Introduction: Cataract is the main cause of blindness among children in Africa, replacing vitamin A deficiency and measles thanks to successful immunization programs. The leading cause of childhood blindness globally is paediatric cataract. Bilateral cataract surgery can help to improve visual performance and diminish the burden of childhood blindness.
Objective: This retrospective observational cohort study reports the long-term
outcomes of 298 children who had bilateral cataract surgery with IOL implantation
from 2001-2016 in Kinshasa, Democratic Republic of the Congo.
Methods: A standardized surgical treatment of paediatric cataract was practiced
on 298 children. Patient’s follow-up, complications, and visual outcomes were
recorded and analysed.
Results: The mean age was 5.7 ± 4.3 years and males were predominant (64.9%).
Most of the children were living mainly in urban poorest areas (96.3%).
Strabismus, nystagmus and microcornea were encountered in 20.1%, 25.1% and 8.7%
of children, respectively. Using WHO criteria most of patients were classified
as blind preoperatively and 81.9% of them had improved visual outcomes after
surgery. Main reasons for reduced vision during follow-up were secondary
cataract (5.7%), IOL decentration (1.2%), retinal detachment (1.2%), and
secondary glaucoma (1.5%). Complications that also negatively influence
outcomes can be divided into short-term and long-term. Short-term complications
(2.3%) include retinal detachment and IOL decentration. Long-term complications
(7.3%) are composed of the groups of secondary glaucoma and secondary
cataracts.
Conclusion: In spite of the post-conflict challenges, the elimination of
cataract blindness in children remains a priority. Children present at a late
age for surgery and long-term follow-up is poor. There is a need for program
strengthening in these areas. It is
recommended that the incorporation of routine cataract surgical outcome
auditing should be performed regularly to monitor outcomes by surgeon. This has
been seen to facilitate consist improvement in surgeons and centre surgical
outcomes and enhances a reduction in surgical complication over time.
Author(s) Details:
Janvier Kilangalanga Ngoy,
Eye Department, St. Joseph Hospital/CFOAC, Kinshasa, DRC.
Thomas Stahnke,
Department of Ophthalmology, Rostock University Medical Center, Rostock, Germany.
Serge Dinkulu,
Eye Department, St. Joseph Hospital/CFOAC, Kinshasa, DRC.
Emile Makwanga,
Programme National de Sante Oculaire et Vision (PNSOV), Kinshasa, DRC.
Astrid Moanda,
Réhabilitation à Assise Communautaire (RAC/CBR), Kinshasa, DRC.
Georgette Ngweme,
Eye Department, St. Joseph Hospital/CFOAC, Kinshasa, DRC.
Edith Mukwanseke,
Eye Department, St. Joseph Hospital/CFOAC, Kinshasa, DRC.
Günther Kundt,
Rostock University Medical Center, Institute for Biostatistics and Informatics in Medicine and Ageing Research, Rostock, Germany.
Frank Thiesen,
Rostock University Medical Center, Institute for Biostatistics and Informatics in Medicine and Ageing Research, Rostock, Germany.
Adrian Hopkins,
Programme National de Sante Oculaire et Vision (PNSOV), Kinshasa, DRC.
Rudolf F. Guthoff,
Department of Ophthalmology, Rostock University Medical Center, Rostock, Germany.
Please see the link here: https://stm.bookpi.org/ANUMS-V5/article/view/13308
No comments:
Post a Comment