Bilateral paediatric cataract surgery - outcomes of 298 children from Kinshasa, the Democratic Republic of the Congo

Afr Health Sci. 2020 Dec;20(4):1817-1827. doi: 10.4314/ahs.v20i4.36.

Abstract

Introduction: The leading cause of childhood blindness globally is paediatric cataract. Bilateral cataract surgery can help to improve visual performance and to diminish the burden of childhood blindness.

Objective: To report in a retrospective observational cohort study the long-term outcomes of 298 children who had bilateral cataract surgery with IOL implantation from 2001-2016 in Kinshasa.

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 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%).

Conclusion: In spite of the post conflict challenges, 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 need for program strengthening in these areas.

Keywords: Paediatric cataract surgery; bilateral cataract; outcomes.

MeSH terms

  • Blindness / etiology*
  • Cataract / diagnosis*
  • Cataract Extraction*
  • Child
  • Child, Preschool
  • Cohort Studies
  • Democratic Republic of the Congo
  • Female
  • Follow-Up Studies
  • Glaucoma / etiology*
  • Humans
  • Male
  • Retrospective Studies
  • Treatment Outcome
  • Vision, Low / etiology*