Title: Paediatric Cataract-Type of Surgery Done in my Current Sample of Cases

Authors: Dr N. Suhasini M.S. FIGS, Dr V. Suryanarayana M.S., D.O.

 DOI: https://dx.doi.org/10.18535/jmscr/v8i11.46

Abstract

Aim: To describe and analyze type of surgery done in the management of paediatric cataracts.

Materials & Methods: A retrospective study of 68 subjects who had undergone cataract surgery during 2007-08 in Govt. REH. PMMA Lens (12mm) was implanted in the bag for children more than 2 years.  Intraocular lenses were not implanted for children aged less than 2 years.  Optical correction was given.

Results & Discussion: SICS+PCIOL done in 29 subjects,  phaco + PCIOL  done in 15 subjects, only ECCE  in 2 patients, ECCE+ACIOL in  1 patient & ECCE + PPC & PCIOL in 1 patient.

Conclusions:

  1. Improvement of child health care is needed for early detection of cataract in children.
  2. Role of rubella and trauma in childhood cataract should be investigated and addressed. Visual assessment and postoperative care should be further improved.
  3. Cataract surgery with unilateral and bilateral IOL implantation can provide a beneficial effect on final visual outcome in children who are operated- on, before abnormal foveolar function develops.
  4. Primary posterior chamber lenses are recommended for children six years of age and older
  5. Proper case selection and a controlled, skilled surgical approach, the use of an intraocular lens for visual rehabilitation in the pediatric age group is a feasible approach.
  6. Intraocular lens implantation for children with congenital or developing cataract is an effective treatment for visual rehabilitation, even for those patients age 2 years and younger.
  7. If nystagmus has developed, the amblyopia is unfortunately irreversible.
  8. Concerted efforts must be made to educate people about the prevention of blindness due to cataract in all age groups in general and the importance of continued follow up in the paediatric age group in particular.
  9. Apart from school screening programmes, training programmes must be conducted to equip teachers to identify vision problems and to sensitise them about the significance of early reporting.
  10. The facilities at primary Health care institutes need to be upgraded and the staff trained to provide postoperative follow up care to paediatric patients.
  11. Although the treatment of childhood cataract has evolved considerably over the years, providing high quality standard eye care still remains a challenge for the providers
  12. The eye care providers should collaborate with the programs related to child health care and address the underlying causes of cataract in children
  13. For this, the cooperation of parents, paediatricians & ophthalmologists is required.

Keywords: PMMA-Poly Methyl Methacrylate; REH: Regional Eye Hospital.

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