Abstract
Purpose: We aim to describe the clinical profile and visual outcome of paediatric patients who underwent cataract surgery in a tertiary ophthalmology referral centre in West Malaysia from 2013 to 2018. Methods: This is a retrospective review of all paediatric patients who underwent cataract surgery in our centre from 2013-2018. Results: A total of 35 eyes from 23 patients were included. There were 10 (43.5%) female and 13 (56.5%) male patients. Twelve patients (24 eyes) had bilateral cataract while 11 patients had unilateral cataract. Sixteen (45.7%) eyes had congenital cataract, followed by ectopia lentis (n=10, 28.6%), traumatic cataract (n=8, 22.9%) and steroid induced cataract (n=1, 2.8%). Three types of intraocular lens (IOL) were implanted: which were posterior chamber IOL (n=22, 62.9%), iris claw IOL (n=12, 34.3%) and scleral-fixated IOL (n=1, 2.8%). Majority of eyes (n=28, 80%) had primary IOL implantation. Twenty-five (71.4%) eyes achieved best corrected visual acuity (BCVA) of 6/12 and better at 6 months post-IOL implantation. There was no statistically significant difference in the BCVA at 6 months post-IOL implantation among the different cataract aetiology, primary or secondary IOL implantation and types of IOL implant. Eight (22.9%) eyes developed post-operative complications, which included posterior capsular opacification (PCO) (n=6, 17.1%), IOL decentration (n=4, 11.4%) and glaucoma (n=1, 2.8%). Nineteen (82.6%) patients required glasses for visual rehabilitation. Conclusion: Majority of the paediatric cataract patients achieved BCVA of 6/12 or better at 6 months post-IOL implantation. The visual outcome among the different cataract aetiology, primary or secondary IOL implantation and types of IOL implanted were similar. PCO was the most common post-operative complication.
Highlights
Paediatric cataract accounts for 13.6% of visual impairment among children in the Southeast Asia region [1]
Sixteen (45.7%) eyes had congenital cataract, ten (28.6%) eyes had ectopia lentis, eight (22.9%) had traumatic cataract and one (2.8%) had steroidinduced cataract
Of the four patients who were younger than 5 years old, they had a target refraction of emmetropia as early visual rehabilitation was required in these patients and parents were not keen for hypermetropic correction via glasses or contact lens during the early post-operative period
Summary
Paediatric cataract accounts for 13.6% of visual impairment among children in the Southeast Asia region [1]. In Malaysia, lens-related pathologies contributed to 17.2% of blindness or severe visual impairment among children aged 15 years and below [2]. World Health Organization (WHO) has identified efforts in paediatric cataract management a priority in their Vision 2020 global initiative in elimination of avoidable blindness [1]. Majority of paediatric cataract cases are congenital. Acquired cataracts (such as following ocular trauma) have been reported to be relatively common [3,4]. Causes of congenital or acquired paediatric cataract include ocular abnormalities, trauma, intrauterine infections, associated syndromes or hereditary causes. [5] Paediatric cataract is regularly associated with Causes of congenital or acquired paediatric cataract include ocular abnormalities, trauma, intrauterine infections, associated syndromes or hereditary causes. [5] Paediatric cataract is regularly associated with
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