Pediatric cataract surgery in Nepal.
OBJECTIVE
To describe the first pediatric cataract surgery case series report from Nepal.


METHODS
Tilganga Eye Center, Kathmandu, Nepal.


METHODS
This study comprised a consecutive series of 112 eyes of 85 children having cataract surgery with intraocular lens (IOL) implantation. General anesthesia of ketamine combined with peribulbar block was used in all patients. Patients' demographics, cataract type and presenting symptoms, surgical intervention, preoperative and postoperative visual acuities, and follow-up clinical examinations were recorded.


RESULTS
Seventy-three eyes (65.2%) of 53 patients had extracapsular cataract extraction with posterior capsulotomy, anterior vitrectomy, and posterior chamber IOL implantation (ECCE+PCAP+AV+PCIOL), and 39 eyes (34.8%) of 32 patients had cataract extraction and IOL implantation with an intact posterior capsule (ECCE+PCIOL). Of all patients, the mean age at surgery was 6.2 years +/- 4.3 (SD). The median age in the ECCE+PCAP+AV+PCIOL group was 4.7 years and in the ECCE+PCIOL group, 11.0 years. The mean follow-up was 5.4 +/- 5.3 months. The most common postoperative complication in the ECCE+PCIOL group was visual axis/posterior capsule opacification, which was seen in 18 eyes (46.2%) compared to 4 eyes (5.5%) in the ECCE+PCAP+AV+PCIOL group. Visual acuity improved with surgery in both groups. The leading cause of poor outcomes was deprivation amblyopia. There were no anesthesia-related complications.


CONCLUSIONS
Implantation of an IOL at the time of cataract extraction under combined systemic ketamine and peribulbar lidocaine anesthesia appeared to be well tolerated and produced significant visual improvement in pediatric patients in Nepal. Primary posterior capsulotomy and AV helped prevent visual axis opacification without a significant increase in complications.
Thakur
Jaya
J
Tilganga Eye Center, Kathmandu, Nepal.
Reddy
Harsha
H
Wilson
M Edward
ME
Paudyal
Govind
G
Gurung
Rita
R
Thapa
Suman
S
Tabin
Geoffrey
G
Ruit
Sanduk
S
D000293:Adolescent; D000768:Anesthesia, General / Q000379:methods; D000778:Anesthetics, Dissociative / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D001766:Blindness / Q000453:epidemiology / Q000209:etiology; D002386:Cataract / Q000150:complications / Q000453:epidemiology; D002387:Cataract Extraction / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D005260:Female; D006801:Humans; D007223:Infant; D007649:Ketamine / Q000008:administration & dosage; D019654:Lens Implantation, Intraocular / Q000379:methods*; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D009390:Nepal / Q000453:epidemiology; D011183:Postoperative Complications; D014821:Vitrectomy
D000778:Anesthetics, Dissociative; D000779:Anesthetics, Local; D007649:Ketamine; D008012:Lidocaine