Abstract
PURPOSE: The study has examined the problems encountered during management of cataract surgery during clinical practice within a developing country. 
 
 METHODS: A retrospective study was conducted by recruiting patients with the diagnosis of congenital cataract operated between 2011 and 2014. Intraocular lens was implanted, when the corneal diameter was 10 mm or more, which approximately corresponded to the capsular bag diameter, regardless of the patients’ age. 
 
 RESULTS: The results showed that 13 were aphakic and none of them developed visual axis opacification. Eleven out of the 49 pseudophakic patients needed 2 or more surgeries to clear visual axis opacification; whereas, 25 out of 49 pseudophakic patients received hydrophobic intraocular lens. However, 3 of them (12%) developed visual axis opacification. The remaining 24 patients received hydrophilic intraocular lens, where 8 of them (33%) developed visual axis opacification. There was increased incidence of visual axis opacification as a result of pseudophakia that required a second surgery, which delayed their visual rehabilitation. 
 
 CONCLUSION: Hydrophobic intraocular lenses are better used because of their lower risk to induce visual axis opacification.
Highlights
The occurrence of congenital cataract has been considered as among leading causes of childhood blindness in the developing countries (H. Lin et al, 2014)
Concerning the hydrophobic group, 3 patients (12%) developed visual axis opacification (VAO) that clarified the requirement of second surgery
Pseudophakia resulted in higher number of patients being lost from follow up, which may be a reason to perform bilateral surgery by taking the necessary measures to prevent postoperative infection
Summary
The occurrence of congenital cataract has been considered as among leading causes of childhood blindness in the developing countries (H. Lin et al, 2014). The occurrence of congenital cataract has been considered as among leading causes of childhood blindness in the developing countries Lin et al, 2014). Cataract is associated with clouding of eye’s natural lens as age of an individual progresses. The congenital cataract commonly occurs among newborn infants as a result of infection, trauma, diabetes, drug reactions, inherited tendencies, inflammation, and metabolic problems (Lambert, 2004). Congenital cataract may even develop as a reaction against tetracycline antibiotic, taken by pregnant women to treat infection (Ventura, Sampaio, Ventura, Ventura, & Nosé, 2013). The abnormalities associated with congenital cataracts occur by the formation of essential proteins that maintain the transparency of eye’s natural lens
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