title: Cataract surgery outcomes in bangladeshi children.
abstract: OBJECTIVE
  To measure visual acuity (VA) outcomes, complication rates, and the social impact of cataract surgery in a cohort who underwent surgery as children in Bangladesh.
  
  
  METHODS
  Case series.
  
  
  METHODS
  A total of 471 of 850 children from 6 Bangladeshi districts who had been identified as cataract blind using key informants (KIs) between 2004 and 2009 during the Bangladesh Childhood Cataract Campaign (BCCC) together with all those children not included in the BCCC database but in the Child Sight Foundation (CSF) database who had been identified as cataract blind.
  
  
  METHODS
  The subjects and families were contacted again by KIs and transported to local examination centers, where parents and subjects were administered a questionnaire and subjects underwent full ocular examination. Where operative data were available (15%), they were analyzed in conjunction with questionnaire and examination findings. Statistical analysis was performed using SPSS Statistics (IBM, Armonk, NY).
  
  
  METHODS
  Presenting and best-corrected visual acuities (BCVAs), cause(s) of poor outcome, postoperative refraction, and school attendance.
  
  
  RESULTS
  A total of 407 of the participants had undergone bilateral surgery as children, with a mean follow-up of 8.8 years. The mean age at examination was 16 years (range, 5-28 years; standard deviation [SD], 4.6 years); 63% of those examined were male; 22% had a binocular presenting VA of >20/60; and 53% were severely visually impaired or blind (VA <20/200). After refraction, 33% had VA >20/60 in their better eye and 33% had VA <20/200. Factors that predicted poor VA in multivariate logistic regression analysis were nystagmus (P < 0.001), longer delay in presentation (P < 0.001), and magnitude of absolute spherical equivalent refractive error (P<0.001). Some 50% had nystagmus, and 69% of those currently aged ≤16 years were attending school. Better acuity was associated with school attendance (P < 0.001), whereas gender was not.
  
  
  CONCLUSIONS
  Approximately one third of all participants had a BCVA of ≥20/60 in their better eye. Amblyopia and nystagmus limited visual outcome, indicating the need for earlier detection and treatment. This is the first study to show the link between pediatric cataract outcome and access to education, a millennium development goal.
authors.affiliation: Moorfields Eye Hospital, London, United Kingdom. Electronic address: guynegretti@gmail.com.
authors.forename: Guy S
authors.initials: GS
authors.lastname: Negretti
authors.affiliation: Moorfields Eye Hospital, London, United Kingdom.
authors.forename: Tariq
authors.initials: T
authors.lastname: Ayoub
authors.affiliation: Department of Ophthalmology, International Medical College, Tongi, Gazipur, Bangladesh.
authors.forename: Sadeq
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: Ispahani Islamia Eye Institute and Hospital, Farmgate, Dhaka, Bangladesh.
authors.forename: Riton
authors.initials: R
authors.lastname: Deb
authors.affiliation: Noakhali Andha Kolyan Samity and Eye Hospital, Maijdee, Noakhali, Bangladesh.
authors.forename: Uttam
authors.initials: U
authors.lastname: Majumder
authors.affiliation: Child Sight Foundation, Banani, Dhaka, Bangladesh.
authors.forename: Johurul
authors.initials: J
authors.lastname: Jewel
authors.affiliation: Child Sight Foundation, Banani, Dhaka, Bangladesh.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Muhit
authors.affiliation: Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Clare E
authors.initials: CE
authors.lastname: Gilbert
authors.affiliation: Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom; Institute of Child Health, London, United Kingdom.
authors.forename: Richard J C
authors.initials: RJ
authors.lastname: Bowman
mesh_terms: D000293:Adolescent; D000328:Adult; D001459:Bangladesh / Q000453:epidemiology; D001766:Blindness / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D002386:Cataract / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D002387:Cataract Extraction / Q000523:psychology / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D011183:Postoperative Complications; D012424:Rural Population / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data; D014786:Vision Disorders / Q000523:psychology / Q000534:rehabilitation; D014792:Visual Acuity / Q000502:physiology*; D055815:Young Adult