Surgical Outcome of Paediatric Cataract Surgery Comparing Hydrophobic vs PMMA Lens.

Singh SK*, Deshmukh A**, Keyal A**


INTRODUCTION: Paediatric cataract is the opacification of the lens and its capsule in children. Childhood blindness is one of the priority eye diseases within the disease-control strategy of the ‘VISION 2020’ initiative. The study was conducted to find out whether PMMA lens can be used as a cheaper alternative to hydrophobic lens for paediatric cataract.

METHOD: In a randomized clinical trial 110 eyes of patients with age less than 15 years were included. Indications included congenital, developmental, traumatic, posterior polar, posterior sub capsular cataracts.55 of them underwent primary lens aspiration with PMMA lens implantation and 55 underwent phacoaspiration with acrylic hydrophobic lens implantation. In all the cases posterior capsulotomy and anterior vitrectomy was done. All the cases were followed postoperatively, in 4 weeks, 3 months and best corrected visual acuity measured at 6 months, cylindrical refractive error and the complications were noted and compared between the two groups.

RESULT: In the PMMA group the mean age of presentation was 8.2±4.06 years out of which 35(63.7%) were males and 20(36.3%) females. Mean age of presentation in hydrophobic group was 9.9±3.06 years with 30(54.5%) males and 25(45.5%) females. The number of developmental cataracts and congenital cataracts in PMMA group and hydrophobic group were 25(45.45%), 24(43.63%) and 40(72.23%), 8(14.55%) respectively. Pre operatively VA ranged from fixation of light to 6/18 in the hydrophobic group and fixation of light and 6/24
in the PMMA group. PMMA group had 20(36%) cases whose BCVA was in the range of 6/6/ to 6/18 while the hydrophobic group had 37(67%) cases in this range. Mean cylindrical error in PMMA group was 1.39±0.56 D and in the hydrophobic group was 1.08±0.65 D.

CONCLUSION: Pediatric cataract surgery results in a good visual outcome if surgery is conducted on time and proper refractive and amblyopia therapy is done. Late presentation of patients is a concern which can be handled by spreading awareness .It is suggested that hydrophobic lens has better postoperative visual acuity and lesser cylindrical error as compared to PMMA lens.

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