Causes, epidemiology, and long-term outcome of traumatic cataracts in children in rural India

Indian Journal of Ophthalmology

关键词: Diabetes-related blindness;    diabetic retinopathy;    key informant;    rapid assessment of avoidable blindness;    retinopathy of prematurity;    tele-ophthalmology;    Blindness;    disability;    equity;    health economics;    health policy;    health and development;    social exclusion;    Community eye health;    prevention of blindness;    ophthalmogical residency;    VISION 2020;    Visual impairment;    blindness;    inequality;    social class;    income;    educational status;    gender and ethnic groups;    Advocacy;    effective service delivery;    enabling environment;    stakeholders;    resources;    Avoidable blindness and visual impairment;    impact;    scaling up;    VISION 2020;    Global blindness;    prevalence;    visual impairment;    visual acuity;    Comprehensive eye care;    eye care model;    pyramidal model;    Comprehensive eye care;    optometrist;    optometry regulation;    eye health;    India;    Economics;    blindness;    visual impairment;    market;    government;    cost;    Millennium development goals;    eye health;    Vision 2020 the Right to Sight;    Blindness;    eye care services;    planning rapid assessment methods;    visual impairment;    Avoidable blindness;    cataract surgical rate;    corneal blindness;    eye care services;    Compliance;    diabetic retinopathy;    services;    Human resource development;    service delivery;    social entrepreneurship;    uncorrected refractive error;    Blindness;    cataract extraction;    cataract;    coverage;    data aggregation;    population;    prevalence;    visual impairment;    Case detection;    comprehensive eye examination;    developing countries;    glaucoma;    integrated approach;    training requirements;    Child health policy;    childhood blindness;    social determinants of eye health;    Access;    Asia-pacific;    coverage;    funding;    low vision;    policy;    Funding;    vision research priorities;    peer review;    research;    Cataract surgery;    clinical outcome;    patient-reported outcome;    quality improvement;    quality;    Global eye health;    health interventions;    health systems;    systems thinking;    Avoidable blindness;    global cost;    health investment;    primary and secondary health;    visual impairment;    Trauma;    pediatric cataract;    visual outcome;   

DOI  :  10.4103/0301-4738.100557

来源: DOAJ

【 摘 要 】

Purpose : To describe preoperative factors, long-term (>3 years) postoperative outcome and cost of traumatic cataracts in children in predominantly rural districts of western India. Subjects : Eighty-two traumatic cataracts in 81 children in a pediatric ophthalmology department of a tertiary eye-care center. Materials and Methods : Traumatic cataracts operated in 2004-2008 were reexamined prospectively in 2010-2011 using standardized technique. Cause and type of trauma, demographic factors, surgical intervention, complications, and visual acuity was recorded. Statistical Analysis : Data analysis done by using SPSS (Statistical package for social sciences) version 17.0 We have used Chi-square test, Fisher′s exact test, paired t-test to find the association between the final vision and various parameters at 5% level of significance; binary logistic regression was performed for visual outcome ≥6/18 and ≥6/60. Results : The children were examined in a 3-7 year follow-up (4.35 ± 1.54). Average age at time of surgery was 10.4 ± 4.43 years (1.03 to 18). Fifty (61.7%) were boys. Forty (48.8%) were blunt and 32 (39%) were sharp trauma. The most common cause was wooden stick 23 (28.0%) and sharp thorn 14 (17.1%). Delay between trauma and presentation to hospital ranged from same day to 12 years after the injury with median of 4 days. The mean preoperative visual acuity by decimal notation was 0.059 ± 0.073 and mean postoperative visual acuity was 0.483 ± 0.417 (P < 0.001). Thirty-eight (46.3%) had best corrected visual acuity (BCVA) ≥6/18 and 51 (62.2%) had BCVA ≥ 6/60. In univariable analysis, visual outcome (≥6/18) depended on type of surgery (P = 0.002), gender (P = 0.028), and type of injury (P = 0.07)-sharp trauma and open globe injury had poorer outcomes; but not on age of child, preoperative vision, and type of surgeon. On multivariable binary logistic regression, only gender was significant variable. Of the 82 eyes, 18 (22%) needed more than one surgery. The parents spent an average of Rs. 2250 ($45) for the surgery and 55 (66.4%) were from lower socio-economic class. Conclusion : The postoperative visual outcomes varied and less than half achieved ≥ 6/18.

【 授权许可】

Unknown