97%, myopia in 28.57% and hypermetropia in 45.45%. Conclusion: Primary IOL implantation with hyperopic correction is accepted practice in congenital and developmental cataract. Emmetropia can be achieved however some hyperopic or myopic refractive status at the age of 8 years is not a surprise. Myopic shift continues as the age increases. Parent awareness for early detection and surgery, optical correction and regular follow-up are essential for good outcome.

Evaluating Risk Factors of Glaucoma Following Paediatric Cataract Surgery

2009 ◽  
Vol 03 (01) ◽  
pp. 27
Author(s):  
Birgitte Haargaard ◽  
John Thygesen ◽  
◽  
Keyword(s):  
Risk Factors ◽  
Intraocular Pressure ◽  
High Risk ◽  
Cataract Surgery ◽  
Pressure Measurement ◽  
Axial Length ◽  
Early Age ◽  
Corneal Diameter ◽  
Paediatric Cataract

The risk of developing glaucoma after paediatric cataract surgery is substantial. A number of risk factors have been associated with the post-operative development of glaucoma, the most important and consistent one being age at the time of surgery. Glaucoma occurs in up to one-third of patients who have had cataract surgery at an early age (<9 months), with a particularly high risk when surgery is performed during the first four weeks of life. The discovery of glaucoma in children <2 years of age often requires additional measurements apart from the intraocular pressure measurement. Young children have elastic eye bulbs, and an increase in axial length, an increase in corneal diameter and/or an increase in excavation of the optic disc may be the only indication of glaucoma. The risk of glaucoma after paediatric cataract surgery continues throughout life, and it is therefore pertinent to perform glaucoma evaluation of these patients during follow-up.

Management of cataracts secondary to intravitreal chemotherapy injections for retinoblastoma seeding

2021 ◽  
pp. 112067212110233
Author(s):  
İrem Koç ◽  
Hande Taylan Şekeroğlu ◽  
Hayyam Kıratlı ◽  
Sepideh Lotfisadigh
Keyword(s):  
Cataract Surgery ◽  
Disease Free Survival ◽  
Preventive Measure ◽  
Tumor Control ◽  
Free Survival ◽  
Anterior Vitrectomy ◽  
Intravitreal Chemotherapy ◽  
Chemotherapy Administration ◽  
Age At Surgery

Purpose: To report our experience in the management of cataracts presumably due to intravitreal chemotherapy administration in eyes with vitreous disease associated with retinoblastoma. Methods: This retrospective study consisted of a cohort of five eyes of five retinoblastoma patients who developed cataracts secondary to intravitreal chemotherapy administration and who then underwent cataract surgery. All patients underwent lensectomy and anterior vitrectomy with/without intraocular lens implantation via clear corneal approach. All cases were administered intraoperative intravitreal melphalan (35–40 mcg) and topotecan (10–20 mcg) at the end of cataract surgery as a preventive measure against retinoblastoma spread. Injections were repeated as needed in monthly follow-ups. Main outcome measures were enucleation rate and disease-free survival time. Results: The age at surgery ranged between 5 and 10 years. Follow-up time varied from 12 to 16 months. Treatment-free period before surgery ranged between 3 and 20 months. Time from last injection to cataract detection was: 2, 2, 10, 6, and 7 months; and time from last injection to cataract surgery was: 8, 3, 20, 7, and 15 months in cases 1–5, respectively. None of the eyes required enucleation. Tumor control was achieved in all patients at the end of follow-up. Conclusions: Injection of melphalan and topotecan into anterior parts of the vitreous may lead to cataract formation. This can be safely managed with lensectomy and anterior vitrectomy and the use of intravitreal administration of melphalan and topotecan at the conclusion of the surgery as a precautionary measure against the potential risk of extraocular spread.

Predicting future axial length in patients with paediatric cataract and primary intraocular lens implantation

2020 ◽  
pp. 112067212094874
Author(s):  
Antonio Carlos Lottelli
Keyword(s):  
Axial Length ◽  
Influence Factors ◽  
Male And Female ◽  
Iol Implantation ◽  
Bilateral Cataract ◽  
Age At Surgery ◽  
Lens Implantation ◽  
Unilateral Cataract ◽  
Paediatric Cataract

Objective: Creating a model to predict Axial Length (AL) growth in paediatric cataract and evaluating influence factors. Material and methods: Eyes with AL measured at surgery and at least one measurement after a 6-month period, from children with unilateral or bilateral cataract and primary IOL implantation, were evaluated. A “rate of axial length growth” (RALG) was calculated for every single eye using these AL measurements and log10 age. One average RALG was calculated for All Eyes and for the groups of Bilateral and Unilateral, Gender, Age at the Surgery, different Visual Acuity, Bilateral Excluded and Not-excluded eye, and Affected and Not-affected eye in unilateral, for comparisons. Results: Average age at surgery from 76 children was 2.83 ± 2.74 (0.11–12.21) years with follow up of 2.84 ± 1.84 (0.52–8.17) years, 29 (37.66%) had unilateral cataract. A total of 357 AL measurements were used, average of 4.70 ± 2.13 (2–10) measurements per eye. The average RALG for all eyes was 4.51 ± 3.06. There were no RALG significant differences comparing Unilateral and Bilateral eyes ( p = 0.51), Male and Female ( p = 0.26), Age at Surgery <0.5 and >0.5 years old ( p = 0.21), both eyes in Bilateral cases ( p = 0.70) and Unilateral Affected and Not-affected eyes ( p = 0.18). The equation Al = initial AL + slope ×  Log10 ((age + 0.6)⁄(initial age + 0.6)) estimates ALs in different ages. Conclusions: A model to predict AL growth in paediatric cataract was developed. Different studied factors did not significantly influence AL growth.

Mobile femtosecond laser platform for pediatric cataract surgery

2017 ◽  
Vol 28 (2) ◽  
pp. 246-250 ◽  
Author(s):  
Simon S.M. Fung ◽  
John Brookes ◽  
Mark R. Wilkins ◽  
Gillian G.W. Adams
Keyword(s):  
Femtosecond Laser ◽  
Cataract Surgery ◽  
Intraoperative Complications ◽  
Cataract Extraction ◽  
Pediatric Cataract ◽  
Corrected Visual Acuity ◽  
Pediatric Cataract Surgery ◽  
Anterior Capsulotomy ◽  
Paediatric Cataract

Purpose: To describe the use of a mobile femtosecond laser platform in assisting paediatric cataract surgery. Methods: A mobile femtosecond laser was brought into the operating room and calibrated on the day of the surgery. After general anesthesia is induced, the femtosecond laser was docked onto the eyes with a liquid-filled interface, without any perioperative adaptations or additional surgical procedures. An anterior capsulotomy was created with the femtosecond laser, followed by conventional cataract extraction and intraocular lens implantation. Results: Five eyes of 3 children with congenital cataracts were treated with this technique. Docking and capsulorhexis were successful in all cases. No perioperative or intraoperative complications were noted in any of the cases. At median follow-up of 15 months (range 6-18 months), all patients had improved best-corrected visual acuity. Conclusions: Using the mobile femtosecond laser platform, a perfectly sized anterior capsulotomy could be created with high precision and accuracy in paediatric cataract cases, while ensuring that perioperative care for the children undergoing the procedure was not compromised.

scholarly journals Prevalence and Associated Risk Factors of Pulmonary Tuberculosis in Diabetic Patients

2020 ◽  
Vol 3 (1) ◽  
pp. 47-51
Author(s):  
P.V.R. Leelamohan ◽  
Mohan Kumar R
Keyword(s):  
Pulmonary Tuberculosis ◽  
Economic Status ◽  
Extrapulmonary Tuberculosis ◽  
Insulin Requirement ◽  
Diabetic Patients ◽  
Sudden Increase ◽  
Female Ratio ◽  
X Ray ◽  
Study Results ◽  
Associated Risk Factors

Background: One-third of India’s population is infected with mycobacterium tuberculosis; there are 12 million active tuberculosis cases in India. One person dies of Tuberculosis every minute in India. No other disease has so much sociological, economic and health significance as Tuberculosis has. In 2005 there were an estimated 8.8 million new cases of Tuberculosis worldwide, with 1.9 million of those occurring in India. In India in 2000, there were an estimated 481,573,000 people over the age of 25 years. Among these, 4.3% i.e. around 20,707,639 had diabetes, 19 and 939,064 developed. Subjects and Methods: The study conducted over a period of 2 yrs. Adult patients with diabetes mellitus with pulmonary Tuberculosis were included, while Diabetic patients with extrapulmonary Tuberculosis were excluded from the study. Results: The maximum incidence of pulmonary Tuberculosis was noted above the age of 30yrs were 13(26.0%). The peak incidence was in the age group of 31 – 40 and 41 – 50 yrs. The mean age is 52.62. As Shown in [Figgure 1], the total numbers of males were 64% and females were 36%. The male to female ratio was 2.11:1 As Shown in [Table 3], the distribution of patient according to their occupation noted were Skilled (18%), Unskilled (38%), Business (16%), Service (2%), Housewife (22%), and Student (4%). As shown in [Table 4], the socio-economic status among 50 patients was distributed into: Upper (2%), Upper Middle (22%), Upper lower (32%), Lower (12%), Lower middle (32%), and Lower-middle (32%). Conclusion: Early diagnosis and properly monitored treatment regimen is the only time tested answer to this problem. All diabetics at the initial diagnosis and every year must have an x-ray chest done. All diabetics with abnormal weight loss,  unexplained cough, or sudden increase of insulin requirement should have sputum examination and chest x-ray done.

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

2018 ◽  
Vol 103 (1) ◽  
pp. 112-118 ◽  
Author(s):  
Mulusew Asferaw ◽  
Sisay Yoseph Mekonen ◽  
Geoffrey Woodruff ◽  
Clare E Gilbert ◽  
Samson Tesfaye
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Case Series ◽  
Northwest Ethiopia ◽  
Retrospective Case ◽  
Postoperative Rehabilitation ◽  
Bilateral Cataract ◽  
Eye Health ◽  
Paediatric Cataract

AimTo assess visual acuity outcomes, and factors associated with the outcome, of paediatric cataract surgery at the Child Eye Health Tertiary Facility, Gondar, Northwest Ethiopia.MethodsThe medical records of children aged below 16 years who underwent cataract surgery between September 2010 and August 2014 were reviewed for preoperative, surgical and postoperative data.ResultsOne hundred and seventy-six eyes of 142 children (mean age 7.9 years±4.2 SD, 66% male) who had cataract surgery were included. Twenty-five per cent (35/142) of children had bilateral cataract, 18 (13%) had unilateral non-traumatic cataracts and 89 (63%) had unilateral traumatic cataracts. An intraocular lens was implanted in 93% of eyes. Visual acuities at last follow-up: bilateral cases in the better eye: good (≥6/18 or fix and follow) in 21/34 eyes (62%), borderline (<6/18–6/60) in 4 eyes (12%) and poor (<6/60) in 9 eyes (26%). In unilateral non-traumatic cases: good in 6 eyes (33%), borderline in 3 eyes (17%) and poor in 9 eyes (50%). In unilateral traumatic cases: good in 36 eyes (40%), borderline in 20 eyes (23%) and poor in 33 eyes (37%). In bilateral cataract, worse outcomes were associated with preoperative nystagmus/strabismus. In traumatic cases, worse outcomes were associated with the preoperative trauma-related complications.ConclusionsVisual 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.

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

2020 ◽  
Vol 20 (4) ◽  
pp. 1817-27
Author(s):  
Janvier Kilangalanga Ngoy ◽  
Thomas Stahnke ◽  
Serge Dinkulu ◽  
Emile Makwanga ◽  
Astrid Moanda ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Childhood Blindness ◽  
Bilateral Cataract ◽  
Visual Outcomes ◽  
Post Conflict ◽  
Long Term Follow Up ◽  
Republic Of The Congo ◽  
Paediatric Cataract

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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