Clinical Profile of Paediatric Cataract and Surgery in a Tertiary Eye Care Centre, Nepal

Introduction: Paediatric cataract is the opacification of lens and its capsule in children below 14 years of age. The management of paediatric cataract is lens aspiration with or without anterior vitrectomy, with or without intra-ocular lens implantation. The objective was to present the profile of pediatric cataract of operated eyes in children ≤14 years. Materials and Methods: This was a descriptive study in a hospital setting. A review of pediatric cataract cases operated between November 2007 and June 2009 in Tilganga Institute of Ophthalmology (TIO), a tertiary eye care centre in Nepal was carried out. The personal profile, preoperative and intra-operative details were noted. In the statistical analysis p value less than 0.05 is considered as significant. Results: A total of 175 eyes of 132 children had presented during study. The sex ratio was 1.6 male per female with mean age of 6.7 years (SD ±4.3). About one-third (32%) presented within the age of three years where as more than two-fifths (46%) presented at the age eight years and above. Seventy two cases were collected through door to door enumeration and screening clinics for children. The proportion of cataract was higher in males than in females (P>0.05). Visual acuity ranged from 6/18 to follows light. Conclusion: Nearly half of the paediatric cataract had presented after the age of eight years mainly from hilly region through the screening program. Most of the pediatric cataract cases presented with the whitish pupillary reflex with more than two-thirds of visual acuity of less than 3/60. The most common type of the cataract surgery performed was lens aspiration with anterior vitrectomy with lens implantation. The earlier the surgery better is the visual prognoses. Hence, community screening through as door to door screening and one day screening clinics will help for early referral and earlier surgery to reduce visual disabilities due to paediatric cataract. Key words: Cataract; Cataract surgery; Childhood blindness; Nepal DOI: http://dx.doi.org/10.3126/jnps.v32i1.5378 J. Nepal Paediatr. Soc. Vol.32(1) 2012 14-18

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Tertiary Eye Care Centre Model for Development of Paediatric Cataract Surgery Services in Developing Countries

Journal of Nepal Medical Association ◽

10.31729/jnma.42 ◽

2011 ◽

Vol 51 (183) ◽

Author(s):

U D Shrestha

Keyword(s):

Developing Countries ◽

Economic Loss ◽

Developing Nations ◽

Care Centre ◽

Ocular Lens ◽

Eye Care ◽

Social Burden ◽

Lens Implantation ◽

Operating Theatres ◽

Paediatric Cataract

It is estimated that every minute a child becomes bilaterally blind in developing nations. Paediatric cataract blindness presents an enormous problem to developing countries in terms of the human social burden, economic loss, and morbidity. The management of the paediatric cataract is lens aspiration with intra ocular lens implantation with anterior vitrectomy. The surgery should be performed by paediatric ophthalmologist in tertiary eye care centres. Facilities of general anaesthesia should be available in these centres and the operating theatres should be well-equipped with vitrectomy machine, biometry and portable keratometer. Keywords: Blindness; paediatric cataract; tertiary eye care centre.

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Visual outcome of congenital and developmental cataract surgery in Lumbini Eye Institute

Asian Journal of Medical Sciences ◽

10.3126/ajms.v9i2.18780 ◽

2018 ◽

Vol 9 (2) ◽

pp. 36-39

Author(s):

Anjita Hirachan ◽

Kabindra Bajracharya ◽

Salma KC Rai ◽

Arjun Malla Bhari ◽

Avinash Chandra

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Visual Outcome ◽

Economic Loss ◽

Final Visual Acuity ◽

Pediatric Cataract ◽

Anterior Vitrectomy ◽

Developmental Cataract ◽

Verbal Group ◽

Prospective Longitudinal

Background: Paediatric blindness presents as an enormous problem to developing countries in terms of human morbidity, economic loss and social burden.Aims and Objective: The objective of this study was to observe the visual outcome of congenital and developmental cataract surgery.Materials and Methods: This study was prospective, longitudinal and interventional. The patients aged ≤15 years, diagnosed either congenital or developmental cataract and planned for cataract surgery were enrolled during March 2014 to February 2015 at Lumbini Eye Institute, Nepal. The patients underwent either: a) Lens aspiration + PPC+ Anterior Vitrectomy; b) Lens aspiration + PPC+ Anterior Vitrectomy + PCIOL; c) Lens Aspiration + PCIOL depending upon age of patient. The patients were examined after surgery day 1, day 2, after 2 weeks and after 6 weeks. Glasses were prescribed at 6 weeks from the date of surgery. Occlusion therapy was initiated in cases wherever necessary.Results: A total of 54 eyes of 43 children were included in the study. The sex ratio was 1.26 female per male with mean age of 3 years (SD ± 2.16). In the verbal group, 61.1% (33 eyes) had final visual acuity (6/6-6/18). In the non verbal group, 16.7% (9 eyes) had final visual acuity of good fixation and follow. There was a statistically highly significant improvement in post surgical Best corrected visual acuity (p< 0.001).Conclusion: Good visual outcome after pediatric cataract surgery can be obtained if surgery is performed by skilled surgeon. The awareness of pediatric cataract, early diagnosis and timely intervention to surgical treatment, and postoperative management of residual uncorrected refractive error and amblyopia are important factors for the prevention of childhood blindness from cataract.Asian Journal of Medical Sciences Vol.9(2) 2018 36-39

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Visual outcomes of pediatric traumatic cataracts

European Journal of Ophthalmology ◽

10.1177/1120672118757657 ◽

2018 ◽

Vol 29 (1) ◽

pp. 23-27 ◽

Cited By ~ 2

Author(s):

Jitender Jinagal ◽

Gaurav Gupta ◽

Parul C Gupta ◽

Sonam Yangzes ◽

Rishiraj Singh ◽

...

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Visual Outcome ◽

Posterior Chamber ◽

Traumatic Cataract ◽

Anterior Vitrectomy ◽

Posterior Capsulotomy ◽

Good Visual Outcome ◽

Posterior Chamber Intraocular Lens ◽

Lens Implantation

Introduction: To report visual outcomes and risk factors of pediatric traumatic cataracts in a tertiary care referral center in northern India. Methods: We analyzed medical records of traumatic cataracts in the pediatric age group (1–15 years) operated for cataract surgery with or without posterior chamber intraocular lens implantation with or without primary posterior capsulotomy with anterior vitrectomy between 2004 and 2012. Causative agents, types of trauma, demographic factors, surgical interventions, complications, and visual acuity were recorded and compared among different groups. Results: A total of 147 children were documented to have undergone cataract surgery for traumatic cataract in the study period, male-to-female ratio being approximately 5:1. Mean age was 7.67 ± 3.30 years (range, 1–15 years). Type of primary insult was penetrating injury in 100 (68%) patients and blunt trauma in 47 (32%) patients. Mean interval between injury and cataract surgery in penetrating injury cases was 3.84 ± 7.05 months and in the blunt injury cases was 6.28 ± 11.13 months. Preoperatively, only 110 patients were cooperative for visual acuity. Out of them, none had vision better than 6/18 and only 21 patients (19.9%) had vision of ≥6/60. Visual acuity of 6/18 or better (was considered good visual outcome) was achieved by 87.9%, 97.3%, and 97.9% at 1, 6, and 36 months, postoperatively. Eyes which underwent primary posterior capsulotomy and anterior vitrectomy during cataract surgery showed statistically better visual outcome than those without it. Conclusion: Phacoaspiration with posterior chamber intraocular lens implantation along with primary posterior capsulotomy and anterior vitrectomy and timely introduction of amblyopia therapy helped in gaining good visual outcome in pediatric traumatic cataract patients irrespective of the age of presentation and the type of injury.

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VISUAL OUTCOME AND COMPLICATIONS OF PEDIATRIC CATARACT SURGERY AT LUMBINI EYE INSTITUTE, NEPAL

Journal of Universal College of Medical Sciences ◽

10.3126/jucms.v3i2.14289 ◽

2016 ◽

Vol 3 (2) ◽

pp. 35-38

Author(s):

Hari Bahadur Thapa ◽

Salma KC Rai ◽

Arjun Malla Bhari ◽

Ken Bassett

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Intraoperative Complications ◽

Demographic Data ◽

Visual Outcome ◽

Posterior Capsular Opacification ◽

Eye Care ◽

Pediatric Cataract ◽

Hospital Administrative

INTRODUCTION: Pediatric eye care, including cataract surgery, has become much more common in Nepal in recent years in tertiary facilities such as the Lumbini Eye Institute (LEI). This study provides the first report of visual outcome and complications after cataract surgery at that Institute. MATERIAL AND METHODS: This is a prospective observational study of all cataract surgical patients <16 years of age between March 1, 2011, and February 28, 2012. Visual outcome was assessed by two optometrists with pediatric eye care training. Clinical data were gathered in a specifically designed pediatric eye program database and demographic data were taken from hospital administrative records. RESULTS: In 2011-12, 334 children (248 boys [74%]) underwent cataract surgery, including 89 Nepali (27%) and 245 Indian (73%) children. In total, 320 (96%), 270 (81%), and 190 (57%) attended their first, second and third follow up visits respectively. Pre-operative visual acuity was <6/60 (91%), 6/60 to <6/18 (7%) and >6/18 (2%). Post-operatively, visual acuity was <6/60(27.5%), 6/60 to <6/18 (36.5%) and 6/18 or better (36%). The mean best corrected visual acuity was 6/38 first follow up, 6/34 second follow up, and 6/30 third follow up. Intraoperative complications were 1.6% pupillary capture and post-operative complications were 35.3% posterior capsular opacification (PCO). CONCLUSION: For 63% of children, visual acuity significantly improved with cataract surgery beyond their presenting vision of <6/60, with over 38% of children achieving visual acuity (>6/18). Follow up beyond one month needs significant improvement to treat postoperative complications particularly posterior capsular opacification.Journal of Universal College of Medical Sciences (2015) Vol.03 No.02 Issue 10Page: 35-38

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Pediatric Cataract Surgery: Comparison between Ages at Surgery and Contrast Sensitivity Outcomes

Ophthalmologica Indonesiana ◽

10.35749/journal.v43i1.138 ◽

2019 ◽

Vol 43 (1) ◽

pp. 50

Author(s):

Aquirina Caesari Putri ◽

Rozalina Loebis

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Contrast Sensitivity ◽

Cataract Extraction ◽

Significant Negative Correlation ◽

Natural World ◽

P Value ◽

Pediatric Cataract ◽

Low Contrast ◽

Significant Difference

Background: Pediatric cataracts are major causes of children’s blindness. Surgery has proven to be beneficial in terms of visual function prognosis. Contrast sensitivity evaluation after surgery is as important as visual acuity considering that natural world consists of various objects in low-to-medium contrasts. The purpose of this study is to analyze the difference of contrast sensitivity outcomes based on ages at surgery. Method: Retrospective data of children with pediatric developmental cataract from July 2013 to November 2015 were collected. All children who underwent cataract surgery at 60-months-old or less were randomized into two groups, ≤24 months and >24-to-60 months. Contrast sensitivity was then examined with preferential-looking method using Hiding Heidi low-contrast test face chart. The main outcome measures were contrast sensitivity of both groups. Age-at-evaluation, cataract onset, duration of follow-up, duration of deprivation and visual acuity were also noted. Result: Of 14 children (23 eyes), 11 eyes (47,8%) were in ≤24 months group, 12eyes (52,2%) were in >24-to-60 months group. All eyes underwent cataract extraction and similar type of intraocular lens implantation. Mean age-at-surgery was 28,2 months±16,8 (SD). Mean contrast sensitivity for each group was 47,50 %±42,29 and 18,33%±27,38, respectively, with p-value 0,031. Further analysis of Spearman’s correlation test demonstrated significant negative correlation (rs = -0,559; p = 0,006) between the two groups. Conclusion: There was statistically significant difference in contrast sensitivity between those who underwent surgery at ≤24 months and >24-to-60 months. Children who underwent surgery at older ages tend to have better contrast sensitivity afterwards.

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