Simultaneous versus Sequential Bilateral Surgery for Congenital Cataracts in University College Hospital, Ibadan

Paediatric Ophthamology & Strabismus

Abstract

Introduction: Globally, 1.4 million children are blind[1]. Congenital cataract is the leading cause in Africa[2]. Type and timing of  paediatric cataract surgery are important because of the risk of amblyobia. There is a global controversy on whether bilateral surgeries should be sequential (performed on separate days) or simultaneous (same sitting)[3,4,5]. Though simultaneous surgery is associated with the rare risk of endophthalmitis and Toxic Anterior Segment Syndrome (TASS), advantages include less exposure to general  anaesthesia, faster visual rehabilitation, no loss to follow-up for second surgery and/or rehabilitation, and lower costs. This study  compared both types of surgery at the University College Hospital, UCH, Ibadan to assist paediatric ophthalmologists and care-givers  in decision-making.

Methods: The study retrospectively compared simultaneous and sequential surgeries for bilateral congenital cataracts in children  younger than three years at UCH from 2010 to 2016. Study outcomes were length of hospital stay, direct costs, complications  (anaesthetic, endolphthalmitis, TASS) and management delays. Differences in mean hospital stay, direct costs and management delays  for both groups were compared  (Independent t-test, P-value <0.05 considered statistically significant).