Long-Term Visual Outcome of Paediatric Cataract Surgery at Kitwe Teaching Eye Hospital, Kitwe, Zambia

Abstract

Aims: To determine the long-term visual outcome of paediatric cataract surgery performed at Kitwe Teaching Eye Hospital, Zambia. Study Design:  Cross sectional study. Place and Duration of Study: Kitwe Teaching Eye Hospital between January 2018 and December 2019. Methodology: Study population included all children aged between five and fifteen operated on. Participants underwent visual acuity and refraction re-assessment two years post-Operatively. Continuous variables were summarized using the median and interquartile ranges. Stuart-Maxwell test for paired data and Univariate and multivariable logistic regression analysis was used for data analysis. Results: A total of 117 children participated in the study. About 29% of the children had complications after cataract surgery, and anterior segment complications were the most common experienced complications 18 (15.4%) after surgery. Only one (0.9%) child had visual acuity of (6/18 and better) before surgery while 24 (24.4%) had good visual acuity outcome six weeks after surgery, and at two years after surgery, 41(41.8%) had attained good visual outcome. The visual acuity outcome at six weeks after surgery significantly differed from the visual acuity outcome after two years with the proportion of good visual outcome increasing after two years. Pre-operatively, posterior segment accessibility (AOR 0.13; 95% CI: 0.03 – 0.69), developmental cataracts (AOR 3.09; 95% CI: 1.17 – 8.14) and refraction done at six weeks, were all associated with good visual outcome at two  years after surgery. Poor outcomes were associated with delayed refraction, done after six weeks (AOR 0.22; 95% CI: 0.08 – 0.58), increased number of anterior segment complications (AOR 0.14; 95% CI: 0.03 – 0.72) and posterior segment complications (AOR 0.09; 95% CI: 0.01 – 0.83). Conclusion: Children's vision significantly improved with time after cataract surgery. Long-term visual outcome follow-up post-surgery is important as it increases the proportion of children attaining good visual outcome after surgery and helps correct uncorrected refractive errors hence optimizing the best visual acuity a child can attain.