scholarly journals Limitations in Cataract Surgical Services in Children in Ethiopia: A Nationwide Survey of Pediatric Cataract Surgeons

2021 ◽  
Author(s):  
Mulusew Asferaw ◽  
Kumale Tolesa ◽  
Sadik Taju Sherief ◽  
Bezawit Tadegagne ◽  
Mandefro Sintayehu ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Addis Ababa ◽  
Nationwide Survey ◽  
Intraocular Lenses ◽  
World Health ◽  
Pediatric Cataract ◽  
Factors Affecting ◽  
Referral Hospitals ◽  
Pediatric Cataract Surgery ◽  
Health Organization

Abstract Background: Bilateral cataract is a significant cause of blindness in Ethiopia. This study aimed to identify the resources available for cataract surgery in children, and to assess current surgical practices, surgical output and factors affecting the outcome of surgery in Ethiopia. Methods: A Google Forms mobile phone questionnaire was emailed to nine ophthalmologists known to perform cataract surgery in young children.Results: All nine responded. All but one had received either 12- or 3-5-month’s training in pediatric ophthalmology with hands-on surgical training. The other surgeon had received informal training from an experienced colleague and visiting ophthalmologists. Five worked in the capital, Addis Ababa, and they worked in six public referral hospitals and one private center. Over 12 months (2017-2018) 508 children underwent surgery; 84 (17%) children had bilateral and 424 (83%) had unilateral cataract, mainly following trauma (mean 66 (range 18-145 standard deviation (SD) ±47) eyes/surgeon). There were substantially fewer surgeons per million population (nine for 115 million population) than recommended by the World Health Organization and they were unevenly distributed across the country.Methylcellulose and rigid intraocular lenses were generally available but less than 50% of facilities had a sharp vitrectomy cutter and cohesive viscoelastic. Mean travel time outside Addis Ababa to a facility offering pediatric cataract surgery was 10 hours. Conclusion: Despite the high number of cases per surgeon, the output for bilateral cataracts was far lower than required. More well-equipped ophthalmologists trained in pediatric cataract surgery are urgently required, with deployment to under-served areas.

scholarly journals Limitations in cataract surgical services for children in Ethiopia: a nationwide survey of pediatric cataract surgeons

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mulusew Asferaw ◽  
Kumale Tolesa ◽  
Sadik Taju Sherief ◽  
Bezawit Tadegagne ◽  
Mandefro Sintayehu ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Addis Ababa ◽  
Nationwide Survey ◽  
Intraocular Lenses ◽  
World Health ◽  
Pediatric Ophthalmology ◽  
Pediatric Cataract ◽  
Factors Affecting ◽  
Bilateral Cataract ◽  
Health Organization

Abstract Background Bilateral cataract is a significant cause of blindness in children in Ethiopia. This study aimed to identify the resources available for cataract surgery in children, and to assess current surgical practices, surgical output and factors affecting the outcome of surgery in Ethiopia. Methods A Google Forms mobile phone questionnaire was emailed to nine ophthalmologists known to perform cataract surgery in young children (0–5 years). Results All nine responded. All but one had received either 12- or 3–5-month’s training in pediatric ophthalmology with hands-on surgical training. The other surgeon had received informal training from an experienced colleague and visiting ophthalmologists. The surgeons were based in seven health facilities: five in the capital (Addis Ababa) and eight in six public referral hospitals and one private center. Over 12 months (2017–2018) 508 children (592 eyes) aged 0–18 years (most < 15 years) were operated by these surgeons. 84 (17%) had bilateral cataract, and 424 (83%) had unilateral cataract mainly following trauma. A mean of 66 (range 18–145) eyes were operated per surgeon. Seventy-one additional children aged > 5 years were operated by other surgeons. There were substantially fewer surgeons per million population (nine for 115 million population) than recommended by the World Health Organization and they were unevenly distributed across the country. Methylcellulose and rigid intraocular lenses were generally available but less than 50% of facilities had a sharp vitrectomy cutter and cohesive viscoelastic. Mean travel time outside Addis Ababa to a facility offering pediatric cataract surgery was 10 h. Conclusion Despite the high number of cases per surgeon, the output for bilateral cataracts was far lower than required. More well-equipped pediatric ophthalmology teams are urgently required, with deployment to under-served areas.

scholarly journals Comparison of Visual Outcomes and Patient Satisfaction Between two Diffractive Trifocal Intraocular Lenses

2021 ◽  
Author(s):  
asli cetinkaya yaprak ◽  
Mustafa Unal
Keyword(s):  
Visual Acuity ◽  
Patient Satisfaction ◽  
Cataract Surgery ◽  
Intraocular Lenses ◽  
World Health ◽  
Uncorrected Distance Visual Acuity ◽  
Significant Difference ◽  
Prospective Comparative Study ◽  
Health Organization ◽  
Clinical Trials Registry

Abstract Purpose To evaluate the clinical outcomes and visual quality of patients undergoing cataract surgery with the implantation of two different models of diffractive trifocal intraocular lenses (IOLs).MethodsThis randomized prospective comparative study included 60 eyes of 15 patients who scheduled to undergo bilateral cataract surgery with the implantation of two models of diffractive trifocal IOLs (RayOne Trifocal and AcrySof IQ PanOptix IOL). Monocular and binocular corrected and uncorrected distance visual acuity (CDVA, UDVA), intermediate visual acuity (DCIVA, UIVA) at 60 and 80 cm, near visual acuity (DCNVA, UNVA), and patient satisfaction were compared over a three-month follow-up.ResultsEach group comprised 30 eyes of 15 patients. No statistically significant differences were determined between the groups in terms of CDVA, UDVA, DCNVA and UNVA. The monocular and binocular UIVA values at 60 cm were better in the PanOptix IOL group (p=0.04 and p=0.01, respectively), and the DCIVA and UIVA values at 80 cm were better in the RayOne IOL group (p=0.01, p=0.047, p<0.001, and p=0.042, respectively). No statistically significant difference was found between the groups in relation to the frequency and severity of visual symptoms evaluated. Regarding discomfort, the RayOne IOL group had more bothersome halos and starbursts (p=0.026 and p=0.01, respectively).ConclusionBoth IOLs provided very good restoration of visual acuity. However, with the AcrySof IQ PanOptix IOL, the likelihood of patients experiencing bothersome halos and starbursts was less. The RayOne Trifocal IOL might be a better choice for patients who require further intermediate vision.The study was registered under the World Health Organization international clinical trials registry platform: NCT04655274, 30/11/2020, prospectively registered.

Heparin-surface-modified intraocular lenses in pediatric cataract surgery: Prospective randomized study

1999 ◽  
Vol 25 (6) ◽  
pp. 782-787 ◽  
Author(s):  
Surendra Basti ◽  
Murali K. Aasuri ◽  
Madhukar K. Reddy ◽  
Padmaja Preetam ◽  
Sreelakshmi Reddy ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Randomized Study ◽  
Intraocular Lenses ◽  
Prospective Randomized Study ◽  
Pediatric Cataract ◽  
Pediatric Cataract Surgery ◽  
Surface Modified

Changes of anthropometric parameters of an eye during the implantation of toric intraocular lenses in children with congenital cataracts.

2021 ◽  
pp. 101-104
Author(s):  
A.I. Shilov ◽  
◽  
K.K. Shefer ◽  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Intraocular Lenses ◽  
Pediatric Cataract ◽  
Congenital Cataracts ◽  
Positive Effects ◽  
Postoperative Astigmatism ◽  
Toric Iols ◽  
Significant Difference ◽  
Pediatric Cataract Surgery

Aim. The aim of the study is to examine changes in the anthropometric and refractive parameters of the eyeball in children with congenital cataracts who have been implanted with various types of IOLs (toric or classic monofocal). Materials and methods. In this work, we retrospectively studied the medical history of 34 children (42 eyes) aged 4 to 15 years, who underwent phacoemulsification of congenital cataracts with implantation of various types of IOLs: toric and simple monofocal. Further, in these groups, by statistical methods, the dynamics of refraction in the first three years after the operation, the incidence of postoperative astigmatism, and its dynamics were assessed. We also assessed the rate of change in the anteroposterior axis of the eyeball, the dynamics of refraction in terms of the total spheroequivalent and maximum visual acuity in 3 years after the operation. Results. According to the results of the study, it was shown that toric IOLs significantly better stimulate the process of emmetropization of the eyeball, and also have a significant tendency to completely eliminate postoperative astigmatism, within 3 years after surgery. However, there were no significant differences in maximally corrected visual acuity between the 2 compared groups. There were also no data showing a significant difference in the more frequent development of myopia in the group receiving the toric IOL. Conclusion. The correct choice and calculation of the IOL remains one of the most difficult tasks in pediatric cataract surgery. New technologies are introduced annually and require constant testing. In this study, we have shown the possibility of using toric IOLs and their positive effects in pediatric cataract surgery and in the prevention and treatment of obscuration amblyopia. Key words: pediatric cataract, intraocular lenses, myopia, refraction, phacoemulsification, amblyopia.

Comparison of polymethylmethacrylate versus hydrophobic acrylic lenses for primary intraocular lens implantation in pediatric cataract surgery

2020 ◽  
Vol 1 (3) ◽  
pp. 160-165
Author(s):  
Gamze Uçan Gündüz ◽  
◽  
Berna Akova Budak ◽  
Keyword(s):  
Postoperative Complications ◽  
Cataract Surgery ◽  
Intraocular Lenses ◽  
Safe Procedure ◽  
Pediatric Cataract ◽  
Iol Implantation ◽  
Group I ◽  
Pediatric Cataract Surgery ◽  
Group Ii ◽  
Hydrophobic Acrylic

AIM: To compare the visual results and postoperative complications of polymethylmethacrylate (PMMA) and hydrophobic acrylic intraocular lenses (IOLs) in children who underwent cataract extraction with primary IOL implantation. METHODS: This retrospective study included 117 eyes of 63 children with bilateral pediatric cataract undergoing cataract surgery and primary IOL implantation. The patients were divided into two groups, Group I included 58 eyes of 30 patients with PMMA IOLs; Group II included 59 eyes of 33 patients with hydrophobic acrylic IOLs. The clinical features, refraction errors, best corrected visual acuity (BCVA) and surgical complications were compared between two groups. RESULTS: The mean age at the time of surgery was 5.8 (2-12)y and mean follow up period was 40.5 (6-196)mo. Postoperatively, BCVA was ≥0.5 in 80 eyes (68.4%) and this was comparable in two groups. Visual axis opacification was seen in 28 eyes (48.3%) in Group I and 16 eyes (27.1%) in Group II and this difference was statistically significant (P=0.018). Postoperative IOL dislocation and posterior synechia formation were also noted. When all postoperative complications were considered, there were significantly less complications in the acrylic IOL group than PMMA IOL group (P=0.020). CONCLUSION: Pediatric cataract surgery with primary IOL implantation is a safe procedure. Hydrophobic acrylic IOLs may lead to less postoperative complications compared to PMMA IOLs.

scholarly journals Factors affecting the visual outcome of pediatric cataract surgery: a hospital based prospective study in eastern Nepal

2018 ◽  
Vol 9 (2) ◽  
pp. 143-148
Author(s):  
Santosh Chaudhary ◽  
Poonam Lavaju ◽  
Bhuwan Govinda Shrestha ◽  
Sangeeta Shah ◽  
Sanjib Kumar Chaudhary
Keyword(s):  
Developing Countries ◽  
Congenital Cataract ◽  
Visual Outcome ◽  
World Health ◽  
Pediatric Cataract ◽  
Childhood Blindness ◽  
Factors Affecting ◽  
The World ◽  
Pediatric Cataract Surgery ◽  
Global Initiative

The World Health Organization’s (WHO) global initiative for the elimination of avoidable blindness by the year 2020 (Thylefors et al., 1995) has prioritized the control of childhood blindness. Currently cataract remains one of the most important causes of treatable blindness in children (Giles et al., 2016).In Nepal, as in other developing countries, cataract is believed to be a leading cause of blindness in children. According to The Nepal Blindness Survey from 1978 to 1980, congenital cataract accounted for 16.3% of blindness detected in children under the age of 15 years (Brilliant et al., 1985). Epidemiology of Blindness in Nepal 2012 survey has suggested that the prevalence of childhood blindness has reduced from 0.68% in 1981 to 0.4% in 2011 (Sapkota, 2012).

scholarly journals Refractive Outcome of Posterior Optic Capture versus Intrabagal Implantation of Intraocular Lenses in Pediatric Cataract Surgery

2020 ◽  
pp. 61-68
Author(s):  
Hend Mohammed Elshershaby ◽  
Waleed Abdelhady Allam ◽  
Ahmed Fekry Elmaria ◽  
Rabab Mohammed Elseht
Keyword(s):  
Cataract Surgery ◽  
Intraocular Lenses ◽  
Refractive Outcome ◽  
Pediatric Cataract ◽  
Iol Implantation ◽  
Significant Difference ◽  
Group A ◽  
Pediatric Cataract Surgery ◽  
The Mean ◽  
Group B

Purpose: To compare refractive outcome of posterior Optic Capture versus In-the-bag Implantation of Intraocular Lenses in Pediatric Cataract Surgery. Design: Prospective, randomized and comparative study. Methods: Forty eyes of 25 children (12 males and 13 females) were included in this study with unilateral or bilateral cataracts in the pediatric age during the period between October 2018 to July 2019. These children were diagnosed to have congenital or developmental cataracts. All children underwent cataract surgery and IOL implantation. In our study, all children were divided into two groups: group (A) included 22 eyes that underwent posterior capsulorhexis and anterior vitrectomy with IOL implantation entirely in the capsular bag and group (B) included 18 eyes that underwent posterior capsulorhexis and posterior optic capture of the IOL. Patient demographics, surgical intervention, presenting symptoms, postoperative refraction and follow up of refractive changes for 6 months were recorded. Results: Ten cases were unilateral and fifteen cases were bilateral. The mean age was 5.44 ±3.30 in group (A) while the mean age was 4.26±1.45 in group (B). At 1.5 month, the mean spherical error in group (A) was 2.85 ± 1.41 D  with range from 1 to 6.5D, and the mean spherical error in group (B) was 2.50 ± 1.70 D with range from -0.75 to 3.75 D with no statistically significant difference in both groups. The mean cylindrical error in group (A) was -0.96 ± 1.87 D with range from -3.5 to 2.25D and the mean cylindrical error in group (B) was -1.38 ± 1.79 D with range from -3 to 2D with no statistically significant difference in both groups. At 6 months, the mean spherical error in group (A) was 0.73 ±1.89 D  with range from -4.00 to 3.75D and the mean spherical error in group (B) was 0.00 ± 2.27 D with range from -3.50 to 2.7D with no statistically significant difference in both groups. The mean cylindrical error in group (A) was -1.21± 0.90 D with range from -2.75 to 1.25D and the mean cylindrical error in group (B) was -1.68 ±0.93 D with range from -3.00 to -0.75D with no statistically significant difference in both groups. Conclusion: There was no statistically significant difference between in-the-bag intraocular lens implantation and intraocular lens posterior optic capture in the term of post-operative refraction.  Posterior optic capture helped in preventing posterior capsule opacification (PCO) postoperatively in all cases.

Sign in / Sign up

Export Citation Format

Share Document