Visual impairment and delay in presentation for surgery in chinese pediatric patients with cataract.

PURPOSE

To report visual impairment and blindness and delay in presentation for surgery in Chinese pediatric patients with cataract.

DESIGN

Retrospective case series.

PARTICIPANTS

A total of 196 children (309 eyes) with congenital or developmental cataract.

METHODS

Surgery was performed in all patients. Visual impairment and blindness were defined as best-corrected visual acuity < 20/60. The characteristics, visual acuity, and time delay to surgery of these children were evaluated.

MAIN OUTCOME MEASURES

Incidence of visual impairment and blindness, ages at disease recognition and at surgery, and duration of delay in presentation for surgery.

RESULTS

Visual acuity was 20/25 or better in 22 eyes (7.1%), between 20/25 and 20/40 in 72 eyes (23.3%), and between 20/40 and 20/60 in 87 eyes (28.2%). Visual impairment and blindness occurred in 41.4% of eyes, 52.0% of patients, 35.4% of patients with bilateral cataract, and 74.7% of patients with unilateral cataract. The frequency of visual impairment and blindness in eyes with combined nystagmus, combined strabismus, total cataract, nuclear cataract, and posterior polar cataract was 84.4%, 75%, 63.8%, 48%, and 48.3%, respectively. Severe postoperative complications resulted in 14.8% of visual impairment and blindness. The mean ages at disease recognition and at surgery were 22.6 ± 30.4 months and 68.3 ± 40.0 months, respectively. The mean delay of presentation for surgery was 49.6 ± 39.8 months in all patients and 35.7 ± 32.2 months in the patients with congenital cataract. The disease was recognized within 6 months of age in 46 children (40.7%) with bilateral cataract and 10 children (12.0%) with unilateral cataract. Among these children, only 18 (15.9%) with bilateral cataract and 1 (1.2%) with unilateral cataract underwent surgery between 3 and 6 months of age. No patients received surgical intervention within 3 months.

CONCLUSIONS

Severe visual impairment is common in pediatric patients with cataract in China. Delayed presentation to the hospital and late surgical treatment are the major reasons and deserve greater attention.