Delayed presentation of cataracts in children: are they worth operating upon?

Abstract

Purpose: Childhood cataract is an important cause of avoidable blindness in children. The study aimed to investigate the outcome of surgery in cataracts with delayed presentation which had been operated upon as new pediatric ophthalmology centers were set up in India.

Methods: This was a retrospective interventional case series from a community eye care center in Western India. Demographic, surgical, pre-operative and post-operative details were obtained from the patients records and entered into Microsoft excel and statistical analysis conducted using SPSS-11 software (SPSS, Chicago, IL). Vision was tested 6 weeks after surgery. The predictors of good vision (> or =6/18) were identified by regression analysis. If the interval between detection of cataract in children and their presentation for surgery was more than 18 months for developmental and 6 months for congenital the cataract was defined having a delayed presentation.

Results: Five hundred and twenty nine eyes of 437 children aged 2 months to 16 years were operated upon in 2004-2006. Preoperative vision was <3/60 in 405 (76.6%) eyes with cataract. Of these 529, 242 eyes were with delayed presentation of cataract (83 congenital and 149 other). 102 had up to 5 years, 91 had 6-10 years and 49 had >11 yrs delay in presentation. At 6 weeks following surgery, vision was > or = 6/18 in 36/93 (38.7%) of eyes with delayed presenting cataracts, as compared to 94/244 (38.5%) > or =6/18 in those without.

Conclusion: Surgery for cataracts with delayed presentation helps to regain functional vision, which can be used for navigation and low vision aids.