Paediatric cataracts in a tertiary eye centre in South‑South Nigeria: an initial audit of surgical outcome

Abstract

Background: Paediatric cataracts is a leading cause of treatable blindness and a major cause of blindness in developing nations. Aim: To present an audit of paediatric cataract and paediatric cataract surgery in a Tertiary Eye Care facility in the South‑South Geopolitical Zone of Nigeria during the Seeing is Believing Project intervention. Materials and Methods: A retrospective study of case notes of children who received surgical and adjunctive treatment for cataracts in the Calabar Children’s Eye Centre during the 24‑month study period from November 1, 2017, to October 31, 2019, was undertaken. Results: Of the 128 children who met the inclusion criteria, 73 (57.0%) were males and 55 (43.0%) were females, giving a male: female ratio of 1.3:1.0. The mean age of patients in years was 5.9 ± 4.1 years, median/interquartile range was 5.0/5. The most frequent diagnosis was bilateral cataracts affecting 80 (62.5%) children. Systemic comorbidities were found in 13/128 (10.2%), of which 7/13 (53.8%) were congenital rubella syndrome. Ocular comorbidities (40.6%) were more common than systemic comorbidities, and sensory esotropia presented most frequently (16.4%). More patients with congenital cataracts had ocular comorbidities, and this association was statistically significant, P < 0.001. The proportion of patients with good visual outcomes was highest among those with bilateral cataracts (64.8%), and ocular comorbidities were a significant negative predictor of best corrected postoperative visual acuity. A total of 94/128 (73.4%) patients received intraocular lens implants, and the most common postoperative complications were visual axis opacification (VAO) 37/69 (53.6%) and fibrinous uveitis 26/69 (37.7). Conclusion: Paediatric cataracts were often bilateral and congenital. Postoperative complications like VAO are common and can be detected early and treated to improve visual outcomes with good follow‑up strategies.