Barriers to follow-up for pediatric cataract surgery in Maharashtra, India: How regular follow-up is important for good outcome. The Miraj Pediatric Cataract Study II.
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Date
2014-03
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Abstract
Background: Regular follow up and amblyopia treatment are essential for good outcomes after pediatric
cataract surgery. Aim: To study the regularity of follow‑up after cataract surgery in children and to gauge
the causes of poor compliance to follow up. Subjects: 262 children (393 cataracts) who underwent cataract
surgery in 2004-8. Materials and Methods: The children were identified and examined in their homes and
a “barriers to follow‑up” questionnaire completed. Demographic data collected, visual acuity estimated,
and ocular examination performed. Statistical Analysis: SPSS version 19. Results: Of the 262 children, only
53 (20.6%) had been regularly following up with any hospital, 209 (79.4%) had not. A total of 150 (57.3%)
were boys and the average age was 13.23 years (Std Dev 5 yrs). Poor follow up was associated with the older
age group (P < 0.001), less education of mother (P = 0.012), father’s occupation (P = 0.031), how much money
spent on travel (P = 0.033) and was it paid or free surgery (P = 0.001). It was not related to gender, numbers
of children in family, ordinal status of child, and social strata. Distance and cost were major barriers, as was
the inability of the eye care center to communicate the importance of follow up. A prospective follow‑up
visit showed that 93 children needed Nd: YAG LASER capsulotomy, 5 needed low vision aids, 4 contact
lens, and 162 a change of spectacles. The average visual acuity improved in 150 (38.8%) eyes >1 line with
regular follow‑up. Conclusion: Regular follow‑up is important and improves vision; eye care practitioners
need to take special efforts to ensure better follow‑up.
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Keywords
Barriers to follow‑up, pediatric cataract, visual outcome
Citation
Gogate Parikshit, Patil Shailbala, Kulkarni Anil, Mahadik Ashok, Tamboli Rahin, Mane Rekha, Borah Rishiraj, Rao G V. Barriers to follow-up for pediatric cataract surgery in Maharashtra, India: How regular follow-up is important for good outcome. The Miraj Pediatric Cataract Study II. Indian Journal of Ophthalmology. 2014 Mar ; 62 (3): 327-332.