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Pediatric cataract surgery in Nepal.

Jaya Thakur1, Harsha Reddy, M Edward Wilson

  • 1Tilganga Eye Center, Kathmandu, Nepal.

Journal of Cataract and Refractive Surgery
|August 18, 2004
PubMed
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Pediatric cataract surgery in Nepal, involving intraocular lens (IOL) implantation, showed significant visual improvement. Combined anesthesia was well-tolerated, and primary posterior capsulotomy with anterior vitrectomy reduced visual axis opacification.

Area of Science:

  • Ophthalmology
  • Pediatric Surgery
  • Global Health

Background:

  • Cataract surgery in children presents unique challenges.
  • Data on pediatric cataract surgery outcomes in Nepal is limited.
  • Understanding surgical techniques and outcomes is crucial for improving pediatric eye care in developing regions.

Purpose of the Study:

  • To report the first case series of pediatric cataract surgery from Nepal.
  • To evaluate the safety and efficacy of intraocular lens (IOL) implantation in children with cataracts.
  • To analyze surgical techniques and postoperative outcomes in a Nepalese pediatric population.

Main Methods:

  • A consecutive series of 112 eyes from 85 children undergoing cataract surgery with IOL implantation at Tilganga Eye Center, Nepal.

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  • Combined ketamine and peribulbar block anesthesia used for all patients.
  • Data collected included demographics, cataract type, surgical approach (extracapsular cataract extraction with or without posterior capsulotomy and anterior vitrectomy), visual acuity, and complications.

    • Main Results:

    • Two surgical techniques were used: ECCE+PCAP+AV+PCIOL (73 eyes) and ECCE+PCIOL (39 eyes).
    • Mean age at surgery was 6.2 years; mean follow-up was 5.4 months.
    • Visual axis/posterior capsule opacification was more frequent in the ECCE+PCIOL group (46.2%) compared to the ECCE+PCAP+AV+PCIOL group (5.5%).
    • Visual acuity improved in both groups; deprivation amblyopia was the leading cause of poor outcomes.
    • No anesthesia-related complications were reported.

    Conclusions:

    • Intraocular lens implantation during pediatric cataract surgery under combined ketamine and peribulbar anesthesia is safe and effective in Nepal.
    • Primary posterior capsulotomy and anterior vitrectomy effectively prevent visual axis opacification without increasing complications.
    • The study highlights the feasibility of achieving significant visual improvement in pediatric cataract patients in Nepal.