P Gogate1,2,3, D Parbhoo4, P Ramson1, R Budhoo4, L Øverland1, N Mkhize1, K Naidoo2,5, S Levine6, A du Bryn4, L Benjamin7. 1. Orbis Africa, Cape Town, Republic of South Africa. 2. African Vision Research Institute, University of KwaZulu Natal, Durban, Republic of South Africa. 3. Dr Gogate's Eye Clinic, Pune, India. 4. Department of Ophthalmology, Inkosi Albert Luthuli, Central Hospital, Durban, KwaZulu Natal, Republic of South Africa. 5. Brien Holden Vision Research Institute, Durban, Republic of South Africa. 6. School of African and Gender Studies, Anthropology and Linguistics, University of Cape Town, Cape Town, Republic of South Africa. 7. Consultant Ophthalmic Surgeon, Stoke Mandeville Hospital, Aylesbury, Bucks, UK.
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.
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.
Authors: P Gogate; D Parbhoo; P Ramson; R Budhoo; L Øverland; N Mkhize; K Naidoo; S Levine; A du Bryn; L Benjamin Journal: Eye (Lond) Date: 2016-08-12 Impact factor: 3.775