Abstract

Objectives: To evaluate visual and functional outcome of bilateral pediatric cataract surgery with intraocular lens implantation in Kabgayi Eye Unit, Rwanda. Methods: Surgical, pre-, and postoperative data of bilateral pediatric cataract surgery cases performed between 1999 and 2007 were collected from the notes. During a prospective follow-up visit in 2008 full eye examination was done, including best corrected visual acuity (BCVA) assessment and refraction. Functional vision in daily life was assessed using a questionnaire. Results: The follow-up examination was attended by 108 children (56.5% girls, participation rate 87.8%). Mean age at the time of surgery was 6.6 years (SD 4.6, range 0-19). Cataract was noticed ≤ 3 months in 83.7% (n = 77). Mean delay between start of symptoms and operation date was 4.9 years (SD 4.0, range 0-16 years). Preoperative blindness was present in 79.1% of children (n = 68). Posterior capsulotomy and vitrectomy were performed in 161 eyes (83.9%). At the study visit (mean follow-up 33.6 months, SD 15.9) 33 children (35.1%) had BCVA ≥ 6/18 in their best eye and 13 remained blind (13.8%). Spherical equivalent ≤ 2 D was present in 42.6% and astigmatism ≤ 2 D in 80.5% (n = 157). Functionally, vision was normal or nearly normal in 76 children (71.7%) and severe low vision and blindness remained in 2 children each (1.9%). Conclusion: Bilateral pediatric cataract surgery can offer good functional results, even if BCVA does not improve to the same extent. Orthoptic and low vision facilities with efficient community liaison are recommended.

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