title: Outcomes of Pediatric Cataract Surgery in the Copperbelt Province of Zambia.
abstract: OBJECTIVE
  To study the outcomes of pediatric cataract surgeries in children operated on in the Copperbelt Province of Zambia and the barriers to accessing surgery.
  
  
  METHODS
  All children who had congenital, developmental, and traumatic cataracts operated on by lens aspiration, primary posterior capsulotomy, and anterior vitrectomy with posterior chamber intraocular lens implantation from 2012 to 2013 and followed up beyond 6 months were studied. Each child underwent a comprehensive preoperative evaluation. An active, assisted follow-up was done and parents were asked about reasons for delay between presentation and surgery.
  
  
  RESULTS
  One hundred two eyes of 70 children met the inclusion criteria of the study. Preoperatively, 76 of 77 (98.7%) eyes in the congenital and developmental cataract group had presenting visual acuity of worse than 6/60. This improved postoperatively, with 19 (29.7%) eyes having best corrected visual acuity (BCVA) of better than 6/18, 23 (35.9%) having BCVA of 6/24 to 6/60, and 22 (34.4%) having BCVA of worse than 6/60. Older age (P = .005), better preoperative vision (P = .045) at presentation, unilaterality (P = .012), and delay between presentation and surgery (P = .004) were predictors of a better postoperative outcome. On multivariate analysis, only age was significant (P = .025). Distance and cost of travel and surgery were the causes of delay in presentation. In the patients with traumatic cataracts, 17 of 25 (68%) had BCVA of better than 6/18, 6 (24%) had BCVA between 6/24 and 6/60, and 2 (8%) had BCVA of worse than 6/60 at the 6-month follow-up. The most common causes of injury were being struck by sticks and stones (10 children, 25%).
  
  
  CONCLUSIONS
  Visual outcomes after pediatric cataract surgery in Zambia were comparable and satisfactory. Cost of treatment was a barrier, but delay did not adversely affect outcome. [J Pediatr Ophthalmol Strabismus. 2016;53(5):311-317.].
authors.forename: Chileshe
authors.initials: C
authors.lastname: Mboni
authors.forename: Parikshit M
authors.initials: PM
authors.lastname: Gogate
authors.forename: Ariel
authors.initials: A
authors.lastname: Phiri
authors.forename: Asiwome
authors.initials: A
authors.lastname: Seneadza
authors.forename: Prasidh
authors.initials: P
authors.lastname: Ramson
authors.forename: Halli
authors.initials: H
authors.lastname: Manolakos-Tsehisi
authors.forename: Lillian
authors.initials: L
authors.lastname: Musonda
authors.forename: Larry
authors.initials: L
authors.lastname: Benjamin
authors.forename: Lene
authors.initials: L
authors.lastname: Øverland
mesh_terms: D000293:Adolescent; D002386:Cataract / Q000151:congenital* / Q000209:etiology / Q000503:physiopathology; D002387:Cataract Extraction / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D003300:Copper; D005131:Eye Injuries / Q000209:etiology*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D019654:Lens Implantation, Intraocular; D007908:Lens, Crystalline / Q000293:injuries*; D008297:Male; D008906:Mining; D017063:Outcome Assessment, Health Care; D019591:Pseudophakia / Q000503:physiopathology; D014786:Vision Disorders / Q000534:rehabilitation; D014792:Visual Acuity / Q000502:physiology; D015024:Zambia / Q000453:epidemiology
chemical_list: D003300:Copper