Visual outcomes following pediatric cataract surgery at Komfo Anokye Teaching Hospital in Ghana

Abstract

BACKGROUND

Pediatric cataract is a public health concern, and it causes long-term functional impairment and impacts the quality of life of the child with cataract. Visual impairment in children due to cataract has devastating consequences on their health, social life, and academic performance and places a socio-economic burden on the child’s family and society as a whole. Globally, pediatric cataract is a significant contributor to ocular morbidity and blindness. Findings from this study will help quantify the visual benefits of pediatric cataract surgical interventions and identify opportunities for improving pediatric cataract services.

AIM

To evaluate the visual acuity outcomes of children after cataract surgery.

METHODS

The study employed a retrospective electronic review of pediatric cataract surgeries from January 2019 to July 2021 at the pediatric unit of the eye department at Komfo Anokye Teaching Hospital (KATH), Ghana. Patient clinical data including demographics, cataract presentation, pre-operative and post-operative visual acuity, surgical procedure, postoperative complications, interventions and refraction were collected and analyzed using the Statistical Package and Service Solution. Pearson's χ² test and regression statistics were used to summarize data at a significance of P < 0.05.

RESULTS

163 children (257 eyes) underwent cataract surgery at KATH. The overall mean age was 3.81 ± 3.56 years. Congenital cataract was commonly observed (56.4%). All children underwent keratometry and phacoemulsification procedures. A few children (9.8%) experienced postoperative complications while 90.8% did not require further intervention after the surgery. After the surgery 27.0% of the children had refraction and the majority were corrected for myopia and near addition (12.9%). An analysis of the association of postoperative visual acuity and the type of cataract was statistically significant (P value < 0.05). There was a significant improvement in the visual outcomes following cataract surgery.

CONCLUSION

Timely pediatric cataract surgery improves postoperative visual outcomes. Creating awareness and implementing screening programs is important to ensure that the prevalence of childhood blindness is reduced to the barest minimum.

Keywords: Pediatric; Cataract; Ghana; Visual acuity; Best-corrected vision; Phacoemulsification

Core Tip: This study examines visual outcomes after pediatric cataract surgery at Komfo Anokye Teaching Hospital in Ghana, revealing significant insights into post-operative recovery. Our findings indicate a substantial improvement in visual acuity among children, with early intervention and tailored rehabilitation playing critical roles. Additionally, we identified key factors influencing visual outcomes, such as age at surgery, type of cataract, the cause and duration of cataract, complications after the surgery, follow-up visits and adherence to post-operative care. This study highlights the importance of creating awareness and implementing screening programs to reduce the prevalence of childhood cataract.