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

2016 ◽  
Vol 3 (2) ◽  
pp. 35-38
Author(s):  
Hari Bahadur Thapa ◽  
Salma KC Rai ◽  
Arjun Malla Bhari ◽  
Ken Bassett

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

2021 ◽  
Vol 7 (2) ◽  
pp. 184-189
Author(s):  
G Srinivasan ◽  
Deepa R

To analyze the visual outcome in patients with pseudoexfoliation and to know the surgical parameters to cogitate in patients with pseudoexfoliation syndrome. An Observational study which was conducted in the Ophthalmology department in a tertiary care hospital in a rural area from June 2019 to December 2019. A total of 52 eyes of 52 patients aged 40 years and above, of either sex, clinically diagnosed with senile cataract and associated with pseudoexfoliation were enrolled in the study. After assessing best corrected visual acuity (BCVA), a detailed anterior and posterior segment examination was performed along with lacrimal sac syringing, manual keratometry, contact A-scan biometry and intraocular lens (IOL) power was calculated. All patients underwent manual small incision cataract surgery under peribulbar anaesthesia and intraocular lens was implanted. Intraoperative complications were noted during the surgery and was reported .Best corrected visual acuity was recorded on day 1, at 1week and at 1 month of follow up. Out of 52eyes of 52 patients, 29 were females (55.76%) and 38 eyes (73.07%) exhibited bilateral involvement. Distribution of the PXF material in various ocular structures was observed and majority of them (36.53%) had PXF material equally in iris, pupillary margin and lens. Based on the morphology of cataract associated with psudoexfoliation, nuclear cataract was the most commonly observed in 16 eyes (30.76%) and 42 eyes (80.76%) had moderate pupillary dilatation. The intraoperative difficulties observed during cataract surgery was poor pupillary dilatation which was managed by controlled sphincterotomy during the surgery in 3 eyes (5.76%), Iridiodialysis, rhexis extension, zonular dialysis each in 1 eye and posterior capsular rent in 2 eyes. Around 92.30% of the total study population achieved post-operative BCVA of 6/12 or better at 1month of follow up. Decreased visual acuity was noted in 2 (3.84%) eyes due to persistent corneal edema, one eye (1.92%) had posterior capsular opacification and one eye (1.92%) had cystoid macular edema. This study concludes that with careful preoperative assessment and necessary intraoperative precautions, good visual outcome can be achieved in patients with cataract with pseudoexfoliation.


2020 ◽  
pp. 173-176
Author(s):  
Kinjal Rathod ◽  
Kinjal Trivedi ◽  
Snehal Nayi ◽  
Somesh Aggarwal

Introduction: Cataract is most common cause of curable blindness worldwide and cataract surgery is most common procedure performed in ophthalmology. Posterior capsular opacification (PCO) is most common complication after cataract surgery which is usually treated with Neodymium-doped: Yttrium Garnet (Nd:YAG) laser posterior capsulotomy or occasionally with a surgical capsulotomy. The incidence and severity of PCO correlates to the type of surgical technique, IOL optic edge designs and IOL materials. Material and Methods: 70 eyes of 64 patients operated for age related cataract were studied in this prospective interventional study. Phacoemulsification was done in 35 eyes and SICS in 35 eyes with hydrophobic single piece biconvex foldable intraocular lens. Patients were followed up at 1, 3, 6, 9 and 12 months for the development of PCO. Clinically significant PCO (loss of 2 or more lines of Snellen’s visual acuity chart) was treated with Nd:YAG laser capsulotomy. Results: The overall incidence of PCO was 22.85%. Amongst the patients who developed PCO, SICS and phacoemulsification was performed in 62.5% and 37.5% patients respectively. Result was statistically significant with p value <0.05 using z test. On first postoperative day, patients operated with phacoemulsification had better visual acuity than SICS. Conclusion: Phacoemulsification can provide early and better visual outcome than SICS and has lower incidence of PCO formation which may be due to difference in irrigation and aspiration and less disruption of blood aqueous barrier than SICS. PCO can be reduced by atraumatic surgery and thorough cortical clean up and capsular polishing.


2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Sarah Claudia Ambroz ◽  
Marc Töteberg-Harms ◽  
James V. M. Hanson ◽  
Jens Funk ◽  
Daniel Barthelmes ◽  
...  

Purpose. To determine and to analyze the outcome of pediatric cataract surgery. Methods. A retrospective chart review of individuals aged up to 10 years who underwent cataract surgery between January 1, 2004, and December 31, 2014, at the UniversityHospital Zurich, Switzerland. Results. 63 children (94 affected eyes) with bilateral (68/94) or unilateral (26/94) cataract were identified. Surgery was performed at a median age of 1.5 months (IQR: 1.3–2.6 months) for the aphakic group (45/94) and of 50.7 months (IQR: 38.0–78.4 months) for the IOL group (49/94). At the last follow-up visit (median 31.1 months, IQR: 18.4–50.2 months), visual acuity was better in bilateral than in unilateral cataract cases. Posterior capsular opacification (PCO) was diagnosed in 30.9% of eyes without a significant difference in the IOL and aphakic groups (p=0.12). Aphakic glaucoma was diagnosed in 12/45 eyes at a median of 6.8 months (IQR 2.1–13.3 months) after surgery. Microcornea (5/12) and anterior segment anomalies (8/12) were associated with glaucoma development (p<0.05). Conclusion. Laterality and timing of surgery influence the outcome of pediatric cataract surgery. PCO was the most frequent postoperative complication. Aphakic glaucoma is often associated with ocular developmental abnormalities and a poor visual outcome.


Author(s):  
Andi Arus Victor ◽  
Fitria Romadiana ◽  
Ari Djatikusumo ◽  
Elvioza ◽  
Gitalisa Andayani Adriono ◽  
...  

Background: Endophthalmitis is one of the emergencies in ophthalmology and can cause blindness. The most common cause of endophthalmitis in intraocular surgery is cataract surgery. Immediate diagnosis and treatment can provide optimal final vision. This research aimed to describe the demographic data, and causative microorganisms, as well as the success rate of visual outcome after pars plana vitrectomy (PPV) in post-cataract surgery endophthalmitis in Cipto Mangunkusumo Hospital. Methods: A retrospective descriptive study of post-cataract surgery endophthalmitis underwent vitrectomy in Cipto Mangunkusumo Hospital, Indonesia, from January 2017 - June 2017. Results: There were twenty one cases of post-cataract surgery endophthalmitis undergoes PPV within the period of January 2017-June 2017. The most frequently identified causative microorganism was Staphylococcus (23%). There was an improvement of visual acuity after PPV procedure in 47,6% post-cataract surgery endophthalmitis. Conclusion: Immediate PPV is an effective treatment and leads to vision improvement in post-cataract surgery endophthalmitis.   Keywords: pars plana vitrectomy, endophthalmitis, cataract surgery


2020 ◽  
Vol 4 (3) ◽  
Author(s):  
Abiola T. Owolabi ◽  
Susannah T. Adepoju ◽  
Olawale Oladejo ◽  
Kunle I. Oreagba

Background: Cataract surgery is the most common operation performed in ophthalmology. It is the commonest cause of reversible blindness globally, in Sub-Saharan Africa and Nigeria. The study examined some factors affecting the outcome of cataracts surgery measured by Visual acuity after 6 weeks. Methods: Data was collected from the records of ophthalmic patients who had cataract surgery at LAUTECH Teaching Hospital Ogbomoso, from the period of January 2013 to December 2018. Two hundred and twenty-seven patients’ records were retrieved for the study. Logistic Regression was used to investigate factors associated with the outcome of Cataracts Surgery. The goodness of fit test was used to determine the fit of the model to the data. Results: Two variables; intraoperative complication, and unaided visual acuity on the fir st postoperative day were statistically significant (p-value < 0.05). The outcome of surgery using unaided visual acuity after six weeks of surgery showed that 47.1% of the patients had a good visual outcome (6/18) or better and 52.9% had a poor outcome (worse than 6/60). Factors such as complications within six weeks, presence of ocular and systemic comorbidity, and presence of intraoperative complications were found to increase the likelihood of poor outcomes in cataract surgery. Conclusion: This study has shown that Intraoperative complications and unaided visual acuity on the first postoperative day are important to the outcome of cataract surgery. Therefore, the two factors should be given attention during cataract surgery


2017 ◽  
Vol 5 (3) ◽  
pp. 1-10
Author(s):  
L R Puri ◽  
G S Shrestha

Trauma is an important cause of monocular blindness in the developing world. This study aims to determine the demo­graphic profile and visual outcome of cataract surgery among the children with traumatic cataract. It was a prospective and longitudinal study of 189 consecutive children below 16 years who underwent cataract surgery with intra ocular lens (IOL) implantation for traumatic cataract at Sagarmatha Choudhary Eye Hospital, Lahan, Nepal from October 2012 to March 2014. Assessment included visual acuity measurement in the Snellen’s chart or the Cardiff card, anterior segment examina­tion with slit lamp, dilated fundus examination with the help of +20D lens in indirect ophthalmoscope, B-scan ultrasonogra­phy of posterior segment and objective and subjective refraction. Follow up was scheduled at first post-operative day, at dis­charge, one month and three months. Cause and type of trauma, demographic factors, surgical intervention, complications, and visual acuity was recorded. Among 189, majority of them were males (73%) and the average age was 8.8±3.6 years. The time of presentation ranged from 3 days to 8 years (median age two months). Wooden stick was the most common cause of injury (34.4%). The average preoperative visual acuity in logMAR scale was 1.6. The average postoperative visual acuity in logMAR scale was 0.8. Eye injuries with traumatic cataract are associated with significant visual impairment. Cataract surgery with intraocular lens implantation restores vision significantly.


2012 ◽  
Vol 32 (1) ◽  
pp. 14-18 ◽  
Author(s):  
UD Shrestha ◽  
MK Shrestha

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  


2013 ◽  
Vol 7 (1) ◽  
pp. 1-3 ◽  
Author(s):  
Oluleye Tunji Sunday

Background: Posterior vitrectomy facilities are lacking in Sub Sahara Africa due to paucity of trained personnel in vitreo retinal subspecialty. More cases are seen needing vitrectomy, especially cases with vitreous opacities and complications of cataract surgery as more residents are being trained. The review will aim to determine whether vitrectomy facility should be a priority as part of ophthalmic facility in the region. Method: A 3 year review was carried out. All cases of posterior vitrectomy performed at the retinal unit of the University College Hospital, Ibadan, Africa between 2008 and 20011 were retrieved. Indications, and visual outcome were documented. Proportions and percentages were used to analyse the data. Results: Sixty six posterior vitrectomies were performed during the period. The most common indication for vitrectomy was vitreous hemorrhage n=30 [45.5%].Complication of cataract surgery such as dropped intraocular lens 7 [10.7%], sclera fixated intra ocular lens 6 [9.2%], and dropped nucleus 5 [7.5%] were emerging indications. Other indications noted include complicated retinal detachments 4 (6.1%), membranectomy for posterior capsule opacity from pediatric cataract surgery 3 (4.5%) and congenital lens subluxation 2 (3.0%). Improved visual outcome was noted after surgery. Forty nine [75%] eyes were blind [visual acuity of < 3/60] before vitrectomy. This proportion dropped to 24 [37%] after vitrectomy with an additional 24% regaining navigational vision [visual acuity of 3/60 to Counting fingers at 1meter] . Conclusion: Vitrectomy should be an integral part of eye care and its availability should be made a priority in ophthalmic facilities of Sub Sahara Africa, especially those involved in ophthalmology training.


2020 ◽  
Vol 5 (8) ◽  
pp. 216-223
Author(s):  
Dr. Deepa R. ◽  
◽  
Dr. V. Panimalar A. Veeramani ◽  

Objective: Posterior capsular opacification (PCO) is a postoperative complication causing decreasedvisual acuity. This study aims to study the efficacy of Nd: YAG laser capsulotomy in posteriorcapsular opacification following cataract surgery by analyzing the visual outcome. Material andMethods: A prospective study included a sample size of 50 eyes of 37 patients with Posteriorcapsular opacification following uneventful cataract surgery with significantly decreased visual acuity.Detailed anterior and posterior segment examination was done, best-corrected visual acuity (BCVA)was recorded along with measurement of IOP. Posterior capsulotomy was performed using Nd: YAGlaser (Neodymium: Yttrium-aluminum–garnet) and patients were followed up. Visual acuity wasassessed and complications if any were recorded. Results: It was noted that 74% of the patients atthe end of 1st week and 78% of the patients at the end of 1st and 3rd month had significant visualimprovement following Nd: YAG laser capsulotomy. There was a statistically significant difference inPost Nd: YAG laser BCVA on follow up with P-value <0.001. Complications encountered were the risein IOP in 6% of the population at the end of 1 hour and 1st day of the procedure, iris bleeding wasnoted in 4% of the population, intraocular lens damage in 2 %, and cystoid macular edema in 2 %of the study population.


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