title: Barriers to follow-up for pediatric cataract surgery in Maharashtra, India: how regular follow-up is important for good outcome. The Miraj Pediatric Cataract Study II.
abstract: BACKGROUND
  Regular follow up and amblyopia treatment are essential for good outcomes after pediatric cataract surgery.
  
  
  OBJECTIVE
  To study the regularity of follow-up after cataract surgery in children and to gauge the causes of poor compliance to follow up.
  
  
  METHODS
  262 children (393 cataracts) who underwent cataract surgery in 2004-8.
  
  
  METHODS
  The children were identified and examined in their homes and a "barriers to follow-up" questionnaire completed. Demographic data collected, visual acuity estimated, and ocular examination performed.
  
  
  METHODS
  SPSS version 19.
  
  
  RESULTS
  Of the 262 children, only 53 (20.6%) had been regularly following up with any hospital, 209 (79.4%) had not. A total of 150 (57.3%) were boys and the average age was 13.23 years (Std Dev 5 yrs). Poor follow up was associated with the older age group ( P < 0.001), less education of mother ( P = 0.012), father's occupation ( P = 0.031), how much money spent on travel ( P = 0.033) and was it paid or free surgery ( P = 0.001). It was not related to gender, numbers of children in family, ordinal status of child, and social strata. Distance and cost were major barriers, as was the inability of the eye care center to communicate the importance of follow up. A prospective follow-up visit showed that 93 children needed Nd: YAG LASER capsulotomy, 5 needed low vision aids, 4 contact lens, and 162 a change of spectacles. The average visual acuity improved in 150 (38.8%) eyes >1 line with regular follow-up.
  
  
  CONCLUSIONS
  Regular follow-up is important and improves vision; eye care practitioners need to take special efforts to ensure better follow-up.
authors.affiliation: Lions NAB Eye Hospital, Miraj, District Sangli; Dr. Gogate's Eye Clinic, Pune, Maharashtra, India.
authors.forename: Parikshit
authors.initials: P
authors.lastname: Gogate
authors.forename: Shailbala
authors.initials: S
authors.lastname: Patil
authors.forename: Anil
authors.initials: A
authors.lastname: Kulkarni
authors.forename: Ashok
authors.initials: A
authors.lastname: Mahadik
authors.forename: Rahin
authors.initials: R
authors.lastname: Tamboli
authors.forename: Rekha
authors.initials: R
authors.lastname: Mane
authors.forename: Rishiraj
authors.initials: R
authors.lastname: Borah
authors.forename: G V
authors.initials: GV
authors.lastname: Rao
mesh_terms: D000293:Adolescent; D002386:Cataract / Q000453:epidemiology*; D002387:Cataract Extraction / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014792:Visual Acuity; D055815:Young Adult