Improving postoperative follow-up of children receiving surgery for congenital or developmental cataracts in Africa

Abstract

Access to cataract surgery for children has improved in recent years, and there are a number of tertiary facilities for children's eye health in sub-Saharan Africa. However, surgery alone will have limited value if postoperative follow-up is poor. We have developed a program to improve follow-up after pediatric cataract surgery and compare the follow-up rates before and after implementation. Baseline information was collected from 2003 to 2004. Program activities were implemented in 2005. Postintervention information was collected from 2006. During both periods all children younger than 16 who had cataract surgery at Kilimanjaro Christian Medical Centre Hospital were included. Follow-up, defined at both 2 weeks and 10 weeks, was recorded. Baseline data showed that 67% and 43% of children, respectively, came for 2-week and 10-week postoperative follow-up. After the intervention, 89% came for 2-week follow-up and 83% came for 10-week follow-up. Gender inequity, documented in the baseline data, was eliminated in the postintervention period. Follow-up of children who have had cataract surgery can be greatly enhanced in Africa. Improved follow-up enables children to receive the spectacles and low vision devices necessary for visual rehabilitation. Multiple strategies will probably be needed to improve follow-up.