title: Surgery for sight: outcomes of congenital and developmental cataracts operated in Durban, South Africa.
abstract: OBJECTIVE
  To study the visual outcomes of congenital and developmental cataract surgery and determine variables for presentation for pediatric cataract surgery in KwaZulu Natal province of South Africa.
  
  
  METHODS
  Care-givers of children presenting with cataract to a quaternary centre were asked when they first detected the condition. The reasons for delay between detection and surgery were studied. The children underwent a comprehensive eye examination and then appropriate surgery. They were prospectively followed up for 3 months and visual acuity and stereopsis were noted. Delay in presentation for surgery and visual outcomes were co-related with demographic and clinical factors.
  
  
  RESULTS
  Eighty-three non-traumatic cataract surgeries in 50 children were studied. Twenty-six (52%) were males, mean age was 3 years 10 months (SD 3yrs 4 months). The mean delay between identification and surgery was 20.7 months (SD 18 months). Twenty-six (52%) children had >15 months interval between diagnosis and surgery. Only mother's occupation was significantly associated with delay (P=0.017). Post-surgery 17/69 (24.7%) had visual acuity ≥6/18, 20/69 (29.0%) had vision between 6/24-6/60, whereas 32/69 (46.3%) had visual acuity ≤6/60. The final vision was associated with age (P=0.031), delay between diagnosis and surgery (P<0.001), type of surgery (P=0.046) and preoperative vision (P<0.001).
  
  
  CONCLUSIONS
  Although the children's vision improved substantially, a longer follow-up and amblyopia treatment would be necessary to optimize the visual outcome, which depended on age and preoperative vision. Health promotion activities aimed at mothers are important in improving visual outcomes.
authors.affiliation: Orbis Africa, Cape Town, Republic of South Africa.|African Vision Research Institute, University of KwaZulu Natal, Durban, Republic of South Africa.|Dr Gogate's Eye Clinic, Pune, India.
authors.forename: P
authors.initials: P
authors.lastname: Gogate
authors.affiliation: Department of Ophthalmology, Inkosi Albert Luthuli, Central Hospital, Durban, KwaZulu Natal, Republic of South Africa.
authors.forename: D
authors.initials: D
authors.lastname: Parbhoo
authors.affiliation: Orbis Africa, Cape Town, Republic of South Africa.
authors.forename: P
authors.initials: P
authors.lastname: Ramson
authors.affiliation: Department of Ophthalmology, Inkosi Albert Luthuli, Central Hospital, Durban, KwaZulu Natal, Republic of South Africa.
authors.forename: R
authors.initials: R
authors.lastname: Budhoo
authors.affiliation: Orbis Africa, Cape Town, Republic of South Africa.
authors.forename: L
authors.initials: L
authors.lastname: Øverland
authors.affiliation: Orbis Africa, Cape Town, Republic of South Africa.
authors.forename: N
authors.initials: N
authors.lastname: Mkhize
authors.affiliation: African Vision Research Institute, University of KwaZulu Natal, Durban, Republic of South Africa.|Brien Holden Vision Research Institute, Durban, Republic of South Africa.
authors.forename: K
authors.initials: K
authors.lastname: Naidoo
authors.affiliation: School of African and Gender Studies, Anthropology and Linguistics, University of Cape Town, Cape Town, Republic of South Africa.
authors.forename: S
authors.initials: S
authors.lastname: Levine
authors.affiliation: Department of Ophthalmology, Inkosi Albert Luthuli, Central Hospital, Durban, KwaZulu Natal, Republic of South Africa.
authors.forename: A
authors.initials: A
authors.lastname: du Bryn
authors.affiliation: Consultant Ophthalmic Surgeon, Stoke Mandeville Hospital, Aylesbury, Bucks, UK.
authors.forename: L
authors.initials: L
authors.lastname: Benjamin
mesh_terms: D002386:Cataract / Q000151:congenital* / Q000175:diagnosis; D002387:Cataract Extraction; D002648:Child; D002675:Child, Preschool; D003867:Depth Perception; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019654:Lens Implantation, Intraocular; D008297:Male; D019591:Pseudophakia / Q000503:physiopathology; D012189:Retrospective Studies; D013019:South Africa; D013997:Time Factors; D014786:Vision Disorders / Q000534:rehabilitation*; D014792:Visual Acuity / Q000502:physiology