Refractive outcomes of phacoaspiration in paediatric cataract : a retrospective cohort study

Author(s): Dr. Sameer Ashraf, Dr. Purendra Bhasin, Dr. Ashish Dhage and Dr. Sana Parveen

Background: Cataract is the mechanism of opacification of the lens of the eye, which is mostly seen in adults as a result of old age, associated comorbid conditions and systemic diseases. Globally, around 70 million blind- person-years are due to childhood blindness, out of which around 14%, i.e. 10 million blind-person-years are because of childhood cataract3. India has a huge burden of approximately 280,000–320,000 children with impaired vision, which leads to loss of millions of dollars. Hence we conducted a hospital based retrospective study on the presentation patterns, visual impairment and surgical outcomes of patients suffering from pediatric cataract in central India. Aim: To determine safety and visual outcomes for pediatric cataract done under RBSK in Ratan Jyoti Netralaya Ophthalmic Institute and Research Centre Gwalior (M.P.). Objective: To determine safety and visual outcomes for pediatric cataract done under RBSK at an Ophthalmic Research Institute in  developing country. Methods: This retrospective cohort study was conducted was conducted on patients diagnosed with congenital and developmental cataract under the age of 18 years presenting to the hospital and undergoing phacoaspiration surgery at xxx institute in Central India. For each patient, the Best Corrected Visual Acuity (BCVA) using snellen’s Chart and age at presentation was assessed. Clinical presentation, management and surgical outcomes were recorded. Results: The postoperative vision of 50 eyes was analyzed (Figure 2). 4 (8%) eyes had vision >6/12 (excellent), 7 (14%) eyes had vision between 6/24 and 6/12 (good), 39 (78%) of the eyes had vision between 6/60 and 6/36 (satisfactory). Conclusions: Our study revealed that cataract extraction with IOLs implantation done with anterior vitrectomy+ primary posterior capsulotomy is the procedure of choice for management of pediatric cataract. Cataracts associated with anterior segment abnormalities have a poor postoperative outcome. Early diagnosis and prompt surgical intervention are extremely important in the management of pediatric cataract, as also adequate visual rehabilitation in the form of spectacles with both distance and near correction.