Abstract
Purpose
To study the visual outcomes of congenital and developmental cataract surgery and determine variables for presentation for pediatric cataract surgery in KwaZulu Natal province of South Africa.
Methods
Care-givers of children presenting with cataract to a quaternary centre were asked when they first detected the condition. The reasons for delay between detection and surgery were studied. The children underwent a comprehensive eye examination and then appropriate surgery. They were prospectively followed up for 3 months and visual acuity and stereopsis were noted. Delay in presentation for surgery and visual outcomes were co-related with demographic and clinical factors.
Results
Eighty-three non-traumatic cataract surgeries in 50 children were studied. Twenty-six (52%) were males, mean age was 3 years 10 months (SD 3yrs 4 months). The mean delay between identification and surgery was 20.7 months (SD 18 months). Twenty-six (52%) children had >15 months interval between diagnosis and surgery. Only mother’s occupation was significantly associated with delay (P=0.017). Post-surgery 17/69 (24.7%) had visual acuity ≥6/18, 20/69 (29.0%) had vision between 6/24–6/60, whereas 32/69 (46.3%) had visual acuity ≤6/60. The final vision was associated with age (P=0.031), delay between diagnosis and surgery (P<0.001), type of surgery (P=0.046) and preoperative vision (P<0.001).
Conclusion
Although the children’s vision improved substantially, a longer follow-up and amblyopia treatment would be necessary to optimize the visual outcome, which depended on age and preoperative vision. Health promotion activities aimed at mothers are important in improving visual outcomes.
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Acknowledgements
We thank Jill Sloan, Nafisa Baboo, Hendrik Grobbelaar, Musa Gumede and Mbali Mpungose from Orbis Africa for help in logistics and data collection. Shrivallabh Sane of Data Clinic, Pune and Bharti Vidyapeeth Medical College, Pune for statistical analysis. We also thank Jyoti Jaggernath, African Vision Research Institute for her inputs. The study was funded by the Pediatric Cataract Initiative, Bausch and Lomb and Lions International.
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Gogate, P., Parbhoo, D., Ramson, P. et al. Surgery for sight: outcomes of congenital and developmental cataracts operated in Durban, South Africa. Eye 30, 406–412 (2016). https://doi.org/10.1038/eye.2015.211
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DOI: https://doi.org/10.1038/eye.2015.211
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