Outcome of childhood cataract surgery at Kenyatta National Hospital

Objectives: To determine visual outcome, intraoperative and postoperative complications due to childhood cataract surgery at Kenyatta National Hospital (KNH). Design: Retrospective study. Setting: Kenyatta National Hospital (KNH) Subjects: Records of 77 children with cataracts seen in KNH between 1995 and 2005 were reviewed; 8 patients were excluded. A total of 121 eyes analyzed from 58 children with bilateral and 11 with unilateral cataracts. Information of up to 6 months post-op was analyzed. Results: The mean duration between the time when cataract was fi rst noted and presentation at KNH was 6.4 months for congenital cataract and 35.7 months for developmental cataract. In 28 eyes, primary IOL implantation was performed, 17 eyes had secondary IOL implantation and 76 eyes remained aphakic. There was some improvement in visual acuity at 2 months after surgery compared to the visual acuity at presentation (p<0.001). However, there was no further improvement in visual acuity at 4 and 6 months after surgery (p=0.213 and 0.238 respectively). The main complications at 2, 4 and 6 months after surgery were posterior capsular opacifi cation and updrawn pupil. PCO occurred in 41.4% of the operated eyes; mainly in patients who had lens washout without anterior vitrectomy. Conclusion: The outcome of childhood cataract surgery at KNH was poor despite low rate of complications occurring during surgery. The poor outcome was attributed to late presentation, poor aphakic correction, development of PCO and loss to follow up.